What to Do in a Diabetic Emergency or Hypo

If someone with diabetes becomes shaky, sweaty, pale or confused, they may be having a hypo (low blood sugar). The first thing to do is give them something sugary to eat or a non-diet drink, help them rest while the sugar takes effect, and stay with them. Do not give diet or sugar-free drinks, because they will not raise their blood sugar.

Most hypos respond quickly to sugar. Stay calm, keep the person comfortable and supported, and reassure them that help is on the way if you have called for it¹. If they become unconscious, are not breathing, or get worse rather than better, call 999³.

This page sets out what to give, what to avoid, the signs to look for, and when a hypo becomes an emergency that needs an ambulance. It is for ordinary households, whether you live with someone with diabetes or simply want to know what to do if a neighbour or visitor is taken ill.

Give them something sugary to eat or a non-diet drink

The aim is to get sugar into the person quickly. Give them something sugary to eat or a non-diet drink: a normal soft drink, fruit juice, sugar lumps, sweets or chocolate. NHS guidance for someone who is fully awake and needs warming gives the example of "a warm non-alcoholic drink and some sugary food like chocolate"⁵. The same principle applies to a hypo: quick sugar, swallowed easily.

What counts as something sugary:

• Sugary drinks: ordinary (non-diet) soft drinks and fruit juice.
• Sugary foods: sugar lumps, sweets, chocolate.
• Anything labelled diet, light or sugar-free is not suitable. These do not contain the sugar needed to raise blood glucose.

It helps to understand why diet drinks are the wrong choice. The NHS advises people with diabetes to drink plenty of water and sugar-free soft drinks in hot weather, because "becoming dehydrated increases the risk of dangerously high blood sugar levels in both type 1 and type 2 diabetics"⁶. That is advice for keeping blood sugar stable day to day, not for treating a hypo. In a hypo you want sugar, so reach for the ordinary drink, not the diet one.

Help them rest while the sugar takes effect

Once they have taken some sugar, help them rest. Keep the casualty comfortable and supported while you wait for help to arrive; if the casualty is responding, you could help them lie down and reassure them that help is on the way¹. Ambulance services put it simply: stay calm².

Rest matters because the sugar needs a few minutes to work, and moving about or panicking can make the person feel worse. Sit them down somewhere safe, loosen anything tight, and keep talking to them calmly. If you are outside, stay with the patient until help arrives⁷.

A diabetic emergency is one of the situations a community first responder may attend⁹, so if you have called 999, someone trained may arrive before the ambulance. While you wait:

1. Keep them sitting or lying down and comfortable.
2. Stay calm and reassure them.
3. Watch for any change: if they become drowsy, confused or unresponsive, call 999 if you have not already.
4. Do not leave them alone.

Signs that someone may be having a hypo

A hypo can come on quickly. Watch for someone who becomes shaky, sweaty, pale, confused, irritable or drowsy, especially if you know they have diabetes. The signs can be easy to miss or put down to tiredness, so if someone with diabetes seems unwell and you are unsure, treat it as a possible hypo and give sugar.

Some signs mean the situation is more serious and you should call 999. Ambulance services advise calling 999 when someone is seriously ill or has life-threatening injuries, for example a traumatic head injury, severe blood loss, chest pains or loss of consciousness³. Difficulty breathing is another reason to call¹⁰. If someone is unconscious, having difficulty breathing, or showing signs of a serious illness, that is an emergency¹¹.

If the person is not breathing, phone 999 and start CPR immediately, and ask someone nearby to get a defibrillator⁴. Our guide to the primary survey walks through danger, response, airway and breathing step by step, and how to do CPR covers the compressions.

When to call 999

Call 999 when someone is seriously ill or has life-threatening injuries³. For a hypo, that means calling if the person becomes unconscious, stops breathing, has difficulty breathing, or does not improve after sugar. Do not wait to see if they come round on their own.

The emergency number is 999 across the UK¹². When you call, the call handler will ask what has happened and talk you through what to do. Stay on the line and follow their instructions. If the person is not breathing, phone 999 and start CPR immediately, and ask someone nearby to get a defibrillator⁴.

If you are unsure whether it is an emergency, it is safer to call. Ambulance services would rather hear from you than have you wait. For guidance on what happens after you call, see how ambulance services prioritise 999 calls.

Sugary supplies to keep at home

A household with someone who has diabetes should keep a small store of quick sugar ready, alongside their medication. Emergency kit checklists from councils across the UK advise including medication and spare medication in a household emergency pack¹⁴. Keep your sugary supplies with it, so they are easy to find in a power cut, a flood or at night.

What to keep ready:

• Sugary drinks: ordinary soft drinks or fruit juice, not diet versions⁶.
• Sugary foods: sugar lumps, sweets or chocolate⁵.
• Medication: keep medication and spare medication with your emergency supplies¹⁴.
• A phone charger: so you can call for help if the power is out¹⁷.

Store these where everyone in the household knows to look. Check them now and then and replace anything past its date. If you support an older or disabled neighbour, you could pick up extra food, water, toiletries or medications for them when you shop¹⁸.

Where to get help and what to do next

If someone is having a hypo and you are unsure what to do, call 999 and follow the call handler's advice³. If the person recovers, stay with them until they are back to normal, and encourage them to tell their diabetes team or GP about the episode.

For more general first aid, our first aid at home guide covers the situations a household is most likely to face. If you are building up supplies, the emergency kit guide explains what to keep ready, and the health emergencies guide covers medicine supplies and looking after someone who is medically dependent. Households with an older or disabled person may find extra help in an emergency useful.