Follow-up after severe hypoglycaemia

Following severe hypoglycaemia, determine the cause of the hypoglycaemia, including investigating for underlying illnesses that increase the risk of hypoglycaemia (see Common precipitants and patient risk factors for hypoglycaemia for a list of common precipitants and patient risk factors for hypoglycaemia). Consider whether the patient's medication needs to be adjusted.

When the patient has recovered from an episode of severe hypoglycaemia, provide dietary review and education about preventing and managing hypoglycaemia. A patient information sheet on hypoglycaemia for adults with diabetes is available from the National Diabetes Services Scheme (NDSS) website. Information on hypoglycaemia for parents and carers of children and adolescents with diabetes is given in the parent's manual Caring for diabetes in children and adolescents1.

Note: After an episode of severe hypoglycaemia, patients are at risk of a recurrence and should be warned of the implications for driving.

For patients with diabetes who drive, after an episode of severe hypoglycaemia:

  • Warn the patient they must not drive until they have been assessed and recommended for resumption of driving by their diabetes specialist. Their driver's licence may need to be reinstated by the licence authority, which usually takes a minimum of 6 weeks2. Laws about reporting episodes of severe hypoglycaemia vary in different Australian states and territories.
  • See Hypoglycaemia unawareness for advice about driving for a patient with hypoglycaemia unawareness.
  • Advise the patient about precautions to take to ensure safe driving; see Driving and type 1 diabetes or Driving and type 2 diabetes.
1 Ambler G, Cameron F, editors. Caring for diabetes in children and adolescents. 3rd ed. Sydney: Children's Diabetes Services; 2010. URLReturn
2 Austroads. Assessing fitness to drive for commercial and private vehicle drivers. 5th ed. Sydney: Austroads; 2016. URLReturn