The lowdown on HYPOS

From what causes them to how to treat them effectively – and what can happen when you don’t – here’s what you need to know about hypoglycaemia

It might start with feeling a bit tired. Before you know it, you’re shaking and sweating a little. Then the dizziness starts. You’re having a hypo, but the big question is, would you recognise what’s happening and know what to do about it?

The fact is, hypos can not only happen and progress quickly, they can also be dangerous – even fatal – if left untreated, so making sure you know as much about them as possible could be a literal lifesaver.

So, what is hypoglycaemia?

A hypo occurs when your blood glucose level drops too low – below 4mmol/L. People who take insulin to manage their diabetes are much more likely to experience hypos, but taking other glucose-lowering tablets increases the risk, too.

People using diet alone to manage their type 2 diabetes can also experience hypos, with a survey conducted by Diabetes UK finding one in two people living with type 2 experience at least one a fortnight. And, while severe hypoglycaemia is rare in cases of type 2, more than 50 per cent of people who experience mild to moderate

hypos agree they impact their quality of life.

Why do hypos happen?

A number of things can cause hypoglycaemia, including taking too much of your diabetes medication, delaying or skipping a meal, not eating enough carbohydrate, or doing more physical activity than planned without eating more or adjusting your dose of diabetes medication to account for it.

Drinking alcohol, particularly on an empty stomach, can also increase your risk of having a hypo.

How do I know if I’m having one?

Getting a reading below 4mmol/L when you check your BGLs is an obvious sign, but on top of the symptoms mentioned earlier, other early warning signs you’re having a hypo include developing a headache and feeling hungry, irritable or more anxious or nervous than usual.

If left untreated, more severe hypo symptoms can occur, including muscle weakness, blurry vision, feeling drowsy, slurred speech, clumsy, jerky movements and loss of consciousness.

People who have lived with diabetes and hypos for many years can be at risk of something called impaired awareness of hypoglycaemia (IAH), where they don’t feel the early warning signs of a hypo, and only realise what’s happening in the latter stages, when their BGL drops very low. This can be dangerous, because by then, a hypo can be harder to treat.

While you should always act when your blood glucose level is 4mmol/L or below, if you’ve noticed you don’t experience any hypo symptoms when this happens, you should discuss this with your doctor or credentialled diabetes educator.

Can hypos be prevented?

Trying to understand why a hypo episode happened when one occurs, by being familiar with the common causes, can help you prevent them recurring as often. Useful preventative strategies include: • Eating regular meals and snacks rather than skipping or delaying them.

• Measuring your diabetes medication carefully and taking it on time.

• Adjusting your medication or eating an extra snack when you undertake more exercise than you usually would.

• Making the effort to eat something when you’re having an alcoholic drink, rather than drinking on an empty stomach.

Plus, taking the time to test your blood sugar regularly can help you spot a hypo early, before any symptoms set in.

If you have hypos several times a week, have a chat to your doctor as you may need to adjust or change your diabetes medication or treatment plan.

More severe symptoms include slurred speech and muscle weakness