What to Do During a Severe Hypoglycemia (Low Blood Sugar) Event

02 Sep 2025

What to Do During a Severe Hypoglycemia (Low Blood Sugar) Event Severe hypoglycemia, or low blood sugar, is a dangerous condition that requires immedi...

What to Do During a Severe Hypoglycemia (Low Blood Sugar) Event

Severe hypoglycemia, or low blood sugar, is a dangerous condition that requires immediate action. It occurs when your blood glucose levels drop to a point where you can't treat it yourself, and you need help from someone else. This can happen suddenly and progress quickly. Understanding the symptoms, causes, and treatment for severe hypoglycemia is critical for anyone with diabetes, as well as their family and friends. This article provides a comprehensive guide on how to recognize, manage, and prevent severe hypoglycemia events.

Why Severe Hypoglycemia is a Serious Concern

Severe hypoglycemia can lead to serious complications if not treated promptly. These complications can include seizures, loss of consciousness, coma, and in rare cases, even death. The brain relies on glucose for energy, and when glucose levels drop too low, brain function is impaired. Recognizing and acting quickly during a severe hypoglycemic event is crucial to preventing these serious outcomes.

Key Reasons for Taking Severe Hypoglycemia Seriously:

  • Brain Function: Low blood sugar deprives the brain of essential energy, leading to cognitive impairment and potential damage.
  • Immediate Danger: It can quickly progress to unconsciousness, requiring emergency intervention.
  • Long-Term Health: Frequent severe episodes can impact overall health and diabetes management.

Recognizing the Signs and Symptoms of Severe Hypoglycemia

The first step in dealing with severe hypoglycemia is recognizing the signs and symptoms. While individual experiences may vary, some common indicators include:

Common Symptoms of Severe Hypoglycemia:

  • Confusion or disorientation: Difficulty thinking clearly or understanding what’s happening.
  • Loss of coordination: Stumbling, difficulty walking, or clumsiness.
  • Slurred speech: Difficulty speaking clearly.
  • Seizures: Uncontrolled muscle spasms and loss of awareness.
  • Loss of consciousness: Passing out or being unresponsive.

Table of Hypoglycemia Symptoms:

| Symptom | Description | Severity | |-------------------------|------------------------------------------------------------------------------|-----------------| | Confusion | Difficulty thinking clearly, disorientation | Moderate to Severe | | Loss of Coordination | Stumbling, clumsiness | Moderate to Severe | | Slurred Speech | Difficulty speaking clearly | Moderate to Severe | | Seizures | Uncontrolled muscle spasms, loss of awareness | Severe | | Loss of Consciousness | Passing out, unresponsiveness | Severe | | Sweating | Profuse sweating even in a cool environment | Moderate | | Tremors | Shaking or trembling, especially in the hands | Moderate | | Rapid Heartbeat | Feeling like your heart is racing or pounding | Moderate | | Blurred Vision | Difficulty seeing clearly | Moderate | | Dizziness | Feeling lightheaded or unsteady | Moderate |

It’s important to note that some individuals may experience hypoglycemia unawareness, meaning they don't experience the early warning signs of low blood sugar. This can make it even more critical for those individuals to regularly monitor their blood glucose levels.

Step-by-Step Guide: What to Do During a Severe Hypoglycemia Event

If you suspect someone is experiencing severe hypoglycemia, it’s essential to act quickly and follow these steps:

  1. Assess the Situation:

    • Check for signs and symptoms mentioned above.
    • If the person is conscious but unable to treat themselves, offer assistance.
    • If the person is unconscious or having a seizure, do not try to give them anything by mouth.

  2. Administer Glucagon (If Available):

    • What is Glucagon? Glucagon is a hormone that raises blood sugar levels quickly. It comes in an injectable form and a nasal spray.
    • Injectable Glucagon: Follow the instructions provided with the glucagon kit. Typically, you will inject the glucagon into the thigh, arm, or buttocks.
    • Nasal Glucagon: Administer the nasal spray into one nostril, following the instructions provided.
    • When to Use Glucagon: Use glucagon if the person is unconscious, having a seizure, or unable to swallow.
    • Example: "If my friend with diabetes loses consciousness, I will immediately inject the prefilled glucagon pen into their outer thigh, as I've been trained."

  3. Call for Emergency Medical Help (911):

    • Even if the person regains consciousness after glucagon administration, it's crucial to call emergency services. They can provide further evaluation and treatment.
    • Clearly explain the situation, including that the person is a diabetic and experienced a severe hypoglycemic event.

  4. Monitor and Comfort:

    • Once glucagon has been administered and emergency services have been called, monitor the person closely.
    • If they regain consciousness, reassure them and help them sit up comfortably.

  5. Provide a Rapid-Acting Carbohydrate (Once Conscious and Able to Swallow):

    • Once the person is awake and able to swallow, give them a quick source of sugar, such as:
      • Glucose tablets: These are designed to raise blood sugar quickly.
      • Fruit juice: Offers a quick source of glucose.
      • Regular soda: Contains sugar that can be rapidly absorbed.
      • Hard candies: Can be sucked on to raise blood sugar slowly.
    • Important: Avoid giving them diet soda or sugar-free products, as they won’t raise blood sugar levels.

  6. Follow Up:

    Related reading: Tired Of Finger Pricks Everything To Know About The A1C Blood Sugar Test

    Related reading: Managing Type 2 Diabetes A Guide To A1C And Blood Sugar Control

    • After the event, work with the individual and their healthcare team to identify the cause of the severe hypoglycemia and take steps to prevent future episodes.

Flowchart: Steps to Take During a Severe Hypoglycemic Event

Start --> Assess the Person (Conscious? Symptoms?) If Conscious and Able to Treat Self: --> Assist with Glucose Intake (Tablets, Juice) Else If Unconscious or Unable to Treat Self: --> Administer Glucagon --> Call 911 End If --> Monitor & Comfort --> If Conscious After Glucagon: Give Rapid-Acting Carbs --> Follow Up with Healthcare Team End

Understanding the Role of Glucagon: A Lifesaving Treatment

Glucagon is a prescription medication specifically designed to counteract the effects of severe hypoglycemia. It works by stimulating the liver to release stored glucose into the bloodstream, rapidly raising blood sugar levels.

Types of Glucagon Available

  • Injectable Glucagon Kits: These kits contain a vial of powdered glucagon and a syringe with sterile water. You must mix the two before injecting.
  • Prefilled Glucagon Pens: These are pre-mixed and easier to administer, making them a convenient option.
  • Nasal Glucagon Sprays: These are administered into the nose and are also easy to use, even if the person is unconscious.

How to Administer Glucagon

  1. Injectable Glucagon:

    • Locate the glucagon kit.
    • Follow the instructions to mix the glucagon powder with the liquid.
    • Draw the solution into the syringe.
    • Inject into the thigh, arm, or buttocks.

  2. Prefilled Glucagon Pen:

    Related reading: Managing Diabetes How Your A1C Relates To Daily Blood Sugar Control

    • Remove the cap.
    • Press the pen firmly against the thigh.
    • Hold for a few seconds to deliver the dose.

  3. Nasal Glucagon Spray:

    • Remove the device from its packaging.
    • Hold the device with your thumb on the plunger and your index and middle fingers on either side of the nozzle.
    • Insert the nozzle gently into one nostril.
    • Press the plunger firmly to release the dose.

Important: Always read and follow the instructions that come with your specific glucagon product.

Who Should Have Glucagon?

Individuals with diabetes who are at risk of severe hypoglycemia should have a glucagon kit readily available. This includes people who: * Have a history of severe hypoglycemia. * Experience hypoglycemia unawareness. * Use insulin or certain oral diabetes medications.

It's crucial to ensure that family members, friends, and caregivers know how to administer glucagon. Regular training sessions with a healthcare professional are highly recommended.

Preventing Severe Hypoglycemia: Proactive Strategies

Prevention is the best approach to managing severe hypoglycemia. Here are some strategies to help prevent these events:

  1. Regular Blood Glucose Monitoring:

    • Check blood sugar levels frequently, especially before meals, after exercise, and before bedtime.
    • Use a continuous glucose monitor (CGM) for real-time glucose readings and alerts for low blood sugar.

  2. Medication Management:

    • Take diabetes medications as prescribed and adjust dosages as directed by your healthcare provider.
    • Be aware of how different medications affect blood sugar levels.
    • Never skip or delay meals if you are taking insulin or sulfonylureas.

  3. Meal Planning:

    • Eat regular, balanced meals and snacks.
    • Consider carbohydrate counting to match insulin doses to carbohydrate intake.
    • Always carry a source of fast-acting carbohydrates with you.

  4. Exercise Considerations:

    • Monitor blood sugar levels before, during, and after exercise.
    • Adjust insulin doses or carbohydrate intake as needed to prevent hypoglycemia during or after exercise.

  5. Alcohol Consumption:

    • Be aware that alcohol can lower blood sugar levels.
    • Eat food when drinking alcohol and monitor blood sugar levels carefully.

  6. Education and Training:

    • Educate yourself, family members, and caregivers about diabetes management, hypoglycemia symptoms, and glucagon administration.
    • Attend diabetes education classes or workshops.

Checklist: Hypoglycemia Prevention Strategies

  • [ ] Regularly monitor blood glucose levels.
  • [ ] Take medications as prescribed.
  • [ ] Eat balanced meals and snacks.
  • [ ] Adjust insulin for exercise.
  • [ ] Be cautious with alcohol.
  • [ ] Educate yourself and others about hypoglycemia.
  • [ ] Carry fast-acting carbohydrates.
  • [ ] Wear a medical ID.

Real-Life Scenarios: Case Studies and Examples

Understanding how severe hypoglycemia can manifest in real-life situations can help you be better prepared. Here are a few examples:

  1. The Athlete:

    • Sarah, a long-distance runner with type 1 diabetes, experiences severe hypoglycemia during a race. Her blood sugar drops rapidly due to prolonged exertion. A fellow runner recognizes the signs – confusion and disorientation – and provides her with glucose gel. They also alert the medical team, who administer glucagon and ensure she receives appropriate care.
    • Lesson: Athletes with diabetes need to monitor blood sugar levels closely during and after exercise and have readily available sources of fast-acting carbohydrates.

  2. The Elderly Individual:

    • John, an elderly man with type 2 diabetes, lives alone. He accidentally takes too much insulin and becomes unconscious. A visiting nurse finds him and administers nasal glucagon. She calls 911, and paramedics arrive to provide further treatment.
    • Lesson: Elderly individuals with diabetes, especially those living alone, should have a plan in place for emergencies and ensure that caregivers are aware of their condition and medications.

  3. The Child at School:

    • Emily, a child with type 1 diabetes, experiences a seizure at school. Her teacher recognizes the signs of hypoglycemia and administers injectable glucagon. The school nurse is called, and Emily is monitored until her parents arrive.
    • Lesson: Schools should have protocols in place for managing hypoglycemia and train staff on how to administer glucagon.

These case studies underscore the importance of recognizing the signs and symptoms of severe hypoglycemia, having access to glucagon, and knowing how to administer it properly.

Resources and Support: Where to Find More Information

Managing diabetes and preventing severe hypoglycemia requires ongoing education and support. Here are some valuable resources:

  • American Diabetes Association (ADA): Provides comprehensive information on diabetes management, including hypoglycemia, and offers resources for patients, families, and healthcare professionals.
  • JDRF (Juvenile Diabetes Research Foundation): Focuses on research and support for type 1 diabetes.
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Offers scientific research and information on diabetes and related conditions.
  • Local Diabetes Education Programs: Many hospitals and clinics offer diabetes education classes and support groups. Contact your healthcare provider or local hospital to find programs in your area.

Additionally, consider using mobile apps designed to help manage diabetes, track blood glucose levels, and provide reminders for medications and meals.

By understanding the causes, symptoms, and treatment of severe hypoglycemia, and by taking proactive steps to prevent it, individuals with diabetes can live healthier and safer lives. Remember, knowledge is power, and being prepared can make all the difference in managing this potentially life-threatening condition.