Living-With-Diabetes-Workbook-Chapter-D-Low-and-High-Glucose-Levels - Hypoglycaemia and Hyperglycaemia

Oct 12, 2026

Guidance on managing blood glucose extremes in children with diabetes, explaining how normal ranges differ from insulin-treated Type 1 diabetes. Covers recognition of hypoglycaemia symptoms, causes, and detection challenges at night, plus stepwise treatment with fast-acting carbohydrates and when to repeat dosing. Also outlines why high blood glucose requires prompt treatment, common triggers, and the role of monitoring to reduce ongoing risk and protect daily wellbeing.

LanguageEnglish

CategoryGeneral

FormatPDF

Pages6

Reading Time2 min

AccessFree to download

Low and High Glucose Levels

Low blood glucose levels (Hypoglycaemia)

How will you know if your child is having a hypo?

Hypoglycaemia at night time

How to treat a hypo

In the case of a severe hypo

Key points to consider

High blood glucose levels (Hyperglycaemia)

Why do I need to treat high blood glucose levels?

D: Low and High Glucose Levels D1: Low blood glucose levels (Hypoglycaemia) Hypoglycaemia-what is it? How to recognise and treat with confidence. In someone without diabetes , the body is able to balance the blood glucose (BG) level between 3.5 and 7mmol/L the majority of the time. In Type 1 diabetes, where insulin is injected either by pen or pump it is much harder to keep the BG between this narrow range. In diabetes we define Hypoglycaemia (Hypo’s) if a BG level goes below 3.9mmol/L What sort of things can cause a hypo? Too much insulin -perhaps too large a dose or too many doses (known as “insulin stacking”) Being more active than usual Not eating or drinking as much as usual – perhaps missing a meal or loss of appetite due to illness After drinking alcohol Stress, hot weather Lipohypertrophy also referred to as lumpy injection sites How will you know if your child is having a hypo? Your child will usually experience some of these sensations first as their body tries to correct the hypo This may include:-Shaking, pounding heart, hungry, sweating , dizzy, feeling weak The effect of low BG levels on the brain means that it may then become:- More difficult to concentrate or perform skills as well as usual or they may complain of a headache. Their behaviour may also seem different to usual. You may notice they seem more:- Irritable, Tearful, Quiet, Drowsy or Uncooperative, Pale Hypoglycaemia at night time Some children have hypos at night without it disturbing their sleep, so can be more difficult to detect. If they have a number of hypos this can also affect awareness so identifying and preventing them is important. Bedtime BG levels do not necessarily predict the BG overnight so checks around 2- 3am may be recommended by your diabetes team. If your child has exercised in the afternoon or early evening hypos later in the evening or overnight (approx. 7-11 hours later) can be more likely so checking overnight is a good idea. How to treat a hypo Take some fast acting glucose. For many children over about 10yrs ofage 15g glucose carbohydrate is required. To calculate this more precisely use 0 .3g/kg of body weight Here is a chart showing the usual amounts of fast acting glucose required forchildren of different ages and include 2g, 5g, 10g and 15g hypo treatment. This will raise BG level by about 3-4mmols. | | 2g glucose
Less than
2years old | 5g glucose
2-5yrs old | 10g
glucose
5-10yrs old | 15g
glucose
Over
10yrs old | | --- | --- | --- | --- | --- | | Lift Glucose shot | 10mls | 20mls | 40mls | 60mls | | Lift Glucose tablets 1 tablet contains 4g | - | 1 tab | 2-3 | 4 | | Lucozade energy tablets 1 tablet contains 3g | 1 | 2 | 3 | 5 | | Dextrosol
1 tablet contains 3g | 1 | 2 | 3 | 5 | | Jelly sweets (average weight) | 3g | 6g | 12g | 18g | | Dextrogel | ¼ tube | ½ a tube | 1 tube | 1½ tubes | | --- | --- | --- | --- | --- | Recheck the BG after 15mins, if still below 3.9mmol/L repeat the hypo remedy as you won’t do any harm but will help your child to recover quickly. If you find you regularly need to repeat the hypo remedy please discuss with your diabetes team. Dextrogel This treatment can be used if your child is sleepy or uncooperative and not wanting to eat or drink is a glucose gel such as “Dextrogel”. Glucose gel can be placed on fingertip and put in the mouth or squirted in the side of the cheek onto the gums and massaged on the outside. Chocolate is not recommended for hypos. This is because it contains fat which slows the absorption of glucose , and lactose which is a more slowly absorbed carbohydrate so your child will likely take longer to recover. Fructose (fruit sugar) is absorbed slightly slower than glucose but not as slowly as lactose. It may be an option if apple or orange juice is more acceptable , and you find it works quickly enough. In the case of a severe hypo This is a rare occurrence which can lead to

FAQs

How is hypoglycaemia defined for people with diabetes?

Hypoglycaemia is defined when blood glucose (BG) drops below 3.9 mmol/L.

What are common causes of a hypo?

Common causes include too much insulin (including insulin stacking), increased activity, missing meals or reduced intake, alcohol, stress, hot weather, and lumpy injection sites (lipohypertrophy).

What steps should be followed when treating a hypo?

Give fast-acting glucose, recheck BG after 15 minutes, and repeat the hypo remedy if BG is still below 3.9 mmol/L. If repeats are frequent, discuss with the diabetes team.

Oct 12, 2026

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