Follow-up after nonsevere hypoglycaemia

If a patient has been having episodes of nonsevere hypoglycaemia, consider the possible cause; see Common precipitants and patient risk factors for hypoglycaemia for a list of common precipitants and patient risk factors for hypoglycaemia.

Continue the patient’s current antihyperglycaemic treatment, but review insulin dosage to consider if a change in insulin dosage is needed; nonsevere hypoglycaemia does not indicate a need to withhold insulin doses. Insulin should never be withheld in a patient with type 1 diabetes; however, insulin doses may need to be reduced.

Also review the patient’s circumstances (including dietary intake, physical activity and exercise) and other antihyperglycaemic drugs to determine the cause of the hypoglycaemia and consider whether to change the dosage or class of antihyperglycaemic drug, if applicable.

Consider provision of a 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.