What to do if you suspect you have hypoglycemia? 

Step 1. Check

·  Confirm that your blood sugar level is less than 4 mmol/L.

·  If you do not have a blood glucose meter, skip to step 2.

Step 2. Treat

·  Take 15g of quick-acting carbohydrate/sugar to raise your blood sugar level quickly. E.g.: 

• 1 tablespoon (or 3 teaspoons) of sugar or
• ½ packet (125ml) of sweetened drink (not the "less sweet" variety) or 
• ½ can of regular (non-diet) soft drink or
• 4 to 7 soft sweets (not sugar-free) or
• 3 glucose tablets.

Be prepared; always carry these quick-acting carbohydrates/sugar with you.

Avoid taking food that is high in fat such as chocolate bars. Fat slows down the movement of sugar into your blood.

Step 3. Re-check

·  Recheck your blood sugar level 15 minutes later.

• If blood sugar level is still below 4 mmol/L, repeat Step 2.

·  When blood sugar is above 4 mmol/L, take a slow-acting carbohydrate. E.g.:

• Your next meal or

• 1 slice of bread or

• 3 pieces of plain crackers or

• 1 cup of low fat milk (250ml)

Record all blood sugar readings and events for your healthcare team to note. Always look for the cause or trigger for the hypoglycaemia. 

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Some common causes of hypoglycaemia

• Delayed meal or skipping a meal

• Too little "starchy" carbohydrate food in the meal

• Drinking alcohol on an empty stomach

• Too much insulin/diabetes medication

• Mismatch between insulin/diabetes medication and meal times

• Being more active than usual

• Having a poor appetite from being sick with an infection, such as flu, food poisoning, urinary tract infection   

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Ways to prevent hypoglycaemia

• Do not delay or skip your meals and discuss with your healthcare team before starting on a fast for religious purposes.

• Eat a suitable amount of carbohydrate food at regular meal times.

• If your appetite is poor (≤ ½ share), supplement your diet with diabetic nutritional supplements such as Glucerna, Isocal or Nutren. You may need to consult your healthcare team regarding a change in the dosage of medications.

• Limit the intake of alcohol. Do not drink alcohol without eating food.

• Inject the correct amount of insulin and take the correct dose of diabetes medications at the right time every day.

• If your blood sugar level is often low, you may need to consult your healthcare team regarding a change in your diabetes medication/insulin dose. 

• Be sensible about exercise. Take a snack before strenuous activities. You may need to consult your doctor about lowering your dose of diabetes medication before planned exercise.

• Get your blood sugar checked as it may be low or even high during an infection. Take a nutritional supplement if you are eating less than half a meal and your blood sugar is not high. See your doctor early. 

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