What to do when you have low blood glucose (hypoglycaemia)? Dr Amanda Lam, Associate Consultant from the Department of Endocrinology at Singapore General Hospital, a member of SingHealth group, shares.
If you have diabetes, you don’t just have to watch out for high blood sugar. You must watch out for low blood sugar as well.
"Symptoms of hypoglycaemia are unpleasant and may interfere with your daily activities. Serious hypoglycaemia may cause accidents, seizures, coma and death. Fortunately, there are ways to recognise, treat, and prevent hypoglycaemia," says
Dr Amanda Lam, Associate Consultant at the
Department of Endocrinology,
Singapore General Hospital (SGH), a member of the
be prepared to deal with hypoglycaemia
Monitor your blood glucose levels frequently
Carry quick-acting carbohydrates with you at all times, so that you are always prepared to treat hypoglycaemia
"Tell your family and friends what symptoms to look out for and what to do, in case you are not able to treat hypoglycaemia yourself," advises
If you experience low blood sugar symptoms, immediately stop any physical activity and check your blood sugar level with a blood sugar monitor to confirm that it is low. It is recommended to consume a sugary food or beverage, or over-the-counter glucose tablets immediately to raise your blood sugar level. Do not take your diabetes medication until your blood sugar level is normal.
How to treat low blood glucose using the 15/15 rule
If you experience symptoms of hypoglycaemia, check your blood glucose using your glucometer. If your blood glucose is < 4.0 mmol/L, eat or drink 15 g of fast-acting carbohydrates immediately.
Examples of fast-acting carbohydrates include:
4-5 glucose tablets, or
1/2 can of soft drink (150ml-200ml), or
1/2 glass of fruit juice (150ml), or
3 teaspoons sugar with half cup water
If you have symptoms of low blood glucose, but cannot check your blood glucose immediately, eat or drink 15g of fast-acting carbohydrates to be safe.
Avoid using these types of foods to treat low blood glucose, as it will take too long to increase your blood glucose levels:
Any food or drink containing fat or protein
Any item that requires a lot of prolonged chewing/sucking
Wait for 15 minutes, and then re-test your blood glucose.
If your blood glucose is still low (< 4.0 mmol/L), repeat steps 1 to 3. If your blood glucose is 4.0 mmol/L and above, proceed to step 4.
Blood glucose levels may fall again about 1 hour after you have treated your hypoglycaemia.
If your next meal is more than 1 hour away, eat an additional snack containing 15g of longer-acting carbohydrates.
3 pieces of biscuits, or
1 slice of bread
Tips to prevent hypoglycaemia
- Take your diabetes medication regularly as recommended by your doctor.
- Eat nutritious meals and time them to balance your diabetes medication.
- Monitor your blood sugar level regularly based on your doctor’s recommendation.
- Adjust your food intake and medication according to your exercise routine.
When should you go to the hospital?
A family member or friend should take you to the hospital or call an ambulance (995) immediately if you:
Continue to have low blood glucose (< 4.0 mmol/L) after repeated treatments with fast-acting carbohydrates
Have a seizure
Are unconscious because of a hypoglycaemia episode
What is hypoglycaemia?
Hypoglycaemia (low blood glucose) happens when blood glucose falls below normal levels. A blood glucose level of < 4.0 mmol/L is considered hypoglycaemia. Hypoglycaemia may happen to anyone with diabetes, but is more common in people who take insulin and certain types of oral diabetes medications.
If you are on treatment for diabetes, hypoglycaemia may occur when you:
Take too much insulin, or certain oral glucose-lowering pills
- Altering the timings or doses of insulin and other diabetic medication
Do not eat enough food
Wait too long between meals, or skip a meal
Exercise more than usual
Drink excessive alcohol, or drink alcohol without food
If you suspect that you may be having hypoglycaemia (low blood glucose), test your blood glucose level using a glucose meter.
Signs and symptoms of hypoglycaemia
Early symptoms of hypoglycaemia
Early signs and symptoms of hypoglycaemia include:
Tingling sensation in your fingers, lips or tongue
Feeling hungry or nauseous
Feeling nervous or anxious
Severe symptoms of hypoglycaemia
Severe symptoms can include:
Weakness and difficulty walking
Confusion and abnormal behaviour
Loss of consciousness
If you have severe symptoms, you or the people around you should call for an ambulance (995) immediately.
Hypoglycaemia may happen while you are sleeping. Some clues that you may be experiencing hypoglycaemia while asleep include:
Profuse sweating while sleeping
Feeling tired or confused, or having a headache after waking up
Other diabetes articles you may be interested in:
Diabetes Foot Care Tips: 10 Steps to Healthy Feet
Diabetes Diet Myths vs Facts
Easy Diabetes Diet
Tips for Travelling with Diabetes
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