Community Diabetes Specialist Nurses Nottingham CityCare Partnership WHAT IS A HYPOGLYCAEMIA HYPOGLYCAEMIA HYPO WHEN GLUCOSE LEVELS DROP USUALLY BELOW 4MMOLS WHY DOES HYPOGLYCAEMIA ID: 934368
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Slide1
HYPOGLYCAEMIAAND TREATMENTS
Community Diabetes
Specialist
Nurses
Nottingham CityCare Partnership
Slide2WHAT IS A HYPOGLYCAEMIA
Slide3HYPOGLYCAEMIA
(HYPO)
WHEN GLUCOSE LEVELS DROP
USUALLY BELOW 4MMOLS
Slide4WHY
DOES HYPOGLYCAEMIA
OCCUR?
Slide5Missed or late meals
Eating less carbs than usual
Too much insulin
Too much sulphonylurea
More activity than usual
e.g
gardening, shopping, golf,
walking, dancing
Slide6Excessive
alcohol consumption
Injecting
muscle
instead of
the fatty layer
under the skin
Extremes in
temperature
Stress and illness
Slide7Consider
If Hba1c is less than 48
mmol
/
mol
Overtreatment of medication
Increase risk of Hypoglycaemia
Slide8What Does A Hypo feel Like?
The way a hypo feels to someone varies
Occasional hypo’s are a normal part of life for someone on insulin or
sulphonylureas but should not be a common feature
Hypo’s are divided into 3 types:
MILD
MODERATE
SEVERE
Slide9Common Symptoms of Hypo
Sweating
Dizziness
Trembling
Tingling hands, feet, lips and tongue
Hunger
Anxiety
Irritability
Palpitations
Slide10If not treated quickly the symptoms
of hypo become more severe
Coordination may suffer
Vision can become blurred
Behaviour can become irrational and erratic, even aggressive
If the hypo sufferer refuses help this needs to be ignored as the effects
of the hypo are causing them to react in an irrational way
Slide11Game
Slide12Treatment of a Hypo
MILD to MODERATE
7
Dextrosol
energy
tablet or 5
Glucotabs
Sweet drink (200mls)– pure fruit juice, fizzy pop (not diet),
lucozade
(amount can vary depending on type)
3-4
Jelly Babies
1
tube of
Glucogel
Each has approximately 15-20g of carbohydrate
CHECK GLUCOSE AFTER 10 MINUTES AND REPEAT IF STILL LOW
DO NOT USE THESE TREATMENTS FOR SOMEONE WHO IS UNABLE TO
SWALLOW OR UNCONSCIOUS
Slide13SEVERE HYPO
This is where the patient is unable to react ‘normally’ to a situation … they
may not be completely still and silent
GLUCAGON
Glucagon is a hormone (like insulin) also made by the pancreas but has
the opposite effect of insulin. It raises the glucose level in the blood
Available in the UK on prescription:
GlucaGen
Hypo Kit
Comes as a vial of powder and syringe of water which is mixed just before
injecting
IF GLUCOGEN IS NOT AVAILABLE IN THIS SITUATION A 999 AMBULANCE
NEEDS TO BE CALLED.
Slide14After a Hypo
Is Normal to feel
Emotional
Headachy
Nauseous
Slide15Following a Hypo
Once the patient has started to recover from the
hypo
If their meal is due they can have this.
If it is a while until their next meal 1 slice of medium bread or toast or 2 digestive
biscuits. These are approximately 15-20g of carbohydrate
Patient will need reassuring as it can be a very frightening experience
.
Slide16If next insulin injection is due following a severe hypo it would be wise to delay this until patient is fully recovered
T
he
I
nsulin
or Sulphonylurea
doses will need reviewing
Consider why the hypo happened
Slide17HYPOGLYCAEMIA AND DRIVING
Slide18DVLA changes to driving and using insulin
DVLA must be informed - 3yr driving licence
New rules brought in end of 2012 + Group 2 drivers ( lorry
and bus drivers) can now use insulin
Testing before driving – 5 to drive – then every 2hrs. Carry
testing kit and hypo treatment always
Sulphonylureas
If hypo while driving what do you advise?
Informing DVLA of any severe hypos – 2 in 1yr licence will be revoked - 1 in 1yr for Group 2 drivers
Slide19