People on insulin or insulin-releasing medication are at increased risk for hypoglycaemia. It is unlikely in people with type 2 diabetes who only take blood sugar normalising medication.

Hypoglycaemia can happen if diabetes medication doses, especially insulin, are too high and/or

carbohydrate intake is too low - as may occur if you skip a meal or increase exercise without adjusting your insulin. Alcohol, especially on an empty stomach, is also a culprit.

Recognise these so you can act quickly to correct your blood sugar. Early symptoms may include:

• Sweating
• Tiredness
• Dizziness
• Hunger
• Tingling lips
• Feeling shaky; trembling
• Fast or pounding heartbeat
• Becoming easily emotional or anxious
• Turning pale

Without treatment, severe symptoms requiring immediate medical attention may occur. These may include:

• Weakness
• Blurred vision
• Confusion, difficulty concentrating
• Unusual behaviour; slurred speech; clumsiness
• Extreme sleepiness/drowsiness
• Seizures
• Unconsciousness

If your blood sugar level is low or you experience symptoms:

1. Have a high-carbohydrate snack e.g. glucose tablets,fruit juice
2. Test blood sugar after 10 minutes – if it’s improved and you feel better, go to step 3.

If there's little change, have another drink/snack. Test again after 10-15 minutes.

1. Have a main meal if it's the right time for it. Or, have a slow-release carbohydrate snack e.g. slice of toast, two biscuits, glass of milk.

You won’t usually require medical attention once you're feeling better, but tell your doctor if you experience hypoglycaemia repeatedly, have low blood sugar without noticing symptoms, or had severe hypoglycaemia.

1. If they’re unconscious or drowsy, put them on their side in the recovery position.

If they’re having a seizure, move them away from anything dangerous.

1. Call an ambulance if:

• Glucagon (hormone to help liver release glucose and raise blood sugar) is unavailable or you aren’t trained to use it
• The person consumed alcohol before the hypo
• A seizure lasts longer than 5 minutes

1. Inject glucagon immediately if you’re trained to do so.If they improve within 10 minutes of receiving glucagon, go to step 5. If there’s no improvement, call an ambulance.
2. Once they can eat and drink safely, provide a carbohydrate snack. Never give food/drink to someone who is unconscious, too drowsy or having a seizure - they may choke.

They should go to hospital if vomiting, or if blood sugar drops again.

• Monitor blood sugar regularly, as medically recommended
• Don’t skip meals.
• Carry glucose snacks.
• Avoid alcohol.
• Stay alert for symptoms.
• Teach family, friends and co-workers about hypoglycaemia symptoms, and how to assist.
• If you take insulin, have glucagon available and be trained to use it.
• Wear medical alert identification.