I’ve never been on a cocktail of drugs (went straight to insulin alone when Glucotrol didn’t work), BUT there is only ONE thing to do when he goes hypo, which is get sugar into him FAST. You can use glucose tabs, Smarties, hard candy, juice or skim milk, but just do it fast.
It also sounds like he needs a talk with the doc. Personally, I tend to be suspicious of TOO many pills. Your brother needs to know exactly WHY he is taking each pill, and whether the insulin will substitute for one or more. For example, he shouldn’t be on insulin AND a sulfonylurea, because the sulf stimulates the pancreas to secrete more insulin, and if he’s taking it by injection, he doesn’t need that stimulation.
Second, maybe the doc put him on a too-large insulin dose, and it needs to be cut down. Better to start with too little than too much!
As far as kick-in times, if he’s taking the drugs according to directions, such as before meals, or once a day, then there shouldn’t be a problem. I’m much more suspicious of too much insulin.
But anyway, do call the office and make an appointment urgently – 2 hypos in one day is unacceptable, but it’s not such a good idea to go off all meds, either.