What Is Low Blood Glucose
Low blood glucose, also called low blood sugar or hypoglycemia, occurs when the level of glucose in your blood drops below what is healthy for you. For many people with diabetes, this means a blood glucose reading lower than 70 milligrams per deciliter .1 Your number might be different, so check with your doctor or health care team to find out what blood glucose level is low for you.
Low Blood Glucose During Sleep
Your blood glucose level can drop while you sleep and stay low for several hours, causing serious problems.7 Symptoms of low blood glucose while you sleep can include
- crying out or having nightmares
- sweating enough to make your pajamas or sheets damp
- feeling tired, irritable, or confused after waking up
Although you may not wake up or notice any symptoms, low blood glucose can interfere with your sleep, which may affect your quality of life, mood, and ability to work. Having low blood glucose during sleep can also make you less likely to notice and respond to symptoms of low blood glucose during the day.
Early Signs Of Diabetes
Both types of diabetes have some of the same telltale warning signs.
- Hunger and fatigue. Your body converts the food you eat into glucose that your cells use for energy. But your cells need insulin to take in glucose. If your body doesn’t make enough or any insulin, or if your cells resist the insulin your body makes, the glucose can’t get into them and you have no energy. This can make you hungrier and more tired than usual.
- Peeing more often and being thirstier. The average person usually has to pee between four and seven times in 24 hours, but people with diabetes may go a lot more. Why? Normally, your body reabsorbs glucose as it passes through your kidneys. But when diabetes pushes your blood sugar up, your kidneys may not be able to bring it all back in. This causes the body to make more urine, and that takes fluids. The result: You’ll have to go more often. You might pee out more, too. Because you’re peeing so much, you can get very thirsty. When you drink more, you’ll also pee more.
- Dry mouth and itchy skin. Because your body is using fluids to make pee, there’s less moisture for other things. You could get dehydrated, and your mouth may feel dry. Dry skin can make you itchy.
- Blurred vision. Changing fluid levels in your body could make the lenses in your eyes swell up. They change shape and canââ¬â¢t focus.
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Treating Low Blood Glucose If You Take Medicines That Slow Down Digestion
Some diabetes medicines slow down the digestion of carbohydrates to keep blood glucose levels from rising too high after you eat. If you develop low blood glucose while taking these medicines, you will need to take glucose tablets or glucose gel right away. Eating or drinking other sources of carbohydrates wont raise your blood glucose level quickly enough.
What If Im Experiencing Hypoglycemic Episodes Even Though My Doctor Has Confirmed That Im Not Diabetic Or Prediabetic
If you have low blood sugar and dont have diabetes or prediabetes, it can be a sign of another serious health issue such as a tumor, hormone deficiency, kidney disorder, anorexia, or other eating disorder, all of which can cause dangerously low blood sugar.
Anorexia has the highest mortality of any psychiatric disorder, and the cause of death can be hypoglycemia, so take your illness seriously and seek help if you suspect your eating disorder may be progressing to the point where it is causing you to faint or experience other signs and symptoms of dangerously low blood sugar. The National Eating Disorders Association has resources on how to identify the signs that you may have an eating disorder, a hotline for help, as well as easily accessible information on everything from how to know when you need help to how to find quality treatment options in your zip code.
People who are not diabetic don’t spontaneously have hypoglycemia for no reason, explains Dr. Christofides. Its often an indication of another underlying issue, such as a hormone deficiency or eating disorder, so its important to schedule an appointment with your doctor to determine the cause in order to prevent complications.
Common causes of hypoglycemia in people without diabetes include:
- Pancreatic tumor
- Medication that inhibits the proper production of insulin
- Hepatitis or kidney disorders
- Hormone deficiencies
- Anorexia and other eating disorders
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What Are The Complications Of Low Blood Glucose
Mild-to-moderate low blood glucose can be easily treated. But severely low blood glucose can cause serious complications, including passing out, coma, or death.
Repeated episodes of low blood glucose can lead to
- high blood glucose levels, if worry or fear of low blood glucose keeps you from taking the medicines you need to manage your diabetes8
- hypoglycemia unawareness, a condition in which you dont notice any symptoms of low blood glucose until your blood glucose level has dropped very low
Your Diabetes Devices And Hypoglycemia
Several insulin pumps are now available that make managing blood sugar levels easier, particularly when connected to a glucose meter or a CGM.
Some of the most important advantages of CGM devices are the improved insulin control and the ability to detect trends and lows early. With improved technology, it is now possible for parents to track blood sugar trends in their kids even when they are hundreds of miles apart .
In addition, automated insulin delivery systems, also known an artificial pancreas or a hybrid closed-loop system, will automatically adjust insulin to match your bodys need to help you spend more time in your target range.
Resources that provide people with T1D and their families with more detailed information about pumps and CGM devices are available through JDRF here. For people looking for a deeper understanding of technology that helps people with T1D better manage their blood sugar, JDRF resources are available here.
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Cuts Or Wounds That Are Very Slow To Heal
Its not uncommon for an individual with high blood sugars to get a bruise or cut that just does not heal.
This is particularly common on the extremities that are furthest from the heart, like hands or feet.
Why does this happen?: Sugar lingering in the bloodstream begins to damage the arteries and veins, which restricts circulation. Blood is required to facilitate healing, so limited circulation to a wound or bruise will slow the healing process dramatically.
What Causes Low Blood Glucose In People With Diabetes
Low blood glucose levels can be a side effect of insulin or some other medicines that help your pancreas release insulin into your blood. Taking these can lower your blood glucose level.
Two types of diabetes pills can cause low blood glucose
- sulfonylureas, usually taken once or twice per day, which increase insulin over several hours
- meglitinides, taken before meals to promote a short-term increase in insulin
The following may also lower your blood glucose level
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What Drinks And Foods Raise Blood Sugar Fast
- 4 teaspoons of sugar
- 1/2 can of regular soda or juice
Many people like the idea of treating low blood sugar with dietary treats such as cake, cookies, and brownies. However, sugar in the form of complex carbohydrates or sugar combined with fat and protein are much too slowly absorbed to be useful in acute treatment.
Once the acute episode has been treated, a healthy, long-acting carbohydrate to maintain blood sugars in the appropriate range should be consumed. Half a sandwich is a reasonable option.
If the hypoglycemic episode has progressed to the point at which the patient cannot or will not take anything by mouth, more drastic measures will be needed. In many cases, a family member or roommate can be trained in the use of glucagon. Glucagon is a hormone that causes a rapid release of glucose stores from the liver. It is an injection given intramuscularly to an individual who cannot take glucose by mouth. A response is usually seen in minutes and lasts for about 90 minutes. Again, a long-acting source of glucose should thereafter be consumed to maintain blood sugar levels in the safe range. If glucagon is not available and the patient is not able to take anything by mouth, emergency services should be called immediately. An intravenous route of glucose administration should be established as soon as possible.
Preventing A Low Blood Sugar Level
If you have diabetes, you can reduce your chance of getting a low blood sugar level if you:
- Check your blood sugar level regularly and be aware of the symptoms of a low blood sugar level so you can treat it quickly.
- Always carry a sugary snack or drink with you, such as glucose tablets, a carton of fruit juice or some sweets. If you have a glucagon injection kit, always keep it with you.
- Do not skip meals.
- Be careful when drinking alcohol. Do not drink large amounts, check your blood sugar level regularly, and eat a carbohydrate snack afterwards.
- Be careful when exercising eating a carbohydrate snack before exercise can help to reduce the risk of a hypo. If you take some types of diabetes medicine, your doctor may recommend you take a lower dose before or after doing intense exercise.
- Have a carbohydrate snack, such as toast, if your blood sugar level drops too low while you’re asleep
If you keep getting a low blood sugar level, talk to your diabetes care team about things you can do to help prevent it.
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How Do You Treat Hypoglycemia
Low blood sugar levels happen when theres too little glucose left in the bloodstream to continue supplying fuel to your organs, muscles, and tissues. It most often occurs when you dont eat enough food, especially carb-containing foods, given your blood-sugar-lowering medications and physical activity levels, ONeill says. Levels can decrease gradually or suddenly.
When the amount of glucose in the bloodstream drops to too-low levels, the body reacts by releasing epinephrine, also called adrenaline or the fight or flight hormone. Epinephrine revs your heart rate and can cause sweating, shaking, anxiety, and irritability. If not enough glucose is able to reach the brain, the result may be difficulty concentrating, confused thinking, and slurred speech. In extreme cases, a lack of glucose within the brain can lead to seizures, coma, and even death, she says.
People with low glucose levels can use the ADAs 15-15 Rule, which advises people consume 15 g of carbs, wait 15 minutes, and check their levels again. If the number is still low, repeat until reaching at least 70 mg/dL.
You can find 15 g of carbs in:
- 1 slice of bread
- 1 small piece of fresh fruit
- cup of yogurt
- Three to four hard candies
- Glucose tablets as indicated on the label
- Glucose gel as indicated on the label
Once your glucose levels are back to normal, the ADA suggests going ahead and eating your next scheduled meal or snack, which will help prevent levels from dropping again.
How Can I Be Better Prepared For Hypoglycemia
You can take some steps to be ready for hypoglycemia:
- Be aware of the symptoms and treat them early.
- Carry some fast-acting carbs with you all the time.
- Check your glucose levels frequently, especially around meals and exercise.
- Inform family, friends and co-workers so they know what do if you need help.
- Talk to your healthcare provider regularly to make and update your plan.
- Wear a medical bracelet that lets people know you have diabetes. Carry a card in your purse or wallet with instructions for hypoglycemia.
A note from Cleveland Clinic
Hypoglycemia is quite common in people with diabetes. If not treated, it can cause troubling symptoms, and even serious health problems. Fortunately, you can avoid hypoglycemic episodes by monitoring your blood sugar. You can also make small adjustments to eating and exercising routines.
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What Are The Signs Of High And Low Blood Sugar
The symptoms vary depending on whether you have hyperglycemia or hypoglycemia. Find out how to spot the warning signs and stabilize your glucose.
Alamy
One of the challenges of managing diabetes is maintaining consistent blood sugar levels. Even with diligence, some situations can cause high blood sugar, or hyperglycemia, while others can bring on low blood sugar, or hypoglycemia.
After all, its not just carbohydrate intake that influences the amount of glucose coursing through your bloodstream when you have type 2 diabetes. Emotional stress and certain medications can increase your blood sugar levels, and a boost in activity can cause it to drop, says Megan ONeill, CDCES, a medical science liaison for diabetes care at Abbott healthcare company in Monterey, California. Sometimes people experience a spike in their blood sugar early in the morning due to the dawn effect, a temporary surge of hormones that occurs as the body prepares to wake, according to the Cleveland Clinic.
For people with diabetes, managing blood glucose levels is especially important, ONeill says. Levels that are too low or high can result in complications that affect your kidneys, heart, and vision, reduce your quality of life, require expensive interventions, or even be fatal.
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- Between 80 and 130 milligrams per deciliter before meals
- Less than 180 mg/dL two hours after meals
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Excessive Thirst Is One Of The Classic Early Signs Of Diabetes
Drinking unusually large amounts of fluids throughout the day and even overnight is a glaring symptom.
Intake can be something like 4 litres or more per day. You can even start to feel thirsty immediately after youve just had a drink.
The more you drink, the more you urinate, which feeds back into the excessive urination cycle.
Why does this happen?: This is the bodys response to increased urination. With all that extra fluid loss, you become very dry and thirsty.
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What Are The Treatments For Hypoglycemia
Make an appointment with an endocrinologist if you feel like youre having episodes of hypoglycemia, even if youre not diabetic. Theyll talk you through treatment strategies, including:
- Adjusting your medications. You may need to change how often you take insulin or other medications, which medications youre on, how much you take, and when you take them.
- Working with a registered dietitian on a personalized meal plan that stabilizes blood sugar levels. Theres no one-size-fits-all hypoglycemia diet, but a nutritionist can help you figure out a consistent meal plan tailored to you, and teach you how to count carbohydrate grams to go along with your health and routine.
- Increasing and improving self-monitoring of your blood glucose levels. Knowing your blood glucose level throughout the daywhen you get up, before meals, and after meals etc.can help you keep it from getting too low.
- Limiting consumption of alcoholic beverages. Alcohol interferes with the way your body metabolizes glucose. If you’re prone to hypoglycemia, consider decreasing how much alcohol you consume.
- Glucose tablets . Make sure you always have glucose tablets on hand, whether at home, school, the office, or the gym. After taking the tablet, check your blood sugar. If its still low, take another tablet. If that doesnt help, check with your doctor.
Slurred Speech And Clumsiness
Your sugar-starved brain may change the way you sound. Slurred speech is a common symptom associated with blood sugar levels that drop below 40 mg/dL, according to University of Michigan Health Systems. Combined with clumsiness another sign of low blood sugar you may seem as though you’ve had a few too many cocktails, even if you haven’t touched a drop, according to the National Health Service.
For more on managing low blood sugar, check out Diabetes Daily’s article “How to Treat Lows Without Sabotaging Your Diet!“
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Does Everyone Have Symptoms From Hypoglycemia
Some people dont have symptoms or dont notice them. Healthcare providers call that situation hypoglycemia unawareness. People with such a challenge arent aware when they need to do something about their blood sugar. Theyre then more likely to have severe episodes and need medical help. People with hypoglycemia unawareness should check their blood sugar more often.
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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