Older people may not begin to experience the signs and symptoms of hypoglycaemia until what is called ’cognitive function’ – that is the ability to recognise and understand something is damaged.

Also the way their body is programmed to respond to the warnings of a drop in blood glucose levels may have deteriorated.

First signs of hypoglycaemia

This means that the first signs (if any) in an older person may be:

• inability to concentrate
• personality changes
• morning headaches
• disturbed sleep

Hypoglycaemia can pass by unnoticed

Hypoglycaemia is often not a recognised problem in care homes. This may be due to a variety of reasons.

• The resident may have to rely on care home staff to help manage their diabetes. If members of the staff have not been trained in diabetes care, they may lack confidence or not have sufficient knowledge.
• Mealtimes may be unevenly spread out compared to what the person was used to. If breakfast is late and the evening meal very early, this can cause a long overnight fast.
• Medication, including insulin, aiming to lower blood glucose levels, may not be linked to the actual meal as closely as is necessary and so lead to a hypo event.
• During episodes of illness, medication may not have been reassessed to prevent episodes of hypoglycaemia.

Reviewed March 2010
Next review September 2011