COMING SOON- Manage your Hypo with HYPO DUO™

The recommended and evidence based treatment for hypoglycaemia (hypo) involves two steps:

1. Have 15g of fast acting carb (depending on the level of hypo and individual needs)

   - Wait 15 minutes for this to absorb into the blood and then recheck your blood glucose level (BGL)   

    to see if you are back in your safe, target range

  - If your BGL is still low, repeat step 1 (have another 15g of fast acting carb) and wait another 

     15 minutes before checking BGL. 

2. When your BGL is in your safe, target range, have 15g of a slow acting carb to maintain your   

     BGLs in a safe range.

Having slow acting carb when your hypo has resolved, will help to keep your BGL in a safe range for longer. Slow acting carbs take longer to break down in the stomach, which causes the glucose to enter the bloodstream slowly over time. Some examples of slow acting carb are yoghurt, fruit, milk, and muesli bars. HYPO DUO, step 2 is also a slow acting carb, formulated with fibres that take longer to digest, keeping your BGL more stable.

If your BGL is at the lower end of your target range, and you're nervous about your BGL dropping further resulting in a hypo, you may only need 15g of slow acting carb to stabilise your BGLs and prevent a hypo. If you're at home or close to a shop, grab a piece of fruit, a small latte, or a half a sandwich. If you're out and about without food, HYPO DUO Step 2 is a perfect option.

Hypos can happen when you least expect , and often for no apparent reason.  Some common situations where blood glucose levels may drop include:

• After exercise (particularly 6 hours after exercise when your muscles are re-fuelling with glucose the most)
• If you've over-calculated your meal time insulin, or you don't end up eating the amount of carb you intended to when you had your pre-meal insulin dose
• When you're unwell 
• When you've skipped or delayed meals
• After drinking alcohol, especially if you hadn't been eating

Hypos shouldn't be a regular occurrence. Most hypos can be prevented, and understanding why they are happening can help you plan ahead. Speak to your Diabetes Health Professional who may review your prescribed insulin or medication dose, particularly the days you plan to exercise or expect to be more active than usual.

Prevent hypos by:

• Eating regular meals
• Ensure medication is taken as prescribed
• Ensure BGL is in your target range, as discussed with your diabetes health professional, before exercise 
• Avoid alcohol on an empty stomach

< 4mmol/L or < 70mg/dL is usually referred to as hypoglycaemia (a hypo). Exercise should be postponed until you have treated your hypo and your BGL is back in your safe target range.  

4mmol/L or 70mg/dL  – 5mmol/L or 90mg/dL:  Have a serve of slow acting carb. I.e. piece of fruit or small glass of milk before you start exercising. If you don't have food on hand, HYPO DUO, Step 2 is a perfect option.

5mmol/L or  90mg/dL – 10mmol/L or 180mg/dL is the ideal BGL range to exercise. 

⟩10mmol/L or 180mg/dL -  Caution needs to be taken with BGLs consistently above this level; consider gentle exercise and see your diabetes health professional to discuss ongoing management.  

⟩15mmol:  If your BGL is above this level, postpone strenuous exercise. This is considered hyperglycaemia (high BGL) and can cause your BGLs to rise further and lead to dehydration. Exercising when BGLs are above this level can also lead to the production of ketones for people with type 1 diabetes.  

People with type 2 diabetes taking insulin injections can experience hypoglycaemia, for the same reasons as people with type 1 diabetes.

Oral medication for type 2 diabetes,  sulphonylureas,  can contribute to a hypo event. Sulphonylureas stimulate the pancreas to produce more insulin throughout the day, even if you are not eating or drinking. Because of this continuous release of insulin, it’s important to eat regularly to ensure adequate glucose is in your bloodstream for insulin to act on. If there’s not enough glucose available in your bloodstream, your BGLs could go too low.  

If you're regularly having hypos and feel you need to eat to 'keep up with your medication', you may need your dose reviewed - discuss with your diabetes health professional.

Other oral diabetes medications have different actions to lower BGLs, and you'll only be at risk of a hypo if you are also taking sulphonylureas and or insulin.