Is The Low Predictable Or Unpredictable
Generally, a low blood sugar is predictable if there is a reasonable explanation for it . Unpredictable lows are when no obvious reason can be found. In this case, the unpredictable low could be a one off that occasionally happens and is more common with cloudy or N insulin. If it happens more than once, it could be a sign that you need to change your insulin routine either the dose or type. For example, it could be a change in your weight or that the liver is not making as much sugar overnight , or just being on the wrong type of insulin that is peaking in the night.
What Are The Symptoms Of Hypoglycemia
Symptoms of hypoglycemia can start quickly, with people experiencing them in different ways. The signs of hypoglycemia are unpleasant. But they provide good warnings that you should take action before blood sugar drops more. The signs include:
- Shaking or trembling.
- Tingling or numbness in the face or mouth.
During a severe hypoglycemic event, a person may:
- Be unable to eat or drink.
- Have a seizure or convulsions .
- Lose consciousness.
- Slip into a coma or die .
How To Recognize Hypoglycemia
The first signs of hypoglycemia include feeling sweaty, shaky, and hungry. However, not everyone has these symptoms or notices them in time to prevent low blood sugar from getting worse. Its also important to know that your symptoms of hypoglycemia will change the longer you have T1D.
As hypoglycemia gets worse, symptoms can include:
- Feeling weak
- Having difficulty walking or seeing clearly
- Acting strange or getting disoriented
- Having seizures
Severe hypoglycemia may make you faint or pass out. This is dangerous if you are driving, climbing stairs, or doing other activities where you need to stay aware of things around you.
Hypoglycemia can happen at night. If it does, you are likely to wake up, but its important not to rely on your body to wake you up. A continuous glucose monitor, or CGM, can alert you and those around you with an alarm to let you know if your blood sugar starts getting low while you are sleeping.
Its a good idea to check your blood sugar often when lows are likely, such as in hot weather or when you travel. Your CGM can also let you know when your blood sugar is getting lower.
Watch out for hypoglycemia unawareness.
You might not have early warning signs of low blood sugar. This is called hypoglycemia unawareness, and it raises the risk of having severe lows. It is more likely if:
- You have had diabetes longer than 5 or 10 years
- You have frequent episodes of hypoglycemia
- You take certain medicines, such as beta blockers for high blood pressure
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What To Do When Your Blood Sugar Levels Drop Too Low
People who use insulin and other diabetes medications are at risk for hypoglycemia. Keep this action plan handy so you’re prepared.
If you take insulin or diabetes medication, you may be at risk of developing hypoglycemia, or low blood sugar. Without quick attention, hypoglycemia can lead to serious complications, so its important to know what to do if it happens to you or someone close to you.
In very severe cases, hypoglycemia can lead to seizures or loss of consciousness, says a clinical assistant professor of medicine, endocrinology, gerontology, and metabolism at Stanford Health Care, and chief of the Stanford Endocrine Clinic.
It’s possible to have hypoglycemia but have no symptoms, according to the National Institute of Diabetes and Digestive and Kidney Diseases . On the other hand, symptoms can also come on rapidly. While symptoms vary from person to person, if you develop mild to moderate low blood sugar you may:
- Feel shaky or jittery
- Have a headache or be lightheaded
- Turn pale
- Be irritable or combative
- Have blurred vision or see double
Some people feel tingling or numbness in their extremities too, says Rodolfo Galindo, MD, an assistant professor of medicine in the division of endocrinology, metabolism, and lipids at the Emory University School of Medicine in Atlanta, and chair of the inpatient diabetes taskforce.
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When It’s Time To Call A Doctor
If any of the symptoms mentioned have begun to impact your life, such as fatigue so severe you can’t stay awake through the day, it’s a good idea to consult your physician. Dr. Fruge warns that “unstable blood sugar levels could put you at higher risk of heart disease and stroke and it is a red flag for serious health issues” — so blood sugar issues should be taken seriously.
You should also see a doctor if you’re experiencing symptoms of hypoglycemia and haven’t been diagnosed with diabetes or any other underlying condition.
If you do have diabetes and your hypoglycemia isn’t responding to the treatments described above, that’s another good cue to call your health care provider.
If testing reveals you have Type 1 diabetes, you’ll need to continue to test your blood sugar levels as often as instructed by your physician, take insulin regularly and participate in regular exercise. This may mean you will need a new glucose monitoring system, so ask your doctor what they recommend. If you’re diagnosed with Type 2 diabetes, you’ll most likely need to do the same as for Type 1, as well as working with health care professionals to make lifestyle changes such as improving nutrition and planning workouts. Medication may be necessary as well.
Healthy eating, regular exercise and other lifestyle changes can help alleviate symptoms and possibly even reverse prediabetes.
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Monitor Blood Sugar Levels Closely
High blood sugar levels often do not cause symptoms until they run well over 200 mg/dL. As such, it is essential for a person with diabetes to monitor their blood sugar several times a day. Doing so will mean that blood sugar levels never get that high.
A person with diabetes can use a home glucose monitor to check blood sugar levels. These are available for purchase online.
Recommendations for how frequently to check glucose levels during the day will vary from person to person. A doctor can make the best recommendations regarding blood sugar monitoring to a person with diabetes.
What Should I Do If This Happens
People and their partners or roommates should learn to recognize the signs of nighttime hypoglycemia. Be prepared! Ask your doctor for an emergency glucagon kit. This kit contains a fast-acting medication that can be injected if the person cant be woken up. Store the kit in a bedside drawer for easy access.
DO NOT PUT ANYTHING INTO A PERSON’S MOUTH IF THEY ARE ASLEEP OR CANNOT SIT UP.
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If the person cannot be woken: If there is no emergency glucagon kit, call 911. If the person has a glucagon kit, the partner or roommate should follow the instructions to fill the syringe and inject the medicine. Once fully awake, he/she should eat a meal and check their blood glucose every few hours using a home test kit. After giving the injection, the persons doctor should be notified.
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If the person can be woken up and sit without support: They should be given a fast-acting glucose source. Good options include hard candy, fruit juice or glucose paste or tablets, which can be purchased at most pharmacies. Once the person is fully awake, they should eat a meal and check their blood glucose every few hours using a home test kit.
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Low Blood Sugar: Warning Signs Ways To Treat And When To Call The Doctor
Physicians explain how to tell when your blood sugar is dangerously low, and how to take action to prevent complications.
According to the Centers for Disease Control and Prevention’s 2020 National Diabetes Statistics Report, 34 million people living in the United States had diabetes in 2018 — and amazingly, 21% of adults with diabetes did not even know they had it. The scariest part is that, if left untreated, diabetes can be deadly. In fact, it was the seventh leading cause of death in the year 2017.
And while normally associated with high blood sugar , diabetic folks can also experience hypoglycemia, or low blood sugar, alongside its own bevy of problems — including more severe and/or long-term effects like seizures, loss of consciousness, dementia and even death. Further, according to the Mayo Clinic, hypoglycemia can also cause low blood sugar in folks without diabetes due to a variety of conditions and medications.
So, needless to say, it’s important to maintain healthy blood sugar levels. But how is this done, especially if you don’t know the first thing about blood sugar?
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How Is Hypoglycemia Diagnosed
The only way to know if you have hypoglycemia is to check your blood sugar with a blood glucose meter. Its a small machine that measures blood sugar. Most of these devices use a tiny prick of the finger to take a small amount of blood.
People with hypoglycemia unawareness may need a continuous glucose monitor. These wearable devices measure glucose every few minutes, day and night. An alarm sounds if blood sugar drops too low.
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Do My Tactics Work Every Time
HA! No, I still have nights where I go low and nights where I overeat to treat it, but they are really few and far between. Im not perfect, but always analyzing why I had a low and making adjustments going forward has helped a lot in reducing my nighttime lows. And having the right food and drink easily available has helped me treat my lows in the right way.
I hope this can help some of you and I would love to hear your advice and tricks as well. If you have a smart way of dealing with nighttime lows, please write it in the comments below this post so everyone can learn from it.
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What If I Have Severe Low Blood Glucose And Cant Treat Myself
Glucagona hormone that raises blood glucose levelsis the best way to treat severely low blood glucose. Available as an injection or a nasal spray, glucagon will quickly raise your blood glucose level. Your doctor can prescribe you a glucagon kit for use in case of an emergency.
If your blood glucose level drops very low, you wont be able to treat it by yourself. Be prepared to address severely low blood glucose by
- talking with your doctor or health care team about when and how to use a glucagon emergency kit. If you have an emergency kit, regularly check the date on the package to make sure it hasnt expired.
- teaching your family, friends, and coworkers when and how to give you glucagon. Tell them to call 911 right away after giving you glucagon or if you dont have a glucagon emergency kit with you.
- wearing a medical alert identification bracelet or pendant. A medical alert ID tells other people that you have diabetes and need care right away. Getting prompt care can help prevent the serious problems that low blood glucose levels can cause.
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Low Blood Sugar Levels In Diabetes
People with diabetes can have low blood sugar levels because of the medicines they have to take to manage their diabetes. They may need a hormone called or diabetes pills to help their bodies use the sugar in their blood.
These medicines help take the sugar out of the blood and get it into the body’s cells, which makes the blood sugar level go down. But sometimes it’s a tricky balancing act and blood sugar levels can get too low.
People with diabetes need to keep their blood sugars from getting too highor too low. Keeping blood sugar levels in a healthy range means balancing when and what they eat, and when they exercise with when they take medicines.
Always Follow Up With The Doctor
It is very important to call your doctor as soon as possible after experiencing nocturnal hypoglycemia. The patient and doctor should try to figure out what caused the episode and how to prevent it from happening again.Often the doctor will suggest:
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Changing the dose or timing of insulin or other medications
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Setting an alarm for the early morning so that the patient can test their blood glucose levels and determine how often the episodes occur
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Having the person wear a continuous glucose monitor that checks blood glucose every five minutes with an alarm that wakes the patient from sleep if levels start to drop too low. This option is usually reserved for patients who experience frequent or severe nocturnal hypoglycemia
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So How Do I Treat Low Blood Sugar At Night
What I do is treat it for what it is, a medical emergency. So I test my blood sugar and immediately eat or drink 8-15 grams of carbs in the form of 2 glucose tablets or 125 ml juice. I then assess whether I need a low glycemic carb as well . The assessment is pretty quick, and for me only involves checking that I didnt bolus within the last 4 hours. If I did, I might have to cover that with a few rice cakes.
The reason why I say 4 hours is because I bolus with Humalog, which stays active in the body for about 4 hours. If it has been more than 4 hours since I took my bolus, I know that just the sugar or juice will get me through the night.
My recommendation is to be honest with yourself, and if you cant go into the kitchen and just have those 15 grams of carbs without emptying the fridge every time, then keep your emergency carbs in the bedroom next to your bed .
I also recommend that you dont treat your hypoglycemia with candy or cake. As I said, its a medical emergency and you need a carb that will hit your bloodstream quickly. Pure sugar or juice is the best for that because the fat in candy or cake will slow down carb absorption. Also, you dont need a treat in the middle of a low blood sugar. Youre not enjoying it anyway, just stuffing your face.
You can read more about the best and quickest ways to treat low in this post: How to Treat Lows as Quickly as Possible
Causes Of Low Blood Sugar
There are many reasons why you may have low blood sugar, including:
- Taking too much insulin.
- Not eating enough carbs for how much insulin you take.
- Timing of when you take your insulin.
- The amount and timing of physical activity.
- Drinking alcohol.
- How much fat, protein, and fiber are in your meal.
- Hot and humid weather.
- Unexpected changes in your schedule.
- Spending time at a high altitude.
- Going through puberty.
- Menstruation.
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How To Prevent Low Blood Sugars In The Future
There is probably no way to completely eliminate low blood sugars at night, but I have learned how to limit them quite a bit. What I do is pretty simple I try to learn from my mistakes. If I have a low during the night, Ill go back and see how my bolus and basal patterns were the day before, what I ate, and what I did.
For example, my last low blood sugar was at 4 am a few nights ago, and when I went back and analyzed the data, this is what I found:
Since it was 4 am and my last snack was at 11 pm, the low couldnt be due to my last bolus. I also hadnt changed my basal amount. However, I had moved my workout to later in the evening. So my conclusion was that to limit future nighttime lows, I should take less basal insulin before I go to bed if I work out later in the evening. Thats a pretty easy fix. I reduced my nightly basal and now Im sleeping through the night again and waking up with perfect sugars.
Helping Someone With Low Sugar
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