Most episodes of mild symptomatic hypoglycemia (plasma glucose 70 mg/dL) are effectively self-treated by ingestion of carbohydrates, such as a piece of fruit or a sugary drink (never diet soda). If you’re confused or losing consciousness, call emergency services.
Intensive blood-glucose control increases the risk of hypoglycaemia by impairing the normal defence mechanisms that maintain glucose concentrations. This is especially true for people using insulin secretagogues.
Causes
People with diabetes need to follow a care plan that includes diet, exercise and medication. Sometimes, a person with diabetes will experience low blood sugar levels. These can be caused by many things. One of the most common causes is eating less than you should. Another cause is drinking too much alcohol. This is because alcohol prevents the body from forming new glucose cells. It can also be caused by certain medications that a person is taking. Some of these medications can interfere with how the body uses insulin.
If a person with diabetes increases their physical activity, their blood sugar level may go down. They can avoid this by talking to their doctor and finding an exercise plan that works for them. They can also use a blood glucose monitor to check their blood sugar before and after exercise. This will help them decide if they need to adjust their medicine or eat more snacks.
Another cause of low blood sugar is feeling nauseous or vomiting. This can cause a person to not eat enough or eat foods that are high in sugar. It is important for a person with diabetes to tell their doctor about any symptoms of nausea or vomiting so they can determine if they need to change their meal plan.
Severe episodes of hypoglycemia are a medical emergency and need to be treated right away. People with diabetes should teach family and friends about the early symptoms of low blood sugar so they can help if something happens. They should also keep a supply of glucagon, which is a hormone that makes the liver release glucose into the blood.
Some people with diabetes don’t feel the early symptoms of low blood sugar. This is called hypoglycemia unawareness and it can be dangerous. It is also more common in older adults with diabetes. People who are very overweight have a greater chance of experiencing this problem. They may have a harder time losing weight and will need to take more insulin. They are also more likely to have coexisting conditions that can affect how well the body uses insulin.
Symptoms
People with diabetes have a long list of symptoms they can watch out for, and it’s important to learn them so you can catch an episode of low blood sugar early. This way you can take action and get the treatment you need before it becomes severe and life-threatening. Severe low blood sugar can cause you to pass out, and it’s a medical emergency. If this happens, you’ll need someone to inject glucagon, a medication that stimulates the liver to release glucose into the bloodstream. It’s best to teach family, friends and co-workers how to administer glucagon so they can help you in case of an emergency.
If you have mild to moderate hypoglycemia several times in one week or experience any severe episodes, talk with your healthcare provider about adjusting your management plan. This may include a change to your meal plan, medications or exercise routine.
You can treat mild to moderate hypoglycemia by eating or drinking something sweet, such as a small piece of fruit or a 4-ounce (half-cup) glass of juice or regular soda with sugar. Alternatively, you can use a glucose gel or tablet. These are fast-acting carbohydrates that raise your blood sugar quickly. Always carry these with you in case of an emergency.
People who don’t have diabetes can also suffer from hypoglycemia. Non-diabetic hypoglycemia is usually caused by an illness or infection that affects the body’s ability to absorb and use sugar, or it can be a side effect of some medications. Non-diabetic hypoglycemia can also occur during pregnancy, when hormone changes can cause the blood sugar level to drop.
If you’re prone to hypoglycemia, it’s important to work with your doctor and keep a journal of when you have these episodes. This will help you and your healthcare provider find patterns that could lead to these episodes, such as when you have them after meals or during a certain activity. Your healthcare provider might also recommend a test called a mixed-meal tolerance test, in which you have a drink that contains protein, fats and sugar. Your healthcare provider will then check your blood sugar levels over a few hours.
Treatment
Symptoms of hypoglycemia can be treated by eating carbohydrates (sugar), such as fruit, yogurt, milk, or candy. For severe cases, a person can have an injection of glucagon, which causes the liver to release sugar into the bloodstream. People with diabetes should carry a kit with glucagon and have a plan for what to do if they pass out from hypoglycemia. They should also tell family and friends where they keep the glucagon and how to use it.
Severe episodes of hypoglycemia can cause a coma or death. They also can result in long hospital stays, serious health complications, and impaired quality of life.
Most people with diabetes can prevent or delay severe hypoglycemia by balancing their medicines, eating well-balanced meals and snacks, and getting regular physical activity. A person with diabetes should check their blood sugar level often, especially before and after exercise. It is important to avoid skipping meals, as this can lead to low blood sugar. People with diabetes should also be aware that drinking alcohol can lower blood sugar, and they should always eat food or a snack after drinking.
Some people with diabetes need insulin therapy, which can be prescribed after lifestyle adjustments and other treatments have failed to control blood sugar levels. Some types of insulin can increase the risk for hypoglycemia, but others, such as gliptins and metformin, can reduce this risk. In addition, some medicines, such as SGLT2 inhibitors, which work by blocking how the kidneys filter glucose, can also reduce the risk for severe hypoglycemia.
A person who is diagnosed with hypoglycemia should see a health care professional right away. He or she will draw a blood sample for testing. If the symptoms are severe, a person may need to fast overnight or longer before the test can be done. This is to allow time for the counterregulatory hormones to return the blood sugar to normal. A blood sugar of less than 70 mg/dL is considered mild to moderate hypoglycemia. This can be treated by eating 15 grams of fast-acting carbohydrates and checking the blood sugar level again in 15 minutes.
Prevention
In some cases, a person can avoid low blood sugar levels by taking more care to plan their meals and snacks. They may also need to adjust their diabetes medicines.
People who are older or have a comorbid condition (such as liver disease, kidney disease or dementia) have an increased risk of hypoglycemia. In addition, a person’s symptoms might not always be clear, especially if they have had diabetes for a long time. This is known as hypoglycemia unawareness.
If a person is experiencing serious symptoms, such as loss of consciousness, it is important that they seek emergency medical attention. These people might need glucagon to be revived. It is also important that these people carry a source of sugar with them, such as glucose tablets or gel, hard candy or regular soda. They should also let friends and family know where they keep their glucagon and how to use it.
A person can prevent hypoglycemia by taking their medications as directed, exercising at the same time each day and eating a healthy diet. In addition, they should check their blood sugar regularly and especially before meals, before and after exercise and before sleep.
Lastly, a person should avoid drinking alcohol, as it prevents the body from forming new glucose cells. People who drink excessive amounts of alcohol over several days may run out of stored glucose and experience severe hypoglycemia.
People with diabetes can also prevent hypoglycemia by teaching themselves to recognize early symptoms. These can include headache, blurred vision, tingling in the hands and feet, and shaky legs. They should also make sure to take part in activities that require full concentration, such as driving, and not skip meals or eat less than usual.
If a person does not recognize their symptoms or do not treat them promptly, they can develop more serious problems such as seizures and loss of consciousness. They should discuss their situation with a healthcare professional to determine whether or not their diabetes medication needs to be adjusted. The healthcare professional will also look into the causes of the episodes and see what can be done to prevent them in the future.
