Hypoglycaemia - "Having a hypo" in Diabetes

Sometimes, people with insulin-dependent diabetes may find their blood sugar levels dropping very rapidly. This can happen if they've accidentally injected too much insulin or waited too long to eat after injecting insulin, or if they've exercised too hard, or overindulged in alcohol. When blood sugar drops too low, it is called hypoglycemia (sometimes called "insulin shock"), and the person is said to be having a "hypo".

A hypo is potentially very serious. It must be treated quickly by the person himself, or if he is confused or beyond looking after himself, by anyone around him.

Symptoms of hypoglycemia include:

• Pale and cold skin.
• Sweating.
• Feeling jittery and dizzy.
• Shaking hands and feet.
• Numbness and tingling of lips and tongue.
• Confusion.
• Bad temper.
• Headache.
• Unconsciousness.
• Fitting.,

Treatment is very simple - eat some sugar fast. Many people mistakenly believe that diabetics can't ever have sweet foods, but one of the most important first aid measures with people with diabetes is to give them sugar. People with insulin-dependent diabetes should always carry some, in case of emergency. Any sort of sugar will do - a couple of lumps or teaspoons of table sugar, half a dozen jellybeans or other soft sweets, half a can of soft drink (not diet soft drink), orange juice, honey or even jam or condensed milk will do. It's best not to give hard lolly, as someone having a hypo may not be able chew them, and/or might choke. If giving sweet drink to a hypoglycemic child, clasp his own hands around the cup and guide it to his lips rather than attempting to force liquid down his throat - he's less likely to resist or push it away. With small children, you can use your finger to put honey or jam on the insides of their cheeks; that way they'll swallow it without choking.

The person having the hypo should recover within 10 or 15 minutes of having sugar. He should then have a meal or, at least, soma carbohydrate (biscuits or a sandwich) to stabilize the blood sugar.

If the hypo doesn't respond to sugar within 10 minutes or so, a family member may be able to inject glucagon (a hormone preparation available on prescription), if available. Otherwise, call an ambulance - this is an emergency. DO NOT TRY TO GIVE SUGAR BY MOUTH TO AN UNCONSCIOUS OR FITTING PERSON. A trained relative may inject glucagon, if available. If not, or if he doesn't respond to the glucagon, call an ambulance. Roll the unconscious person on to his side in the recovery position while you're waiting for the ambulance.
 

BE ALERT

Because confusion is part of hypoglycemia - the brain isn't functioning properly because it's being starved of glucose - people having hypos don't always respond quickly enough, or at all, to the situation. They may appear drunk. This can be a particular problem as drinking alcohol can bring on hypoglycemia, but drinking companions may not realize anything is amiss other than ordinary drunkenness.

WHOM TO TELL

If you are having repeated hypos, record all the circumstances of each episode - time, how soon after injecting insulin if applicable, what and how long ago you last ate - and discuss the matter with your doctor. Your diet and medication regime may need adjustment.