4.4 Describe actions to take if an individual is hypoglycaemic

This guide will help you answer 4.4 Describe actions to take if an individual is hypoglycaemic.

Hypoglycaemia means low blood sugar. This can happen when the glucose level in a person’s blood drops below what their body needs to function well. Sugar (glucose) is a main source of energy for the body and brain. People with diabetes are especially at risk if they take insulin or certain tablets that lower blood sugar.

Always seek professional medical advice and follow your own policies. The information below are examples but every situation will vary.

Recognising symptoms quickly can stop more serious problems. Typical signs of hypoglycaemia include:

• Sweating
• Shakiness or trembling
• Feeling hungry
• Pale skin
• Fast or pounding heartbeat
• Blurred vision
• Weakness or tiredness
• Dizziness or feeling lightheaded
• Confusion or difficulty concentrating
• Irritability or sudden mood changes

More serious symptoms, if it worsens, may lead to:

• Slurred speech
• Loss of coordination
• Seizures (fits)
• Losing consciousness

Not everyone has every symptom. Sometimes, especially for people who have lived with diabetes for a long time, warning signs are less obvious. This is called “hypo unawareness”.

Causes of Hypoglycaemia

Hypoglycaemia most often affects people with diabetes, especially those using insulin or other medication that lowers blood sugar. Causes can include:

• Skipping or delaying meals
• Taking too much insulin or too many diabetic tablets
• Doing more physical activity than usual
• Drinking alcohol on an empty stomach
• Illness or infection which changes how the body uses insulin

Knowing the cause can help prevent further incidents.

Immediate Actions to Take

Responding to hypoglycaemia quickly can prevent further problems. Early treatment can stop serious health risks such as seizures, injuries from falls, or unconsciousness. If you think a person is having a ‘hypo’ (short for hypoglycaemia), act straight away.

The first step is always to check the person’s care plan or individual support guidelines if you have access to them. Some individuals with diabetes have specific instructions for managing a hypo based on their needs.

If someone is showing signs of hypoglycaemia but is still awake and able to swallow:

Give Quick-Acting Sugar

These help raise the blood glucose level fast. Options could include:

• 3 – 6 glucose tablets
• 150–200 ml of pure fruit juice (like orange juice)
• 150–200 ml of a regular (not diet or sugar-free) fizzy drink
• 5–7 jelly babies or similar sweets
• 2 tubes or 1 full tube of glucose gel if available

Check the package of any products, as sugar content can vary.

Stay With the Person

Never leave someone having a hypo alone. They might become more confused or lose awareness. Watch their response.

Wait and Recheck

After giving sugar, wait 10 – 15 minutes. Reassess how they feel.
Some people may have a blood glucose meter to check their own level. Support them to use it if needed.

• If the person gets better:
• Offer a starchy carbohydrate snack (see below).
• If there’s no improvement or if symptoms get worse:
• Call for medical help as soon as possible.

Give a Starchy Carbohydrate Snack

Once recovered, encourage the person to eat some slower-acting carbohydrate to keep their blood sugar up. Ideas include:

• Two plain biscuits
• A slice of bread/toast
• A bowl of cereal with milk
• A sandwich
• A meal (if it’s mealtime soon)

This step helps stop another hypo from happening straight away.

What If the Person Cannot Swallow or Is Unconscious?

If the individual is unconscious, drowsy, or unable to swallow safely, do NOT give anything to eat or drink. There is a danger of choking.

Actions to follow:

• Put the person in the recovery position (lying on their side, mouth facing down so the airway stays open).
• Call 999 immediately for an ambulance.
• Do not try to force-feed, or put any food, fluids, or gel in their mouth.
• If the person has a glucagon injection kit and care staff are trained to use it, you may use it. Glucagon is a hormone that helps raise blood sugar, given as an injection.
• Stay with the person and monitor their breathing and response until help arrives.

Following the Individual’s Care Plan

Always follow the agreed ways of working and the person’s individual care plan. Many people with diabetes have clear steps to follow set out by their nurse, doctor, or diabetes team.

Key points include:

• Check if there is a specific procedure for dealing with a hypo for that person.
• If they have a ‘hypo kit’, use what is included.
• Note any allergies or dietary restrictions.
• Record what happened and what you did.

If you are unsure or there are no instructions, treat using basic first aid and get help quickly.

Seeking Further Help

Some hypoglycaemic episodes can be more severe or lasting. You should get medical help by calling 999 if:

• The person is unconscious or cannot swallow
• The person does not improve after 10–15 minutes, even after sugar is given
• Seizures (fits) occur
• You are not sure what to do, or no care plan/instructions are available
• You suspect the person could have had a stroke, heart attack, or other serious issue

Keep the person as safe as possible until help arrives.

Recording and Reporting the Incident

Accurate reporting is very important. Once the person has recovered or has been taken to hospital, make a record of the incident. Include:

• Date, time, and location
• What signs and symptoms you noticed
• Actions taken (what was given, how much, and what happened)
• Any advice given or next steps from healthcare staff
• If medical help was called, note who took over and what they did
• Who you reported the incident to (line manager, nurse, family member)

Records help future care by showing what worked or what might need changing in the care plan.

Preventing Future Episodes

Prevention is key for people at risk. This can mean:

• Making sure meals and snacks are not missed or delayed
• Checking and supporting the person to take medication at the right time and dose
• Encouraging regular blood glucose checks if the person is able
• Being aware of any new or increased activity, illness, or change in medication
• Reminding the person to carry a ‘hypo kit’ (like glucose tablets or sweets)
• Supporting the person to wear a medical alert bracelet or carry a diabetes card

Share concerns with the nurse, doctor, or diabetes team if frequent episodes happen.

Educating and Supporting the Individual

Support from care workers can make a big difference. Help people understand the signs of low blood sugar and what to do. Some people will be used to managing their own diabetes, but may still need reminders.

Engage in open, positive communication:

• Ask how the person prefers to manage a hypo
• Promote self-management if the person is able
• Encourage them to let staff know if feeling “off” or different

Understand that having hypoglycaemia can be upsetting, frightening, or embarrassing for some. React with reassurance and kindness.

Training and Skills

Handling hypoglycaemia needs some training. Workers should follow their organisation’s policy. Refresher training makes staff more confident to act properly and safely.

Remember, when unsure, ask a nurse, senior colleague, or call for medical advice.

When Supporting Children or People Who Cannot Speak

For children, people with learning difficulties, brain injuries, or communication barriers, extra care is needed. Staff must know the non-verbal signs and the best way to act.

• Learn the person’s usual signs and communication aids.
• Share information with family or regular carers.
• Use clear, simple language and visual cues when possible.

Supporting Choice and Dignity

Preserving dignity and personal choice is important, even in an emergency. Explain what you are doing and why. Get consent if the person is able to give it. Stay calm and encouraging.

Multi-Disciplinary Working

Working together gets the best outcome. Share learning with others in the care team. Keep families up to date if this is agreed in the care plan.

• Encourage teamwork and respect everyone’s input.
• Discuss any changes or patterns noted with diabetes nurses or GPs.

Good teamwork reduces risk and supports independence.

Final Thoughts

Hypoglycaemia is a serious but common risk for people with diabetes. Fast, calm, and confident action can prevent harm. Acting on early signs and knowing the right steps gives people the best chance of a quick recovery.

For care workers, recognising symptoms, giving the correct first aid, and following agreed care plans are the basics of good support. Recording what happened and reviewing care afterwards help everyone learn and improve safety. Your role is key in preventing more episodes and giving reassurance to individuals and their families.

Never be afraid to ask for help if you are unsure. Putting the person’s safety, dignity, and wishes at the centre of everything you do makes a real difference. Remember, clear team communication and up-to-date training build both skill and confidence in handling hypoglycaemia.