Actions to Reduce the Risk of Severe Lows

Actions to Reduce the Risk of Severe Lows

Practical Tips to Reduce Your Risk of Severe Low Blood Sugar

00:00 – 00:39 Speaker 1: If I was to consider the most important things that an individual with diabetes should be aware of and should know in order to prevent them experiencing hypoglycemia. Ideally, it would be these: 1. Know the situations when you’re likely, or you have an increased risk of going low. 2. Wear a (medical) I.D.. 3. Know the early symptoms for you. And I reason I say for you is because symptoms are often very individual to that person.

00:40 – 01:13 Speaker 1: Take action early. And 4. Share it with as many people as you can in your immediate social circle, be they family or friends, if at all possible and you feel this is something that you can do. Those I think are the most important things that we should be making sure everybody with insulin as I said, whether they have Type 1 or Type 2 Diabetes should be told. For those people who live around them,

01:13 – 01:54 Speaker 1: I think we need to teach them possibly about the early symptoms. But most important of all, I think is to say that they have a responsibility that if they begin to notice that their partner, friend, child is behaving differently, they should be alert and they should ask the question. I wonder if they could be hypoglycemic. And in fact, we published a research study which showed that people with relatively longstanding Type 1 diabetes, when you ask the question who recognizes hypoglycemia first?

01:54 – 02:18 Speaker 1: And you might think it would be the patient. In the majority of cases, it was the other person, the family member who noticed and and the conversation would go: “I think you might be low. Oh, no, I’m definitely not low. I feel fine. I think you should definitely check. No, I’m really OK”. And then finally they were persuaded to check they do that glucose.

02:18 – 02:31 Speaker 1:“Oh, my goodness. It’s much lower than I thought. So, so because that is so common, it’s very important that they should be aware of that and they can prevent a severe event.

02:31 – 02:55 Speaker 2: I think the most important way to prevent severe hypoglycemia is to talk about it and make a plan. So, you know, pretending that this will never happen, even if you’re really, really good with your medication and your diet is probably not realistic considering how common we know severe hypoglycemia is. So I think it’s important to prepare for the worst and say, “OK, what would happen in worst case scenario?

02:55 – 03:25 Speaker 2: What would happen in a best case scenario?” Where are you going to keep the product that can help get you through an episode of severe hypoglycemia, like glucagon in your house? Who do you live with? Who can we educate in your household to help you if you need help? Who are you close with at work that you can talk to about helping you? And I think sometimes patients feel hesitant or embarrassed to bring friends and family into the plan because they don’t want to burden people,

03:26 – 03:35 Speaker 2: but the real burden would be if they were totally unprepared to take care of their friends and loved ones, not if they were well-educated and had a good plan.

03:36 – 03:58 Speaker 3: And I always tell people having something kind of it’s like a unit of food or whatever that, you know, if you drink it or eat it, you know, raise your blood sugar and you can kind of relax. So I keep the apple juice by my bed. I know my blood sugar is low. I drink the whole thing, and I’m going to be good because anybody that’s ever had a low blood sugar would tell you that your desire to eat is just crazy.

03:59 – 04:12 Speaker 3: And if you get out of bed, you’ll eat everything in the fridge and your blood sugars will be 400. So having something with you that is a unit of kind of carbohydrate, you usually talk about 15 grams that’ll raise your blood sugar and put that stuff everywhere.

04:13 – 04:43 Speaker 4: Yes, I try to let patients know that it’s essential to making their low blood sugar visible with self-monitoring and continuous glucose monitoring to prevent severe low blood sugar and to proactively take actions against low blood sugar. Detailed guidance regarding timing, target blood sugar level, and the quality and quantity of sugar to take is important with regard to proactive treatment.

04:43 – 04:59 Speaker 4: I also help my patients understand the importance of sharing with their caregivers this guidance and talking about symptoms that they actually have when blood sugar goes low, so that their caregivers can notice the signs and assist them when the patients have low blood sugar.

Actions You Can Take To Help Prevent Severe Low Blood Sugar

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When your daily routine changes, test your blood sugar more often to track your levels.

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Watch out for early warning signs of low blood sugar when your daily routine changes.

You may not notice any signs or symptoms, but if your blood sugar is less than 70 mg/dL, you need to take action to treat it.

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Keep snacks with fast-acting carborhydrates with you. Fast-acting carbohydrates are in food like: 

  • Hard candies
  • Fruit
  • Glucose tablets

Treat low blood sugar before it becomes severe by following the 15-15 rule.

15 grams of carbohydrates – 15 minutes
To treat non-severe low blood sugar as soon as signs or symptoms appear:

  • Eat or drink 15 grams of fast-acting carbohydrates, such as:
    • Half a cup of juice
    • 5-6 hard candies
    • 6 large jellybeans
    • 4 glucose tablets
  • Avoid carbohydrates that are also high in fat, such as chocolate. These are absorbed slower and take longer to
    raise your blood sugar.
  • After 15 minutes, if you still have symptoms or if your blood sugar is still less than 3.9 mmol/L (70 mg/dL), eat or
    drink another 15 grams of fast-acting carbohydrates.
  • When your blood sugar starts to return to normal, eat a meal or snack to prevent another low blood sugar event

Before you take short trips, such as...

Grandparents taken a child to the park


Two people buying tickets at the cinema


Someone grocery shopping


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Be sure you have your emergency pack with you:

1 icon

Your medical ID

2 icon

Fast-acting carbohydrates, like hard candies or glucose tablets

3 icon

Your blood sugar monitor and supplies

4 icon

Glucagon–just in case

Before you take longer trips, such as...

a plane


Somebody hiking in the mountains


a road going off into the distance between two mountains


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Be sure you have your emergency pack with you:

1 icon

Your medical ID

2 icon

All of your diabetes medicines and supplies, including your glucagon rescue medication

3 icon

Fast-acting carbohydrates, like hard candies or glucose tablets

4 icon

Your blood sugar monitor and supplies

What to Do for Low Blood Sugar Events

If you do have a low blood sugar event, use the 15-15 rule to treat it before it becomes severe.

Until your blood sugar is in the safe range, avoid:

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Using heavy machinery

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Any activities that could lead to a fall or injury

Review Your Knowledge

Learn More About Severe Low Blood Sugar Below

  1. O’Reilly JE, et al. Diabetologia. 2021;64(1):S1-S380. 
  2. EASD 2021 (European Association for the Study of Diabetes), September 27-October 1, 2021; Virtual; Day #2 Highlights.
  3. Kedia N. Diabetes Metab Syndr Obes. 2011;4:337-346.
  4. Lammert M, et al. J Med Econ. 2009;12(4):269-280.
  5. American Diabetes Association. Diabetes Care. 2021;44(1):S73-S84.
  6. Lipska KJ, et al. Diabetes Care. 2013;36(11):3535-3542.
  7. Frier BM. Nat Rev Endocrinol. 2014;10(12):711-722.
  8. Kovatchev B, et al. Diabetes Care. 2016;39:502-510.
  9. American Diabetes Association. Hypoglycemia (low blood sugar). November 1, 2021.
  10. Cox DJ, et al. Diabetes Spectr. 2006;19(1):43-49

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