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Hypoglycaemia (low blood sugar)

Hypoglycaemia · Hypoglykémie (nízký cukr v krvi)

What it is

Blood sugar falls below 4 mmol/L — mostly from insulin or sulfonylureas; the brain runs out of fuel within minutes.

Symptoms & signs

  • Shaking, sweating and hunger
  • palpitations
  • irritability and confusion
  • blurred vision
  • seizures or unconsciousness if severe
  • nightmares and night sweats

🚩 Get help if…

  • call 112 / 911 now Unconscious, fitting or too drowsy to swallow
  • call 112 / 911 now Confused and not better 15 minutes after sugar
  • see a doctor soon Low sugar that comes back after a sulfonylurea or long insulin
  • see a doctor soon Lows without warning or with no diabetes

Where it strikes

Medical treatment

  • 15–20 g of fast sugar (glucose tablets, juice), recheck in 15 minutes
  • glucagon injection or nasal spray if unconscious
  • IV glucose
  • review insulin and sulfonylurea doses
  • continuous glucose monitors with alarms
  • automated insulin delivery (hybrid closed loop) — approved (FDA from 2016, and in the EU)
  • ready-to-use liquid glucagon (Gvoke) and dasiglucagon — FDA-approved 2019 and 2021

Natural & lifestyle

  • Regular meals, and snacks with exercise
  • limit alcohol, especially on an empty stomach
  • carry glucose and wear ID

Emerging & experimental

  • Glucose-responsive 'smart' insulin

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Honey or dates instead of glucose tablets — they work, but more slowly than pure glucose anecdotal / traditional
  • Chromium — trials in diabetes disagree; not a treatment for lows mixed evidence
  • Cornstarch at bedtime against night lows — small studies in type 1 diabetes early / small studies

ICD codes