Responding to diabetic hypoglycaemia in the workplace
A sudden drop in blood glucose can affect a worker’s ability to think clearly, move safely and carry out routine tasks.
In a workplace, recognising the signs of hypoglycaemia, and responding promptly, can help prevent a medical emergency.
When a person with diabetes has a drop in blood glucose levels (below 4mmol/L) they may experience hypoglycaemia, or a “hypo” as it is commonly known. Signs and symptoms include weakness, trembling, shaking, sweating, light-headedness or headache, behaviour change, lack of concentration, teary or crying, irritability or confusion, numb fingers and/or lips, seizure, or loss of consciousness.
Hypoglycaemia is most likely to affect people with diabetes who use insulin or certain glucose-lowering medicines. It can occur in offices, warehouses, factories, construction sites, commercial kitchens and vehicles.
Because symptoms can develop quickly and may resemble other conditions, workers and workplace first aiders should know what to look for and how to respond.
Why hypoglycaemia can become a workplace emergency
Glucose provides the body with energy, including the energy the brain needs to function.
When blood glucose falls too low, a person may become shaky, sweaty, dizzy or confused. As the episode becomes more severe, they may struggle to communicate, lose consciousness or have a seizure. Severe hypoglycaemia requires urgent medical attention.
The workplace environment can add to the risk. A worker who becomes confused while operating machinery, working at heights, driving a vehicle or handling hot equipment could injure themselves or others. Even in an office, a sudden loss of concentration or coordination can create hazards.
Some episodes may be associated with a missed or delayed meal, more physical activity than usual, medication side-effects or alcohol consumption. Workers may also experience hypoglycaemia without immediately recognising the early symptoms.
Colleagues who understand the warning signs can help ensure the person receives appropriate assistance quickly.
Recognising the signs of diabetic hypoglycaemia
Early symptoms vary from person to person.
A worker might appear pale, sweaty or shaky, complain of dizziness or headache, or suddenly seem unusually quiet, upset or irritable. They may have difficulty concentrating, speak differently or behave in a way that seems out of character.
These changes can be mistaken for fatigue, stress, intoxication or another medical condition. A worker who appears confused or uncooperative may be experiencing a serious drop in blood glucose and need immediate help.
If the person is known to have diabetes and shows symptoms consistent with hypoglycaemia, act promptly. If a blood glucose meter is readily available, the person may be able to check their level, but treatment shouldn’t be delayed when symptoms strongly suggest a hypo and testing is unavailable.
How to respond to diabetic hypoglycaemia
The appropriate response depends on whether the person is fully conscious and can swallow safely.
Stay with them, speak calmly and assess their condition. If they have a diabetes management plan or hypo treatment instructions, follow these where practical.
The following steps provide general first aid guidance for a suspected hypo.
1. If person is fully conscious and able to swallow, give a fast-acting sugary drink or small glucose snack, eg. 200ml fruit juice or 6-7 jelly beans. Fast-acting carbohydrate helps raise blood glucose quickly, and the person should take it while seated somewhere safe. Follow their individual hypo management plan if available, and avoid diet drinks because they do not provide the sugar needed to treat a hypo.
2. Improvement is usually rapid. Rest and reassure them during recovery as confusion is common. Stay with the person and observe whether their symptoms improve over the next 10 to 15 minutes. If a blood glucose meter is available, recheck their level according to their management plan, and repeat the fast-acting treatment if their level remains low or symptoms persist and they can still swallow safely.
3. Once fully alert, offer a more substantial slow-release carbohydrate like bread, milk, dried fruit or yoghurt. This can help maintain blood glucose after the initial fast-acting treatment, particularly if the next meal is not due soon. Check that the person is alert enough to eat and swallow normally before offering food.
4. Seek medical advice after full recovery. Encourage the person to contact their doctor or diabetes care team, particularly if the episode was severe, unexpected or recurrent. They may need to review their diabetes management plan, medication, meal timing or work arrangements to help reduce the risk of another episode.
5. If no improvement, status deteriorates or person is unable to swallow, call Triple Zero (000) for an ambulance and state they are diabetic. An ambulance is also required if the person becomes unconscious, has a seizure or is too drowsy or confused to swallow safely. Do not wait for symptoms to become more severe before seeking emergency assistance.
6. Place in recovery position, monitor breathing, airways and pulse until help arrives. DO NOT give food or drink. If the person is unconscious but breathing normally, place them on their side and continue monitoring their breathing until paramedics arrive. If they are not breathing normally, call Triple Zero (000), begin CPR and use an automated external defibrillator (AED) if available, following the emergency call-taker’s instructions.
If a seizure occurs, protect the person from nearby hazards, do not restrain their movements and do not put anything in their mouth. Once the seizure ends, check their breathing and follow emergency first aid procedures.
Preparing the workplace for a hypoglycaemic episode
A clear response plan can reduce confusion when an episode occurs.
Employers should consider first aid arrangements as part of their broader workplace risk assessment, taking into account the work being performed, the number of workers, the location and the time it may take for emergency services to arrive.
Safe Work Australia advises that workplaces must have access to first aid equipment, facilities and trained first aiders. The number of first aiders and the equipment required should reflect the workplace’s risks and circumstances.
Practical preparations may include ensuring first aiders understand the signs of hypoglycaemia, keeping emergency contact details accessible and making sure workers know how to call for assistance. In remote or isolated workplaces, arrangements should account for longer emergency response times and limited access to medical services.
A worker who is at risk of hypos may choose to tell a trusted colleague or first aider what their symptoms usually look like and where they keep their hypoglycaemia kit at work.
This can help colleagues respond appropriately if the worker becomes confused or cannot explain what is happening.
Supporting workers with diabetes
People with diabetes can have productive working lives across a wide range of occupations.
A diagnosis alone does not determine whether someone can safely perform a role. Workplace arrangements should consider the person’s circumstances, the inherent requirements of the job and any relevant safety risks.
Diabetes Australia recommends that workers consider how their diabetes management plan applies to their work and discuss work-related needs with their healthcare team. Depending on the individual and their role, practical adjustments may include access to food or snacks, flexibility around meal breaks, a suitable private place to monitor blood glucose levels and access to treatment supplies.
Confidentiality also matters. Information about a worker’s health should be handled sensitively and shared only where appropriate. Employers and workers can discuss relevant emergency arrangements without disclosing personal medical information more widely than necessary.
For safety-sensitive roles, such as driving, operating heavy machinery or working at heights, it may be particularly important to plan for the possibility of a hypo. A suitable plan can help the worker manage their condition while protecting themselves and others.
Keep hypo treatment supplies accessible
Workers who are at risk of hypoglycaemia should follow their individual diabetes management plan and keep their recommended treatment supplies available.
A personal hypo kit may include glucose tablets or another fast-acting carbohydrate, a longer-acting snack and relevant emergency information.
Workplaces can support these arrangements by ensuring workers can access their supplies when needed, including during shifts, breaks, travel or work away from the main site.
First aid kits should be regularly checked and maintained, although personal hypo treatment supplies shouldn’t be assumed to be available in every standard workplace first aid kit.
Workers and first aiders should also know the location of the nearest phone, how to contact emergency services and who can guide paramedics to the person if the incident occurs in a large or remote facility.
Conclusion
Hypoglycaemia can develop quickly and affect a worker’s judgement, coordination and consciousness.
Recognising the warning signs, providing fast-acting carbohydrate when the person is fully conscious and able to swallow, and calling Triple Zero (000) when symptoms are severe or fail to improve are essential parts of a safe response.
Australian workplaces can improve preparedness through first aid training, accessible treatment supplies, clear emergency procedures and sensible support for workers managing diabetes.
A calm, informed response can make a significant difference when a hypo occurs.
References
Diabetes Australia - In the workplace