Managing hypoglycaemia (a hypo) when you have chronic kidney disease (CKD)

What is this information about?

This information is about how to treat low blood glucose levels, also called a hypo, when you have chronic kidney disease.

What is a hypo?

A hypo is short for hypoglycaemia. This is when your blood glucose levels drop too low. This is usually below 4mmol/l.

How do I know if I’m having a hypo?

Some early signs of a hypo might be:

Trembling
Becoming pale
Feeling anxious
Palpitations (when your heart beats very fast or feels as if it is pounding)
Hunger
Tingling lips
Becoming sweaty or clammy

If this isn’t treated, then symptoms may get worse and you may experience the following:

Slurring words
Behaving out of character
Becoming aggressive
Becoming tearful
Difficulty concentrating or feeling confused

At the first signs of a hypo, check your blood glucose levels.

What should I do if I have a hypo?

You need to increase your low blood glucose levels as quickly as possible. To do this you need to eat food or drink liquid that is a fast acting carbohydrate.

You should always treat a hypo with fast acting carbohydrate, even if you are about to eat.

The following are examples of suitable food or drink to treat hypos. They are also low in potassium.

Fast acting carbohydrates for hypo treatment

Check label for each food product.

Food: Glucose/dextrose tablets

15g Carbohydrates is found in: 4 to 5 tablets

20g Carbohydrates is found in: 5 to7 tablets

Food: Lucozade Energy

15g Carbohydrates is found in: 170 ml

20g Carbohydrates is found in: 220 ml

Food: Cola-type fizzy drink (be aware, this is high in phosphate)

15g Carbohydrates is found in: 150 ml

20g Carbohydrates is found in: 200 ml

Food: Jelly babies (check packet)

15g Carbohydrates is found in: 3 to 5 babies

20g Carbohydrates is found in: 4 to 6 babies

Food: Jelly beans

15g Carbohydrates is found in: 10 beans

20g Carbohydrates is found in: 14 beans

Food: Fruit pastilles

15g Carbohydrates is found in: 6 pastilles

20g Carbohydrates is found in: 8 pastilles

How to treat a hypo

STEP 1:

Take 15–20g fast-acting carbohydrate and wait 10 to15 minutes. Then re-test and, if your blood glucose level has not risen above 4mmol/l, take a further 15–20g fast-acting carbohydrate and test again.

Repeat until your blood glucose level is more than 4mmol/l.

STEP 2:

Once your blood glucose levels have recovered, have an extra 10-20g carbohydrate in the form of slower acting carbohydrate, to help prevent your blood glucose from dropping again.

This is particularly important if you tend to have hypos during the night or if you are not planning to eat a meal within the next 30 minutes. You do not need to do this if your next meal is due.

Suitable slower acting carbohydrate foods are:

fruit
wholegrain bread
cereal
yoghurt or milk
two or three plain biscuits.

Should I have insulin too?

No. Do not take insulin to cover the carbohydrates you take to treat a hypo.

Does the fluid I drink to treat a hypo count towards my fluid allowance?

Yes. If your fluid allowance is very low, choose solid options to treat your hypo.

Can I eat chocolate or biscuits to treat a hypo?

No. Don’t use chocolate or biscuits to treat a hypo since they break down to glucose too slowly.

Should I eat a lot when I have a hypo?

No. It is tempting to eat a lot when your glucose is low, but this can result in your blood glucose becoming very high. Sticking to your hypo treatment is best.