Hypoglycemia is a condition characterised by abnormally low blood glucose levels, usually less than 70 mg/dl. This can happen if you: Do over exercise Don’t eat enough Skip a meal Take too many medicines However, it is important to talk to your health care provider about your individual blood glucose targets, and what level is too low for you.

When You Have Low Blood Sugar First, eat or drink 15 grams of a fast-acting carbohydrate, such as: Three to four glucose tablets One tube of glucose gel Four to six pieces of hard candy (not sugar-free) 1/2 cup fruit juice 1 cup skim milk 1/2 cup soft drink (not sugar-free)

Shaking Sweating Dizziness Hunger Fast heartbeat Blurry vision Headache Weakness or fatigue If you have a low blood sugar problem, it’s important to eat or drink 15 grams of fast acting sugary food right away, such as; ½ can of regular (not diet!) soda 1 tablespoon (or two packets of a real sugar) 3 hard candies that you can eat quickly

Nocturnal hypoglycemia or night time hypos are common in people who treat their diabetes with insulin. Symptoms are usually only realised once waking up from a hypo. Due to their nature, you will usually only find out about having a hypo during the night after waking up from a hypo. Therefore people may not even be aware that they are having night time hypos, so it’s useful to be able to spot the signs and symptoms of when nocturnal hypoglycemia may be taking place. Whilst nocturnal hypoglycemia is most common in insulin users, it can also occur for people who take oral anti-diabetic drugs.

Sometimes you may wake during an episode of nocturnal hypoglycemia. However, if you don’t, you may notice one or more of the following indications that hypoglycemia may have occurred whilst you were asleep. Restless sleep Vivid dreams or nightmare Morning headache Night sweats Mood changes Fatigue Convulsions

For parents of children with diabetes, nocturnal hypoglycemia can be particularly worrying. Parents of diabetic children may wish to check their child’s neck whilst they are sleeping if they are worried that night time hypoglycemia may be occurring.

Insulin works best when you inject it into the fatty parts of the body just under the skin. Before you leave the clinic, ensure that you know how to: Prepare insulin Inject insulin Rotate injection site

There are different devises to deliver insulin into your body through; syringes, insulin pen, insulin pump, and i-Port are different options for insulin delivery. Syringe- Insulin syringes are different from normal one. They are thinner, have almost pain less needle and come with removable needle guard. The outer side of the syringe is marked with lines to assist you to withdraw correct amount of insulin. Pen- It is composed of an insulin cartridge (integrated or bought separately) and a dial to measure the dose, and is used with disposable pen needles to deliver the dose. Insulin pens offer several significant advantages over insulin syringes: Ease of handling Accuracy

Wash hands with warm & soapy water If using cloudy insulin, roll the bottle (do not shake) between hands. Clean rubber stopper of insulin bottle with alcohol. Fill syringe with air equal to the number of units of insulin you will be taking. Insert needle into the bottle and push air into the insulin bottle. Turn syringe and bottle upside down and draw out your dose of insulin. Insert the needle into the skin Press the plunger on the end of the syringe to deliver the dose

Screw or click on a new pen needle. If necessary, prime the pen to remove any air from the needle Turn the knob on the end of the pen (or "dial") to the number of units needed Insert the needle into the skin Press the button on the end of the pen to deliver the dose Count to five or ten depending on dose injected Remove used pen needle for disposal Some tips for using the syringe and Pen for insulin delivery: Shorter needles mean lesser injection discomfort. However, injection depth affects how quickly insulin takes effect. Coordinate syringe size (e.g., 1cc, 1/2cc, 3/10cc) to match insulin dose. Do not re-use a syringe/pen needle. Do not share a syringe. Dispose of used syringes/ pen needle properly

Insulin works best when you inject it into the fatty parts of the body just under the skin. Following are insulin injection sites Back of upper arms Stomach (around navel) Front and side area of thighs Back above waist Rear end (buttocks) Keep 1 inch away from the last few injection sites. Keep 2 inches away from the navel and any scars. Do not use sites that are bruised, tender; swollen or hard to the touch. Things to note while choosing site of injection Rotation of the injection sites may reduce the risk of lipodystrophy, lumps of fat that develop under the skin from injecting in the same spot repeatedly. Two rules for proper site rotation Same general location at the same time each day Rotate within each injection site Angle of injection and Skin folding Most people pinch up a fold of skin and insert the needle at a 90° angle to the skin fold. To pinch your skin properly, follow these steps: Squeeze a couple of inches of skin between your thumb and two fingers, pulling the skin and fat away from the underlying muscle. (If you use a 4 or 5 millimeter mini pen needle to inject). Insert the needle. Hold the pinch so the needle doesn't go into the muscle. Push the plunger (or button if you're using a pen) to inject the insulin. Release the grip on the skin fold. Remove the needle from the skin. Monitoring