Hypoglycaemia: Recognising and Preventing Low Sugar Episodes
Sweating, tremor, hunger and confusion can signal a sugar below 70 mg/dL. Knowing the 15-15 rule keeps a minor dip from becoming an emergency.
Low blood sugar is the most common avoidable emergency in treated diabetes. It is usually the result of a missed meal, an extra dose, or unusual physical activity — all of which are predictable and preventable.
Early warning symptoms
- Sweating, palpitations and tremor
- Sudden intense hunger
- Irritability or difficulty concentrating
- Blurred vision, slurred speech or confusion in more severe episodes
The 15-15 rule
If your reading is below 70 mg/dL and you are conscious and able to swallow, take 15 grams of fast-acting glucose — three teaspoons of sugar in water, 100 ml of fruit juice, or glucose tablets. Recheck after 15 minutes and repeat if still low. Follow with a small meal or snack containing protein.
Chocolate and sweets with fat are slower to act and are not first choice.
Preventing repeat episodes
- Never skip or delay a meal after taking sulfonylureas or insulin
- Reduce the dose or add a snack before unusually heavy activity
- Limit alcohol, particularly on an empty stomach
- Bring your readings to every follow-up so doses can be trimmed
Key takeaways
- Below 70 mg/dL needs immediate fast-acting glucose
- Use the 15-15 rule, then eat a proper snack
- Repeated lows mean the medication dose needs review
- Anyone with severe confusion or unconsciousness needs emergency care
This article is general health information and does not replace a consultation. Treatment decisions depend on your history, examination and reports. For medical emergencies, visit the nearest emergency department.
