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Warning Symptoms of Hypoglycaemia

When the blood glucose levels start to drop at the stage of mild hypoglycaemia, then usually there are warnings signs/symptoms of the impending hypo. These are usually:

  • Sweating
  • Trembling
  • Pallor
  • Weakness
  • Hunger

These are called the adrenergic effects of hypoglycaemia because the body reacts to the low blood glucose level by the production of counter-regulatory hormones, mainly adrenalin and glucagon. These hormones are the ‘fight and flight’ hormones that the body releases when there is any danger. Hypoglycaemia is a danger and these hormones give the warning symptoms of an impending hypo and trigger the release glucose from the liver.

If the mild hypo is not treated for any reason, then the blood glucose drops further and the symptoms of this are less obvious to the person with diabetes – the signs are usually:

  • Confusion
  • Irritability
  • Behavioural changes such as aggression, excitement or violence
  • Sensory changes such as blurred vision

These symptoms are much harder to recognise and can be missed and so remain untreated. This can lead to a severe hypo and unconsciousness.

These are the neuroglycopenic effects of hypoglycaemia because the blood glucose level has dropped to lower levels and the brain is starved of glucose. This results in reduced cognitive function with confusion and behavioural changes. The person who is hypo may well say that they are “definitely not hypo” but in reality this may be part of the confusion caused by the neuroglycopenia. Research has shown that brain function can be impaired when the blood glucose falls below 3.5mmols.

Important to remember:

  • The warning symptoms vary from person to person and can vary in the same person at different times. Many people have found that the warnings seem to vary with the rates at which the blood sugars fall. For example, after exercise they drop quickly but at other times it may be a gradual, slow drop over a longer period with less obvious warning signs.
  • Often the family carer or friend notices the signs of a hypo before the person with diabetes, especially the behavioural changes which can be difficult to handle, especially aggressive and/or violent hypos.
  • It is very common for the person with diabetes to deny that they are hypo even though they are. Family carers get used to this as one of the signs that there partner or child is actually hypo!
  • If the person who is hypo carries out a blood test while hypo the results are not necessarily reliable because of their confused state while doing the blood test.
  • The warning symptoms are the body’s mechanism for WARNING of an impending DANGER and that danger is hypoglycaemia.