Managing Blood Glucose Lows and Highs

As the person you care for gets older, low blood glucose levels (hypoglycaemia) and high blood glucose levels (hyperglycaemia) may affect them differently, and they may need extra support.

Their symptoms may change or become less obvious. They may be at higher risk of falls or other problems, or they may be taking medications for other health conditions that affect their glucose levels.

What’s on this page

Low blood glucose levels

How to treat a hypo

High blood glucose levels

How you can help

Information and support

Low blood glucose levels

People who take certain diabetes medications or use insulin are at risk of having a low blood glucose level or hypoglycaemia (‘hypo’).

This is when blood glucose levels drop below their target range, usually below 4.0 mmol/L or for some older people, below 6.0 mmol/L.

Not everyone is at risk of a hypo, so check with the person’s health professional.

Signs of a low blood glucose level

Older people may find their hypo warning symptoms become less obvious. This means you may be the first to notice the signs. These include:

difficulty concentrating

a personality change

morning headaches

sleep disturbance

Look out for early signs of hypoglycaemia and prepare a hypo kit in advance. Remember to consider any chewing or swallowing issues.

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How to treat a hypo

It’s important to treat a hypo quickly. If you detect symptoms:

Check their blood glucose levels. If you cannot do this, treat these symptoms as if they are having a hypo.
Treat the symptoms as quickly as possible by giving them fast-acting carbohydrates, such as 6–7 jellybeans or half a glass (125 mL) of non-diet soft drink or juice.
Wait 10–15 minutes and check their blood glucose level. If it is back in its target range, move to Step 4. If it is below target, repeat Step 2.
Have the person eat a slower-acting carbohydrate snack, such as a muesli bar, glass of milk or piece of fruit. If they are due to have a meal, they can have that.

If the person is unconscious or unable to swallow, do NOT give them any food or drink by mouth. Instead:

Place the person on their side and make sure their airway is clear.
If you are trained to do so, give an injection of glucagon.
Phone 000 and explain that the person is having a diabetes emergency.
Wait with them until the ambulance arrives.

If the person you care for is experiencing hypos, let their health professional know.

Reducing the risk of hypos

To reduce an older person’s risk of hypoglycaemia:

Make sure they do not miss or delay eating meals
Include carbohydrate foods with each meal
Make sure they check their blood glucose levels before physical activity, and more often during and after physical activity
Include a carbohydrate snack or meal if they are drinking alcohol.

High blood glucose levels

Hyperglycaemia is when a person’s blood glucose levels go too high. This is usually considered a blood glucose level above 15 mmol/L.

High blood glucose can affect everyone differently and sometimes an older person’s symptoms can change over time. Make sure you know the common signs and causes of hyperglycaemia.

How you can help

Know how to reduce the older person’s risk of hyperglycaemia:

Make sure they are taking their insulin or glucose-lowering medication correctly
Support them to be physically active each day as directed by their health professional
Help them follow their recommended eating plan
Seek help early if they are ill or have an infection
Support them in reducing emotional stress.

You can also help them manage times of illness:

Know the person’s sick day action plan (their doctor or diabetes educator can put one together)
Encourage them to check their blood glucose levels more regularly
Offer more water or unsweetened drinks
Make sure they get plenty of rest
Seek medical attention if they are not improving, or if they are no longer able to look after themselves.

Learn more about managing sick days and preparing a sick day kit.

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