Barriers to communication

Barriers to talking about hypoglycaemia


Research in type 2 patients has shown that:

  1. During follow-up visits with their doctor, only 15% of type 2 patients who had experienced a recent mild or moderate episode of hypoglycaemia raised it with their healthcare professional.
  2. 30% of type 2 patients reported increased fear of future hypoglycaemia, having had an episode.
  3. As a direct result of experiencing hypoglycaemia, 43% of type 2 patients modified their insulin dose without speaking to a healthcare professional.


One study showed that of those patients who failed to report hypoglycaemia:*

  1. 1 in 5 felt that the issue was not important enough to discuss during appointment times.
  2. 1 in 10 were worried about wasting their healthcare professional's time.


Also, many patients may be under-reporting their hypoglycaemia due to a fear of losing their driving licence, although not all incidents of hypoglycaemia need to be reported to the Driver and Vehicle Licensing Agency (DVLA).  For further information on DVLA restrictions, please visit

Research shows that patients with diabetes ranked 'fear of hypoglycaemia' as their most significant challenge.

These incidents are particularly concerning as, though patients are reluctant to discuss hypoglycaemia with a healthcare professional, fear of hypoglycaemic episodes can cause patients to 'self-treat' and make changes in their dosing regimen, which may result in poor diabetes control and diminished quality of life.

Additionally, having repeated episodes of hypoglycaemia can, over time, lead to 'hypo unawareness', where the warning symptoms of hypoglycaemia stop being felt, making it harder and more difficult to manage.

*statistics refer to patients experiencing night-time hypoglycaemia.


Encouraging conversations around hypoglycaemia


To raise the subject of hypoglycaemia with your patients as part of your consultation, the below questions may be useful:

  • What do you understand by the term hypoglycaemia, or hypo?
  • What do you think causes a hypo?
  • How would you recognise a hypo?
  • Have you ever felt shaky and sweaty, maybe when you haven't eaten for a long time?
  • Do you drive, cycle regularly or operate machinery?
  • Have you ever had a hypo and how did you feel?
  • How would you treat a hypo?

Further information for primary and secondary care healthcare professionals can be found in the Joint British Diabetes Societies Inpatient Hypo Guidelines.


Hypoglycaemia is a two way conversation


We are encouraging people living with diabetes to come prepared for their next appointment by using the Hypo Journal.  This is a downloadable tool to help support patients track any hypos they experience from month to month and any potential triggers.


This page is intended for UK healthcare professionals only
UK/WB/0616/0022(1)  September 2016

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Information about the impact of hypoglycaemia

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Hypo Hub

Access information, resources and practical guidance on how to manage hypoglycaemia (hypos)

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TALK Hypos

Awareness campaign and information on day and night-time hypoglycaemia

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Below the Surface

Watch the Below the Surface films to learn more about the varying symptoms of hypos

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Practical information and resources

Download the Hypo Journal and find out where to access more information on hypos

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