The outbreak of COVID-19 has challenged millions of people across the world to change the way they live their lives. Many people have been asked to stay indoors, either in self-isolation or quarantine. You may not be able to go outdoors for a walk or go to the gym as often as you like, and there may even be difficulties in going out and buying the food you prefer to eat. It can therefore be more challenging than normal to follow your daily routine – and this may also affect how your blood glucose levels regulate.

In this section, we will provide some ideas for how to manage your blood sugar during the COVID-19 crisis to help you stay within your optimal blood sugar range and reduce the risk of getting a low blood glucose level, which is also called hypoglycaemia or a “hypo”.

With self-isolation and having to stay indoors most of the time you may be finding it more difficult to adjust your insulin dose to your reduced level of physical activity. If so, please consult with your doctor as you may be at an increased risk of experiencing low blood glucose levels. 

A hypo is low blood sugars, low blood glucose.

Hypos are caused by insulin therapy and sulphonylureas.

In this section, we will provide some ideas for how to manage your blood glucose to help you stay within your optimal blood glucose range and reduce the risk of getting a low blood glucose level, which is also called hypoglycaemia or a “hypo”.

The way you feel when your blood glucose level is low varies from person to person and may not be the same every time. You will soon learn to recognise your own early warning signs and how to take action.

If you experience any of the following symptoms you could be having a hypo:

• Sweaty
• Dizzy
• Hungry
• Cold
• Faint
• Tired
• Confused
• Irritable

Some of the common symptoms of hypos include confusion, intense hunger, feeling sick, clumsiness, blurred vision and slurred speech. You may find you experience one or more of these when your blood sugar levels are low. Or a family member or friend might mention that you are acting a little strangely or that you look unwell.

• Test your blood glucose levels regularly
• Do not delay in treating your hypo
• Always carry food or drink with you containing 15g of fast acting carbohydrate e.g. glucose tablets
• Wear a diabetes identification bracelet/necklace or carry a diabetes emergency card
• Tell friends, relatives and people at work about hypos and how they can help
• Don’t walk or swim long distances alone
• If you drink alcohol keep to sensible amounts and never drink on an empty stomach
• Always check your blood glucose level before driving - do not drive without eating if your blood glucose level is below 5.0 mmol/L
• Try not to miss meals
• Take your diabetes medication correctly
• Identify what caused your hypo so you can avoid the same thing happening again
• Visit your doctor or nurse regularly to check your medication and general health

Having a daily routine is one of the best ways to help you adapt to your new life during this unprecedented situation. Creating a daily routine, planning your mealtimes and ensuring you eat regularly, plus having planned time to check your blood glucose levels and take your insulin, will help you to spend more time within your ideal blood glucose (sugar) range and reduce the risk of getting hypos.

It is also a good idea to manage your stress levels to help reduce the likelihood of hypos. Try reading, meditating, yoga, or perhaps something creative, like painting and drawing. Spending time with any pets you may have can also help ease any worries and stress. See this article to learn more about how to deal with stress.

So while responding with anxiety to something is sometimes reasonable, let’s discuss different ways to reduce the risk and impact of anxiety and discomfort.

It would be beneficial for your blood glucose (sugar) balance, as well as your overall well-being, even if you just exercise for 10 minutes a day indoors – or outdoors if at all possible. There are many online fitness classes that you may wish to try. More ideas can be found in the “Tips for Exercise” section here.

Prolonged periods of stress can also lead to changes in blood glucose levels, increasing the risk of hypos. You can read more about how to monitor your blood sugar here.

Do not delay in treating your hypo. Take some sugary food or drink as quickly as possible if you are conscious and can safely swallow. Try to take 15g of fast acting carbohydrate (unless instructed otherwise).

• Re-check your blood glucose level after 10-15 minutes
• If you still don’t feel well and your blood glucose level remains less than 4.0 mmol/L, re-treat as above
• If you are starting to feel better, eat your next meal if due, or if not due within an hour have a small carbohydrate snack e.g. slice of bread, piece of fruit
• If you are due to take your insulin and / or diabetes medications please do so as normal

Remember to recheck your blood glucose after 15 minutes to reassure if blood glucose levels have recovered. More severe cases (if loss of consciousness occurs or a seizure happens) may require getting support from an emergency medical service. If a glucagon injection kit is available, it can be administered to manage severe hypos too.

The following are good options to treat a mild hypo:

• 5 glucose tablets
• 5 jelly babies
• 1 or 2 tubes of a glucose gel such as GlucoGel^®*
• 150mL of fruit juice
• 60mL Lift^®* energy shot
• 150mL of sugary fizzy drink (eg. non-diet cola or lemonade)

Note: brands of fizzy drinks may change their sugar content so check the labels regularly to ensure you are getting the correct amount of carbohydrate

If you are having difficulties in controlling your blood glucose levels and reducing the risk of hypos, you should seek the advice of your doctor or nurse.

If you start to feel unwell or notice some of the typical symptoms of a hypo, first check your blood sugar levels. If your blood glucose levels are too low, it’s always recommended to treat a mild hypo with fast-acting sugar sources such as glucose tablets or sweets. Fruit juice or a regular soda drink can also be helpful to quickly raise your blood glucose levels.

Remember to recheck your blood sugar after 15 minutes to reassure if blood glucose levels have recovered. More severe cases (if loss of consciousness occurs or a seizure happens) may require getting support from emergency medical service. If a glucagon injection kit is available, it can be administered to manage severe hypos too.

Food with complex carbohydrates, such as highly-processed white bread, takes longer to be broken down by the body. These are not so good for the immediate management of a hypo, but can be useful for keeping blood glucose at a normal level after a hypo.

If you are having difficulties in controlling your blood glucose levels and reducing the risk of hypos, you should seek the advice of your doctor or nurse.

January 2024. IE23DI00243