Diabetic Hypoglycemia

What Is Hypoglycemia?

Hypoglycemia is the medical term for low-blood sugar. Hypoglycemic episodes occur when there is too much insulin and not enough glucose, or blood sugar, in a person’s bloodstream. Though we tend to associate it with too-high levels of blood sugar (hyperglycemia), diabetes can sometimes lead to the opposite condition of hypoglycemia, which is also a health risk. Symptoms range from fairly mild cases of physical weakness and anxiety to more serious problems, such as passing out and seizures. Diabetic patients should learn to recognize the signs of hypoglycemia and be prepared to deal with them.

What Are the Symptoms of Hypoglycemia?

Hypoglycemia is marked by the following symptoms:

  • Hunger and shakiness
  • Physical weakness or unsteadiness
  • Headaches
  • Irritability or crankiness
  • Sweating
  • Dizziness
  • Anxiety and nervous behaviors

More severe symptoms include:

  • Disorientation and lack of focus
  • Slurred speech
  • Blurred vision
  • Extreme sleepiness
  • Clumsiness or lack of coordination
  • Seizures
  • Unconsciousness

Extreme cases of hypoglycemia can be fatal. 

Physicians recommend that diabetic individuals maintain blood sugar levels between 70 to 130 milligrams per deciliter (mg/dL) or 4.0 to 7.2 millimoles per liter (mmol/L). If your glucose levels fall below these lower limits, then you’re experiencing medically defined hypoglycemia. 

What Are the Causes of Hypoglycemia?

Hypoglycemic episodes in diabetics tend to be linked to insulin usage or daily-life decisions. The importance of insulin as a cause means that low blood-sugar episodes are more common in persons with type 1 than type 2 diabetes:

  • Insulin usage: A primary factor in diabetic hypoglycemia is taking too much insulin for the amount of glucose in your blood. A similar problem can occur with diabetic medications that are not based on insulin.
  • Diet: Certain food choices can reduce blood-sugar levels. For example, eating too few carbohydrates for the amount of insulin taken can lower glucose levels significantly. Also playing a role are meal composition – the relative percentages of proteins, fats, and carbohydrates – and the timing of insulin shots, both of which can affect rates of glucose absorption from food. 
  • Physical activity: Exercise is like other good things in life – healthy in moderation but potentially risky if overdone, particularly for diabetics. Physical activity can decrease blood sugar levels, triggering a hypoglycemic episode. 

Learning management techniques for diabetes is the best means of preventing hypoglycemia. Monitor your blood sugar levels on a regular basis, using a continuous glucose monitor. This includes before and after meals, before and after exercise or physical exertion, before going to bed, and when waking up. 

How Is Hypoglycemia Treated?

If you’re experiencing a hypoglycemic episode, remember the 15/15 rule: consume 15 grams of a carbohydrate and then measure your glucose levels 15 minutes later. Repeat this process until your blood sugar level is above the minimum (70 mg/dL or 4.0 mmol/L).

Quick sources of carbohydrates are listed below. Read all labels or instructions to verify appropriate amounts:

  • Gumdrops, jelly beans, or other candies
  • 1 tablespoon of honey or sugar
  • One-half cup of juice or a non-diet soda
  • Gel tubes
  • Glucose tablets

More severe cases might call for injections of glucagon, a pancreatic hormone that stimulates the liver to release glucose into the bloodstream. Glucagon kits are available by prescription. Because of the risk of unconsciousness, be sure to teach a family member or friend how to administer glucagon, if you are unable to do so. If he or she has any doubt about how to respond to your situation, call 911 immediately. 

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