Insulin Glargine

Low blood sugar (Hypoglycaemia)

The most common side effect with the use of insulin is low blood sugar (hypoglycaemia).

Low blood sugar may occur if you:

• you inject too much insulin;
• you do not eat on time, miss your meals or change your diet;
• you exercise or work too hard just before or after a meal;
• you do not eat well due to an infection or illness (especially diarrhoea or vomiting);
• you drink alcohol on an empty stomach while injecting insulin;
• there is a change in your need for insulin;
• you have trouble with your kidneys or liver which gets worse.

Alcohol and some medicines can also affect your blood sugar levels.

Symptoms of low blood sugar are weakness, dizziness, hunger, sweating, trembling, blurred vision, walking unsteadily or fast heartbeat.

If you experience any of these low blood sugar symptoms, do the following immediately:

Step 1: Check your blood sugar with a home blood sugar meter (glucometer) if available. If your blood sugar level is less than 4 mmol/L, take 15 grams of sugar such as:

• 3 glucose tablets or
• Half a glass of fruit juice or
• 3 teaspoons of sugar, honey or syrup

Step 2:  You should feel better after  15 minutes. If you have a home blood sugar meter, you should check your blood sugar level again.

Step 3: If your blood sugar level is still less than 4 mmol/L or you still have symptoms of low blood sugar, you should take another 15 grams of sugar.

If your symptoms still do not get better, see a doctor or go to the hospital immediately.

Other side effects

• Some patients may also experience mild pain, redness, inflammation, bruising, swelling, shrinking or thickening of the skin at the injection site. Continuous rotation of the injection site within the recommended areas for injections will reduce the chances of developing such reactions. They also usually go away in a few days to a few weeks.
• You may also gain weight with insulin injections. Thus, you are encouraged to exercise regularly (at least 3 times a week) while on this medication.

See a doctor or go to the hospital immediately if your blood sugar level is always low and experience symptoms even after taking amounts of sugar (see instructions below for management of low blood sugar).

​Inform your doctor if:

• you are allergic to this medication or any of the other ingredients of this medication
• you drink alcohol often
• you are eating less than usual due to sickness/ changed diet as your dosage may need to be changed
• travelling across time zones as timing of your insulin may change 
• you are pregnant or breastfeeding

If your doctor has informed you that you need to do a fasting blood test, do not inject insulin until after you have your blood taken and are ready to eat.

​Avoid taking alcohol with this medication.