Hypoglycemia

Hypoglycaemia ("hypo" or low blood sugar) is a blood glucose below 70 mg/dL. It mostly affects people with diabetes on insulin or certain oral tablets — and in them it is a true emergency. Severe untreated hypoglycaemia can cause seizures, brain injury and death.

Early warning symptoms

• Sweating, trembling, palpitations.
• Sudden hunger.
• Pale skin, cold hands.
• Nervousness, irritability.
• Light-headedness.

Late / severe symptoms

• Confusion, slurred speech, odd behaviour.
• Drowsiness or sudden tiredness.
• Seizures.
• Loss of consciousness.

What to do — the 15-15 rule

• If aware and able to swallow: have 15 g of fast-acting sugar — 3-4 teaspoons of sugar in water, half a glass of fruit juice, 3-4 glucose biscuits, 1 tablespoon of honey, or 3-4 glucose tablets.
• Wait 15 minutes. Re-check sugar if you have a glucometer.
• If still low, repeat another 15 g.
• Once above 70, eat a small balanced snack (roti, sandwich, curd-rice) to prevent drop again.

If the person is unconscious or cannot swallow

• Dial 112.
• Do NOT put food or sugar into the mouth — risk of choking.
• Turn the person on their side.
• If glucagon is available and you are trained, administer it.
• Stay with them until help arrives.

Common triggers in people with diabetes

• Missed or delayed meals.
• More exercise than usual.
• Too much insulin or diabetes tablets (especially sulfonylureas).
• Alcohol, especially on an empty stomach.
• Fasting (including religious fasts) without adjusting medicines.
• Kidney or liver disease.

Prevention

• Don't skip meals; carry a sugar source at all times.
• Test sugar regularly, especially at new times of day or with new activity.
• Discuss fasting days (Karva Chauth, Navratri, Ramzan) with a Health Expert in advance — doses usually need adjusting.
• Any episode of severe hypoglycaemia — tell your Health Expert; treatment usually needs adjustment.
• Family members should know how to spot and respond to a hypo — teaching them is as important as the insulin dose itself.