Feeling wobbly or confused? Got tingly lips and
blurred eyesight? You could be having a hypo.
Almost everyone with diabetes will have a hypo
at some stage. No-one likes them, but you need
to know why they happen and what to do about
them. Hypos happen when your blood glucose
level drops too low - below 4 mmol/l.
There’s no definite way of predicting when
hypos may happen. However, they’re more
likely to happen when:
• You’ve not eaten in a while or your meal was delayed
• You were physically active without taking extra carbohydrate or reducing your insulin to allow for it
• You’ve got too hot (a hot bath or being in the sun for too long increases the rate at which insulin is absorbed).
• You’ve had too much alcohol to drink without food
Signs and symptoms of a hypo
Your hypo warning signs are your back-up. Everyone has different signs, but some of the common ones are:
• feeling shaky • finding it hard to concentrate
• sweating • increased heart rate
• feeling hungry • becoming stroppy/stubborn
• tiredness • feeling anxious or tearful
• blurred vision • going pale
• pins and needles around mouth • headaches
Having an identity card, bracelet or necklace is very useful in case you become disorientated or unconscious somewhere people don’t know you (or don’t know you have diabetes).
Mighty DUK's Top Tips for treating hypos
• STOP what you are doing – ignoring a hypo won’t make it go away.
• Tell people you are with what is happening.
• Eat or drink something sugary. This will raise your blood glucose level.
• Good snacks to treat a mild hypo are: a glass of Lucozade or non-diet drink, three or more glucose tablets, five sweets, eg jelly babies however if you’ve discussed this beforehand you’ll know what’s best.
• Check your blood glucose after 15-20mins and, if it's still low, repeat with the same treatment.
• To prevent your blood glucose levels from dropping again, you may need to follow this with 15-20g of longer acting carbohydrates such as a sandwich, or fruit, or biscuits, or a bowl of cereal, or your next meal (if it is due) to make sure you don’t have another hypo.
• Sit down and relax until you start to feel better.
• If you are still not sure how you feel, do a blood test.
• Take identification with you when you are out so that people know you have Type 1 diabetes and that you might be having a hypo. Having an identity card, bracelet or necklace is very useful in case you become disorientated or unconscious somewhere people don’t know you (or don’t know you have diabetes).
A severe hypo is when you need assistance from someone else to bring you back out from your hypo. If you don’t treat it, a hypo will get worse and there is a risk that you may become unconscious. Make sure people know what to do if this happens.
If the hypo is severe and you find the person with diabetes unconscious:
DO NOT give them anything by mouth.
CALL an ambulance straight away.
If possible place the person in the recovery position - on their side with their head tilted back
Even if you become unconscious, your body can slowly respond by naturally increasing blood glucose levels and you’ll eventually come round. It’s only rarely – for example, after a lot of alcohol or a huge intake of insulin – that having a hypo can be more serious and your body may not be able to respond in this way.
Hypos and sleeping
Many people worry about having a hypo at night. You will know you may have had a night time hypo if you wake up in the morning feeling very tired or headachy, or you might remember having a vivid nightmare. You may even wake up during the night with hypo symptoms.
What do I do?
Keep hypo treatments by your bed - a sugary drink, fruit, biscuits or some glucose tablets.
If you think you might be having hypos at night, test your blood glucose before you go to bed. Make sure you have a bedtime snack, such as cereal or toast.
If night-time hypos are happening a lot, talk to someone in your healthcare team about it – you may need to alter your dose of insulin or have more for your bedtime snack. It is also a good idea to blood test during the night, ask your healthcare team about the best time to test as this can depend on your insulin regimen.
Hypos are part of life if you have diabetes – no one can have perfect control all of the time. You’ll soon realise, though, that it’s better to party and have the occasional hypo than hide yourself away ‘just in case’.
You might be tempted to try to keep your blood glucose levels constantly high (say above 10mmol/l) to avoid having a hypo. If you do this, you may develop the symptoms you had before you were diagnosed – and this could make you seriously ill. You are also putting your body under a lot of strain.
Factsheet Downloads (PDF)
“When I have a hypo, it feels like some faraway part of my mind still works but the part still connected to my body is full of thick, dark nothingness.” Mairi, 17