Understanding Hypoglycaemia: Symptoms, Diagnosis, and Treatment

Hypoglycaemia, or low blood sugar, is a critical condition that can affect individuals with diabetes, especially those undergoing glucose-lowering treatments. A person experiencing a hypoglycaemic episode may exhibit unusual behavior or symptoms, leading to confusion about their condition. It's essential to recognize that not every fit or seizure is indicative of epilepsy; individuals can have seizures due to hypoglycaemia without having epilepsy. Moreover, those who do not experience typical warning signs, which can diminish over time, are at an even greater risk.

The warning signs of hypoglycaemia can become less noticeable, particularly in long-term diabetes patients. Reports suggest that about 25% of insulin-treated individuals have reduced warning signs, a figure that escalates to 50% for those living with diabetes for over 25 years. This lack of awareness can be alarming for patients and their caregivers, especially as many are unaware of nocturnal hypoglycaemia, which can occur during sleep without any prior warning.

Diagnosis of hypoglycaemia should be approached with caution. In any situation where a person on glucose-lowering treatment displays unusual behavior, hypoglycaemia must be considered until proven otherwise. In high-risk scenarios, such as swimming or rock climbing, immediate glucose intake is critical at the first suspicion of low blood sugar, as delays can exacerbate symptoms and increase the risk of injury.

When diagnosing hypoglycaemia, it’s important to check blood glucose levels promptly. A finger-prick test can provide initial insight, but it’s crucial to remember that these results can sometimes be misleading. If there is any doubt, especially if the patient appears cold or is displaying signs of vasoconstriction, a laboratory blood glucose test should be performed immediately. Regardless of test outcomes, treatment should not be delayed.

For individuals who can swallow, treatment for hypoglycaemia begins with consuming fast-acting carbohydrates, such as glucose in liquid form. This should be followed by slow-releasing carbohydrates to stabilize blood sugar levels. It is essential to avoid over-treatment but ensure that action is taken swiftly if hypoglycaemia is suspected. If no improvement is seen after several doses, professional medical assistance should be sought.

Regular monitoring of blood glucose is vital after a hypoglycaemic episode, especially for the next 24 hours. Adjustments to insulin doses may also be necessary to prevent future occurrences. Understanding the complexities of hypoglycaemia can empower patients and caregivers to act quickly and effectively, ensuring safety and well-being.