Questions Caregivers Should Ask
As a family member, friend, or caregiver, you want to do your best to keep your loved one, friend, or patient safe from severe hypoglycemia. But knowing whats best can be overwhelming. Here are some questions to help you get started.
- What are my loved ones/friends/patients chances for severe hypoglycemia?
- How often should my loved one/friend/patient check their blood glucose?
- What should I do if there is no change after giving the glucagon?
- What would be the best food or drink to give my loved one/friend/patient once they wake up?
- Should I talk with a diabetes educator?
- How can I help treat their hypoglycemia?
What Complications Can Be Caused By Hypoglycemia
Passing out from low blood sugar because you have not recognized the early signs and symptoms is called hypoglycemia unawareness, and can be quite dangerous depending on where you are, explains Dr. Klonoff. As doctors are required to report such incidents to the Department of Motor Vehicles, it can also mean a suspended drivers license.
If this is something youre worried about, Wearing a continuous glucose monitor with an alarm for hypoglycemia can alert a person who is prone to developing low blood sugar levels that their blood glucose concentration is becoming dangerously low, so appropriate preventive action can be taken before they lose consciousness, explains Dr. Klonoff.
The Dangers Of Low Blood Glucose
At some time, most people with diabetes experience the sweating and shakiness that occurs when blood glucose levels fall below 70 mg/dl a condition known as hypoglycemia. The average person with type 1 diabetes may experience symptoms of low blood glucose up to two times a week. However, not all are aware that these symptoms can rapidly progress to seizures, coma and even death if hypoglycemia is severe. Though hypoglycemia can be common and occur repeatedly in some people with diabetes, symptoms of low blood glucose should always be taken seriously. People with diabetes and their families, friends or coworkers should be prepared to act quickly and responsibly at the earliest signs of low blood glucose.
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Possible Causes Without Diabetes
Even if you dont have diabetes, you may experience low blood sugar. However, hypoglycemia is much less common in people without diabetes.
Some possible causes of low blood sugar in people who dont have diabetes are:
- certain medications, such as quinine
- some medical conditions, such as hepatitis and kidney disorders
- a tumor that produces excess insulin
- endocrine disorders, such as adrenal gland deficiency
About High Blood Sugar
High glucose levels occur when the body doesn’t have enough insulin or can’t properly use the insulin it has to shuttle glucose from the bloodstream to the bodys muscles, organs, and tissues for fuel, ONeill says. As a result, the amount of sugar in the blood builds up.
Hyperglycemia typically happens when you consume more carbohydrates or bigger portions of food than usual if you don’t take enough insulin or other diabetes medication as prescribed and if you decrease your levels of physical activity, she says. Heightened stress levels can also increase blood sugar levels. Non-diabetes-related medications that are known to raise blood sugar levels include steroids, beta-blockers, birth control pills, and many mental health medications, she explains.
Signs of high blood sugar include frequent urination, fatigue, dry or itchy skin, feeling thirsty, more frequent infections, and eating more food but not gaining as much weight as usual, says Athena Philis-Tsimikas, MD, the corporate vice president for the Scripps Whittier Diabetes Institute in La Jolla, California.
High blood sugar levels can cause these symptoms through various mechanisms, according to the Mayo Clinic. For example, high blood sugar levels damage blood vessels and nerves throughout the body. They can also deprive organs of energy and can cause fluid to accumulate in the eyes. And in an attempt to get your blood sugar to a healthier level, your body will often increase urine output.
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What Are The Symptoms Of Low Blood Sugar How Do I Know Im Experiencing A Low Blood Sugar
All this talk about lows, and we havent told you what to watch out for! Shame on us.
The signs and symptoms of low blood sugars happen quickly, can vary a lot, and can even be different each time. The American Diabetes Association has a comprehensive list:
When To Call 911
Your friend, relative, or coworker should call 911 for help if:
- You pass out and no glucagon is available
- You need a second dose of glucagon
- You had glucagon, but are still confused
- Your blood sugar stays too low 20 minutes after treatment or doesnt respond to your usual treatments
The emergency medical technicians can give you IV sugar . This raises your blood sugar level right away. You might need to stay in the hospital for a few hours.
NEVER be afraid to call 911 or ask someone to call 911 for you if you are concerned .
Other things to know about hypoglycemia:
It takes time for blood sugar to rise after eating, and its important to give your first treatment time to work. Use the table above to guide your treatment and timing instead of eating until you feel better, which will almost always lead to eating too much.
Hypoglycemia can be common with certain types of exercise. Managing blood sugar during and after physical activity is important and is something that a lot of people with T1D have questions about. JDRF has a number of resources available for people with T1D and their families, many of which can be found here.
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A Low Blood Sugar Level And Driving
You may still be allowed to drive if you have diabetes or you’re at risk of a low blood sugar level for another reason, but you’ll need to do things to reduce the chance of this happening while you’re driving.
You also need to tell the Driver and Vehicle Licensing Agency and your car insurance company about your condition.
For more information, see:
Always Remember If In Doubt Treat
1. Eat or drink 1 serving of a quick-acting carbohydrate. Each of the following is 1 serving:
- 3 teaspoons of glucose powder in water
- of glucose tablets
- 3 teaspoons of jam or sugar
- a small glass of sugar-sweetened lemonade or cordial
- 6 large jelly beans/5 Mentos.
2. After 10 minutes test your blood glucose again. If it is still less than 4mmol/L, have another serving of quick-acting carbohydrate from the list above.
3. Once your blood glucose is above 4mmol/L, eat some carbohydrate food or if its your mealtime, eat your meal.
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Nighttime Low Blood Sugars
You may experience a low blood sugar night. The low blood sugar might wake you up and your symptoms might be similar to those you have during the day. However, the symptoms may be different. You might have nightmares, sleep poorly, perspire, or feel hot and cold. In the morning you may have a headache, feel nauseated, or feel confused. Notify your doctor if this happens. Check your blood sugar at the time you have the symptoms.
Treatment for a low blood sugar that occurs at night is the same as described earlier.
Your doctor may request that you check a 3:00 a.m. blood sugar 1 to 2 times per week in order to detect any low blood sugars during the night.
Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health care professional.
Treating Mild To Moderate Hypoglycemia
If you start feeling any of the symptoms listed above, check your blood sugar as soon as possible, then follow the chart below to treat low blood sugar. If you have any concerns, or cant test immediately, its best to treat first and check when possible.
If your blood sugar is
What to do next
51 to 70 mg/dL
10 to 15 grams of fast-acting carbs, such as 4 ounces of fruit juice, 6 to 8 hard candies, or 3 to 4 glucose tablets.
Test your blood sugar again in 15 minutes. Repeat the treatment if necessary.
Under 50 mg/dL
Eat 20 to 30 grams of fast-acting carbs, such as 8 ounces of fruit juice, 12 to 16 hard candies, or 6 to 8 glucose tablets.
Test your blood sugar again in 15 minutes. Repeat the treatment if necessary.
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Examples Of Appropriate Snacks May Be:
- 6 saltine crackers
- 1 slice toast and 1/2 cup milk
- 1 cup milk
The food eaten for a reaction need not be subtracted from a meal plan.
Obtain a blood sugar when symptoms occur if you are able. If symptoms are severe, treat the reaction first and then obtain a blood sugar. Do not drive nor operate equipment if you feel your blood sugar is low.
If your blood sugar drops low enough for you to become unconscious, you must be taken to the hospital and/or treated with glucagon.
Glucagon is a hormone that causes the blood sugar to rise. It can only be given by injection. It is used to treat a low blood sugar if a person becomes semi-conscious or unconscious due to a severe low blood sugar. Please ask your nurse for instruction on glucagon. Your doctor will need to write a prescription for glucagon so you can have it available at home.
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How To Restore Your Blood Sugar
If you notice you have low blood sugar, the most important thing to do is to take action immediately.
The leading cause of low blood sugar is food, which produces the glucose that converts into energy and used by our cells. So if you have the condition, the following tips are your best bet to increase blood sugar.
Take High Carbohydrate Snack
Consuming snacks that contain a high amount of carbohydrate can help you restore low blood sugar level. According to the American Diabetes Association having snacks that contain at least 15 grams of Carbohydrates is what you need t increase blood sugar level. Examples of snacks are
- Fruit juice
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Digestive Endocrine And Circulatory Systems
After you eat, your digestive system breaks down carbohydrates and turns them into glucose. Essentially, glucose is your bodys fuel source.
As your sugar levels rise, your pancreas releases a hormone called insulin, which helps glucose get taken up and used by cells throughout your body. If you have insulin-dependent diabetes, you must take the right about of insulin to get the job done.
Any excess glucose goes to your liver for storage.
When you go a few hours without eating, blood sugar levels go down. If you have a healthy pancreas, it releases a hormone called glucagon to make up for the absence of food. This hormone tells your liver to process the stored sugars and release them into your bloodstream.
If everything works as it should, your blood sugar levels should remain in the normal range until your next meal.
Insufficient blood sugar levels can cause a rapid heartbeat and heart palpitations. However, even if you have diabetes, you may not always have obvious symptoms of low blood sugar. This is a potentially dangerous condition called hypoglycemia unawareness. It happens when you experience low blood sugar so often that it changes your bodys response to it.
Normally, low blood sugar causes your body to release stress hormones, such as epinephrine. Epinephrine is responsible for those early warning signs, like hunger and shakiness.
How Can I Help My Child Live With Hypoglycemia
Children with type 1 diabetes or other conditions that may cause hypoglycemia need to follow their care plan. Its important to test blood glucose often, recognize symptoms, and treat the condition quickly. It’s also important to take medicines and eat meals on a regular schedule.
Work with your child’s healthcare provider to create a plan that fits your child’s schedule and activities. Teach your child about diabetes. Encourage them to write down questions they have about diabetes and bring them to healthcare provider appointments. Give them time to ask the provider the questions. Check that the answers are given in a way your child can understand. Work closely with school nurses, teachers, and psychologists to develop a plan that’s right for your child.
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How Does Hypoglycemia Occur Without Diabetes
Hypoglycemia usually happens to people living with diabetes, but its possible to have low blood sugar without diabetes.
Blood sugar, or glucose, is what your body uses for energy. After eating a meal or drinking a beverage, the hormone insulin allows sugar to enter your bodys cells, where its used for energy. Insulin is a hormone produced by your pancreas.
Hypoglycemia occurs when you have too much insulin in your bloodstream. This might happen if you dont eat for several hours, such as 8 hours or more. A drop in blood sugar means there isnt enough glucose in your bloodstream to fuel your brain and body.
Low blood sugar without diabetes can also occur if you take a medication that lowers your blood sugar. These include pain relievers like:
- blood pressure medication
- some antibiotics
Other causes of low blood sugar without diabetes include binge-drinking and increased physical activity.
Plus, some medical conditions can increase the amount of insulin your pancreas produces. These include a pancreatic tumor, adrenal gland disorders, and hepatitis.
You could also experience low blood sugar if you have prediabetes, or if you eat a lot of refined carbohydrates, such as white bread, pasta, and pastries.
How To Test Your Blood Sugar At Home
To perform a blood sugar test, you will need to prick your finger with a lancet . Youll put a small sample of blood from this onto a strip inserted into the blood glucose meter.
Before you test your blood sugar at home, its important to find out from your doctor what a healthy blood sugar range is for you. Your doctor will determine this range based on factors such as:
- the type of diabetes you have
- how long youve had diabetes
- your age
- whether you have any other chronic health conditions
If you dont have a blood sugar testing machine on hand and are experiencing signs or symptoms of low blood sugar with diabetes, your symptoms may be enough to diagnose low blood sugar.
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What To Do When Your Blood Sugar Drops
Well, one of the best ways is to eat to get blood sugar up. If you are suffering from diabetes and you think that you have hypoglycemia, it is important to check your blood sugar levels. If you feel that the blood sugar levels drop after you eat a meal, you need to change the diet you are following. You need to avoid taking any foods that are high in sugar content and stick to eating small meals during the day.
If you are having low blood sugar levels even when you havent eaten anything, you can try having a snack before hitting the bed. You can eat a snack that is rich in protein or complex carbohydrate.
In case the doctor finds out that too much if insulin is causing trouble, he/she might as well reduce the dose and observe the levels. Do follow the below mentioned routine when you have low blood sugar levels.
Test The Sugar Levels Well, this goes without saying. But, remember that the value less than 70 milligrams per deciliter means you have low blood sugar.
Try To Eat or Even Drink Some Fast Acting Carbs When you are suffering from low blood sugar, you certainly need to act quickly. You need to consume at least 15 gms of carbs. You can try taking about 4 ounces of juice or just have a tablespoon of sugar with water.
Glucose Tablets or Gel You can as well take glucose tablets or opt for the glucose gel. Medical experts say that people who take medications for diabetes need to carry glucose tablets with them for sure.
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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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What Else Can You Do To Control Blood Sugar Levels
Yes. People with diabetes should wear identification stating they have diabetes and whether they have recurrent low blood sugar. Those at risk for the health condition should be counseled on checking blood sugars before they drive a car, operate heavy machinery, or do anything physically taxing. In addition, it is important to carry a quick-acting glucose source at all times, and keep a source in their car, office, and by their bedside. Efforts should be made to minimize the hypoglycemic effects of drug regimens and to avoid variable surges in exercise, activity, and drinking alcohol.