By Dr. Zulfikar Bux
Assistant Professor of Emergency Medicine
Low blood sugar, medically known as hypoglycemia, occurs when levels of glucose (sugar) in the blood are too low. It is common in people with diabetes who take insulin and some oral diabetes medications. Most of the time it is preventable. It often occurs due to misuse of diabetic medications.
Today we will discuss this condition so that you may prevent yourself or someone else from dying with low blood sugar.
HOW DO I GET LOW BLOOD SUGAR?
Low blood sugar happens when a person with diabetes does one or more of the following:
● Takes too much insulin (or an oral blood sugar medication that causes your body to secrete insulin)
● Does not eat enough food
● Exercises vigorously without eating a snack or decreasing the dose of insulin beforehand
● Waits too long between meals
● Drinks excessive alcohol, although even moderate alcohol use can increase the risk of low blood sugar in people with type 1 diabetes
WHAT ARE THE SYMPTOMS OF LOW BLOOD SUGAR?
The symptoms of low blood sugar vary from person to person and can change over time. During the early stages of low blood sugar, you may:
● Feel hungry
● Feel anxious
● Getting headaches
If untreated, your symptoms can become more severe, and can include:
● Difficulty walking
● Difficulty seeing clearly
● Bizarre behaviour or personality changes
● Unconsciousness or seizure
● If left untreated, death will occur
When possible, you should confirm that you have low blood sugar by measuring your blood sugar level. Low blood sugar is generally defined as a blood sugar of 60 mg/dL (3.3 mmol/L) or less. Some people with diabetes develop symptoms of low blood sugar at slightly higher levels. If your blood sugar levels are high for long periods of time, you may have symptoms and feel poorly when your blood sugar is closer to 100 mg/dL (5.6 mmol/L). Getting your blood sugar under better control can help to lower the blood sugar level when you begin to feel symptoms.
HOW SHOULD I TREAT LOW BLOOD SUGAR?
The best way to treat low blood sugar is to apply the 15-15 rule. It means that you should have 15 grams of carbohydrate to raise your blood sugar and check it after 15 minutes. If it’s still below 70 mg/dL, have another serving of 15 grams. Repeat these steps until your blood sugar is at least 70 mg/dL. Once your blood sugar is back to normal, eat a meal or snack to make sure it doesn’t lower again.
This may be:
• Glucose tablets
• Banana or another sweet fruit
• 4 ounces (1/2 cup) of juice or a beverage
• 1 tablespoon of sugar or honey
• 8 ounces of nonfat or 1% milk
• Hard candy (check label for amount that equals 15 grams)
• Have a carbohydrate based meal or snack
You should still visit your doctor and let him/her know what happened. He/she can suggest ways to avoid low blood glucose in the future. Also, if you are on diabetic medications, your risk of having another episode of low blood sugar in the next 24 hours is high. Your doctor may want to keep you in for observation.
If you find someone unresponsive with low blood sugar, do not try to give them anything in their mouth. You may make this worse as they can easily choke or the food can go into their airway which can lead to infections. The best thing to do is to rush them to the nearest medical facility.
CAN LOW BLOOD SUGAR BE PREVENTED?
The best way to prevent low blood sugar is to monitor your blood sugar levels frequently and be prepared to treat it promptly at all times. You and a close friend or relative need to learn the symptoms and should always carry glucose tablets, hard candy, or other sources of fast-acting carbohydrate. Glucose tablets are recommended since they have a pleasant taste, but you are not likely to eat them unless your blood sugar is low.
Low blood sugar can be frightening and unpleasant, and it is common to be fearful of future episodes. This may lead you to keep your blood sugar level high, which can lead to long-term complications.
It may be helpful to discuss fears of low blood sugar with a doctor. In addition, ask about blood sugar awareness education. Blood sugar awareness training can improve your ability to recognize low blood sugar earlier and prevent the loss of a life.
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