Hypoglycemic attacks (also known as hypos) are one of the most common complications of diabetes - and can occur when glucose levels in the blood are too low to provide enough energy for the body's activities. Symptoms can include a pounding heart, trembling, hunger, difficulty concentrating and blurred vision. Left untreated, hypos can become serious and cause unconsciousness but despite this, they are still under-recognised and under-reported by patients.
"People with diabetes can fail to report hypos to clinicians for a range of reasons, including lack of awareness, a fear of losing their driving licence or a belief that their doctor or nurse is unable to do anything to help," says Simon O'Neill of Diabetes UK. "To make matters worse, we know that people with diabetes and their families are often fearful of hypos and feel powerless to do anything."
Diabetes affects 3.2million in the UK and the figure is projected to rise to 5million by 2025. The disease develops when there is too much sugar in the blood due to the body being unable to produce or respond to the hormone insulin in the normal way. There are two main types. For those with Type 1 diabetes, the body's immune system destroys the cells that produce insulin which is needed to allow glucose to enter the body's cells, where it is used as fuel. Those with Type one diabetes need insulin injections for the rest of their lives. Type 2 diabetes is where the body does not produce enough insulin, or the body's cells do not react to insulin (known as insulin resistance). Type 2 diabetes can sometimes be controlled by exercise, a healthy diet and carefully monitoring blood glucose levels, but if the condition gets worse over time, it may need to be managed by medication.
Although there is no single cause as to why hypos occur, some things increase the risk such as excess insulin, a delayed or missed meal or snack, not enough carbohydrates, unplanned physical activity and drinking large quantities of alcohol or drinking alcohol without food. However sometimes there is no obvious cause.
As well as the more immediate symptoms, a some sufferers experience severe hypos which can require emergency assistance. Regularly occurring severe hypos have been linked to serious health complications including heart disease. Having repeated hypos can, over time, lead to 'hypo unawareness', where the warning symptoms of an attack are no longer felt, making them harder to identify and more difficult to manage.
To tackle the problem, Diabetes UK and Novo Nordisk have launched a joint campaign called TALK Hypos which aims to encourage diabetics to report their attacks. "The first step is to recognise the symptoms of hypos and better manage their condition by encouraging a regular discussion about them during consultations," says Simon. "Steps can be taken to better manage hypos, including simple changes to lifestyle, diet and treatment."
Advice to prevent a hypo includes; not skipping meals, eating enough carbohydrate and eating extra carbs if you are more active than normal, taking tablets and/or insulin injections correctly. Don't drink alcohol on an empty stomach or drink too much.
For those who do suffer a hypo, it should be treated immediately with 15-20g of fast-acting carbohydrate such as a small glass of sugary (non-diet) drink, three glucose tablets or a small carton of pure fruit juice or glucose gel.
• This is Hypo Awareness Week. For more information on the TALK Hypos campaign visit: www.novonordisk.co.uk or www.diabetes.org.uk.
