How to manage hypoglycaemia?


September 12th, 2023

How to manage hypoglycaemia?

1. What is hypoglycaemia?

The blood glucose level is the amount of glucose in the blood. When these levels drop too low, it’s called hypoglycaemia. Very low blood glucose levels can cause serious symptoms that need to be treated right away.

People with type 1 diabetes need to keep their blood glucose from getting too high or too low.

Read more.

2. How to recognise hypoglycaemia?

The signs and symptoms of low blood glucose can vary depending on the person and how quickly the level falls.

Warning signs of low blood glucose include:

  • Sweating
  • Very hungry
  • Rapid heart rate
  • Difficult to talk clearly
  • Irritability
  • Disiness
  • Tiredness
  • Blurred vision
  • Crying without reason
  • Trembling

Sometimes hypoglycaemia can get very serious and you can faint or have seizures.
Remember: These symptoms are not always because of low blood glucose. Always test your blood glucose level when you feel unwell. DO NOT GUESS!
If you experience nocturnal hypoglycaemia you may have bouts of crying, nightmares, or night sweats (with damp bed sheets and/or pyjamas), and might wake up groggy or with a headache.

3. What can cause hypoglycaemia?

You can get low blood glucose when:

  • Skipping meals or eating not enough food during a meal
  • Exercising longer or harder than usual without eating some extra food
  • Getting too much insulin
  • Not timing the insulin doses properly with meals, snacks, and exercise
  • During sleep, known as nocturnal hypoglycaemia
  • Several hours after exercise, known as delayed post exercise hypoglycaemia
  • After someone drinks alcohol, the alcohol hurts the body’s ability to keep blood glucose in a normal range, which can cause a sudden drop in blood sugar. There are important health risks of alcohol and drug use.

Also, some things may increase the risk of hypoglycaemia more likely.

These include:

  • Injecting the shot into a muscle instead of the fatty layer under the skin
  • Injecting the insulin into a part of the body used a lot in a particular sport (like injecting the leg right before soccer practice)

All of these situations increase the chances that a person may get hypoglycaemia.

4. Checking for low blood glucose levels.

The only way to know for sure if you’re having a low blood glucose level is to test. But if you can’t quickly check your blood glucose level, it’s important to treat yourself for hypoglycemia immediately to prevent symptoms from getting worse.
Some people with diabetes don’t actually notice the typical signs of low blood glucose levels. For them, it’s even more important to check blood glucose levels often and take extra precautions to prevent low blood glucose (see our prevention tips below). If you’re having trouble feeling the symptoms of low blood glucose, let your diabetes health care team know.

5. How to treat low blood glucose (hypoglycaemia)?

If your blood glucose is below 4.0 mmol/l (72mg/dL) you have to take action quickly.

Here are the steps you have to follow:

  • Take 1 tablespoon of syrup or drink half a cup of sweet drink (e.g. pure fruit juice or cola (not diet cola) then rest for 15 min and then check the blood glucose
  • If your blood glucose level is higher than 4.0 mmol/L (72mg/dL), retest 20-30 minutes later to confirm target glucose (>4.0 mmol/L) is maintained
  • If your blood glucose level is still below 4.0 mmol/l (72mg/dL), take once again 1 tablespoon of syrup or drink half a cup of sweet drink (fruit juice or cola (not diet) then rest for 15 min and check your blood glucose level

If hypo happens just before a meal time (when insulin is usually given) the hypo should be treated first and once the blood glucose is >4.0 mmol/L (>72mg/dL) the insulin should be given as usual. DO NOT OMIT INSULIN, especially important with an early morning hypo.

If someone is experiencing seizure or is unconscious do not attempt to feed them as this could present a risk of choking or aspiration (food going into the airways can cause serious pneumonia). You must go to the hospital in an emergency.

6. Key Takeaways

For persons with type 1 diabetes, hypoglycaemia is a serious concern. This is why it’s very important for diabetics to know the possible signs of this condition, what they can do in case it happens, and how they can prevent it from happening in the first place.


HelloType1 content is based on published, internationally recognised guidelines and then reviewed by local experts to ensure it fits local context. The translation is based on simplified English language to ensure it conveys the safest and clearest possible message in regional languages. Basic insulin and blood glucose testing access is still an issue in the South-East Asia region and our chief aim is to address this. HelloType1 content is not intended to replace the advice of individual healthcare professionals but as a collaborative tool to help them improve the outcomes of disadvantaged people with Type 1 Diabetes in the region.

HelloType1 content is curated for the topics using information only taken from accredited sources such as the International Diabetes Foundation (IDF) and the International Society for Paediatric and Adolescent Diabetes (ISPAD).

This content is then reviewed and adapted by a panel consisting of healthcare experts (e.g. endocrinologist, nutritionist, diabetes nurse, psychologist) and members of the South-East Asia T1D communities, helping ensure the information is appropriate in a local context.

Writers of HelloType1 content:
Anne-Charlotte Ficheroulle, Pharmacist, Digital Innovation Manager at A4D
Charlotte O’Brian Gore, Research assistant ImmunoEngineering, King’s College. UK

Content Reviewers – healthcare professionals:
Dr. May Ng, Paediatric Endocrinologist, Chief Medical Advisor A4D, UK
Dr. Yeow Toh Peng, Endocrinologist, Malaysia
Dr Jaturat Petchkul, Paediatric Endocrinologist, Thailand
Dianna Culbertson, Physician Assistant T1D care, US
Prof Dr Malene Iv, Endocrinologist, Kantha Bopha Hospital, Cambodia
Steffen Tange, Consultant Psychology, Denmark
Soe Nyi Nyi, Nutritionist, Myanmar
Lucas Lim, Dietician, Malaysia

Content Reviewers – people with Type 1 Diabetes:
Jerry Gore, Co-Founder A4D, Mountaineer, UK
Diana Maynard, T1D advocate, UK
Emelyne Carmen Ho, College Student, Malaysia
Molly Seal, College Student, UK

Content Reviewers – parents with T1D child:
Samantha Seal, Teacher, Thailand
Kim Than, Deputy Country Director – Plan International, Cambodia

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