Warning Signs Of Low Blood Sugar
Hypoglycemia can cause both short- and long-term complications. Know the signs so that you can treat the condition as soon as you’re aware of it.
As a person living with diabetes, you know how important it is to reduce blood sugar when it is too high, a phenomenon called hyperglycemia. But blood sugar that is too low, or hypoglycemia, is equally critical to avoid.
“Hypoglycemia happens when the amount of blood glucose drops to a level that’s too low to sustain normal functioning,” says Erin Palinski-Wade, RD, CDCES, who is based in Sparta, New Jersey. “In most people, this is defined as a blood sugar level at or below 70 milligrams per deciliter .”
Hypoglycemia is common among people with type 2 diabetes, according to a review published in June 2015 in the journal PLoS One. Individuals with the condition had an average of 19 mild or moderate episodes of hypoglycemia per year and nearly one severe episode per year on average, according to the researchers. Low blood sugar was particularly common among those taking insulin.
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This decrease in blood sugar levels can cause both short-term complications, like confusion and dizziness, as well as more serious issues, including seizures, coma, and, rarely, death, according to the American Diabetes Association .
Hypoglycemia is usually the result of a too-high dose of insulin or a change in diet or exercise habits, according to Harvard Health Publishing.
Act Quickly To Treat The Situation
If you suspect you have low blood sugar, Dr. Fruge recommends quickly treating the situation, which she says should include “eating healthy foods such as complex carbohydrates, beans or fruit.”
“At the Pritikin Longevity Center we serve a cup of fruit with a cup of veggies to prevent a spike in insulin, which can sometimes lead to a later drop in blood sugar again,” she explains. “Adjusting your diabetes medication as prescribed by your physician may also be necessary. It’s important to retest your blood sugar 20 minutes after eating to confirm it has improved.”
Keep a fast-acting carbohydrate snack or two on hand in case your blood sugar dips below healthy levels.
What Is Hypoglycemia And Low Blood Sugar
Hypoglycemia is the state of having a blood glucose level that is too low to effectively fuel the body’s cells.
Glucose, which comes from carbohydrates found in foods, is a main source of energy for all of the cells of the body and, especially, the brain. While the body is quite good at extracting glucose from the foods we eat, it relies on a hormone called insulin to actually get the glucose inside the cells of specific organs: the liver, fat, and muscle.
We can think of insulin as holding the key to a cell without insulin, the glucose just remains in the blood, where its also known as blood sugar. During an episode of hypoglycemia, theres not enough glucose in the blood. The normal range is approximately 70 to 150 mg/dl .
Hypoglycemia is most common in newborns. In older children, its most often seen as a complication of insulin therapy for diabetes but can sometimes have other causes as well.
In the majority of cases, hypoglycemia is temporary, easily treated, and usually does not have serious consequences. There are several rare disorders in which hypoglycemia is recurrent and potentially life-threatening. However, with timely diagnosis and appropriate treatment, these can be effectively managed.
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With Elena Christofides and Jennifer Shine Dyer MD, MPH
When youre diabetic, a severe drop in blood sugar can strike even when youre doing everything right. Glucose is your bodys main source of energy and fuels your brain, so its critical to recognize the early signs of an episode before it becomes severe enough to cause you to pass out or worse. Were here to empower you with clear answers to all your pressing Qs.
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What Is Low Blood Sugar
Low blood sugar, or low blood glucose, from a medical perspective, is called hypoglycemia and refers to low blood serum glucose levels. Glucose is the “sugar” which is low in this case, and when it drops below 70 mg per deciliter of blood, a person is concerned hypoglycemic. People may also use the term low blood sugar much more casually to express hunger, or feelings of faintness or irritation that come over them when they skip meals. Some people will feel a little nauseous if they don’t eat regularly and may attribute this to abnormally lowered blood sugar even if they’re not technically hypoglycemic.
True hypoglycemia has numerous causes. People most commonly prone to hypoglycemia are those with diabetes, whose bodies do not make enough or cannot properly use the hormoneinsulin, which allows glucose to be used as energy by cells. Diabetics must regularly monitor their blood sugar levels to make sure they have the proper balance of insulin and glucagon, which produces glucose. Low blood sugar could be a result of skipping meals or accidentally injecting too much insulin. Other conditions that might result in low glucose levels include absence of human growth hormone, certain antibiotics or other medications, liver failure or liver insufficiency, extreme food poisoning or stomach flu, and some infections.
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How Do You Feel If Your Blood Sugar Is Low
If your blood sugar is low, you may feel out of it confused, annoyed, and without focus. You should treat lows immediately, whether your glucose is below 70 mg/dL or trending toward that number, and whether or not you are feeling symptoms.
Its important to take hypoglycemia seriously. Read on to learn what to do when your blood sugar is low.
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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Signs That Blood Sugar Levels Are Low
There are a bunch of symptoms that someone with low blood sugar might have. It’s not the same for everybody. The symptoms are as minor as feeling hungry and as serious as having seizures or passing out. Have you ever had low blood sugar? If so, do you remember how it felt? Noticing those problems early can help you if it happens again.
If you have diabetes and you have low blood sugar, you may:
- feel hungry or have “hunger pains” in your stomach
- feel shaky or like you’re trembling
- have a rapid heart rate
- feel sweaty or have cold, clammy skin
- have pale, gray skin color
- have a headache
- be unsteady or stagger when walking
- have blurred or double vision
- feel confused
- have seizures
- pass out
If you think your blood sugar level could be low, tell a parent, teacher, or whoever is taking care of you. An adult can help you test your blood and get you treatment so you start feeling better.
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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Exams And Tests For Hypoglycemia
The doctor will assess the adequacy of the patient’s medications. Changes in eating habits or in their medication regimen may be recommended. A blood test known as the hemoglobin A1c may be performed to assess the patient’s blood sugar control over the past three-month period.
Kidney function and liver function may be checked. If low sugar is unexplained, then further tests are indicated to assess adrenal gland function and to rule out insulinoma or other problems as causes of hypoglycemia.
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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How To Treat A Low Blood Sugar Level Yourself
Follow these steps if your blood sugar level is less than 4mmol/L or you have hypo symptoms:
You do not usually need to get medical help once you’re feeling better if you only have a few hypos.
But tell your diabetes team if you keep having hypos or if you stop having symptoms when your blood sugar level is low.
Prevention Of Low Blood Sugar
Do not skip or delay meals. If your diet plan includes snacks, make sure to take these.
Measure insulin dosage carefully and inject it properly. If you cannot see well, a family member or a visiting nurse can prepare your insulin injections for you.
Take only the prescribed amount of insulin or oral medication for diabetes that your doctor has ordered.
Keep exercise consistent from day to day. Eat a snack or reduce your insulin prior to unusual exercise.
If you are taking insulin, notify your doctor if you have low blood sugars four or more times per week or if you have a severe low blood sugar. Severe low blood sugars are those less than 40 mg., those requiring help from another person, or those which cause you to have a convulsion or become unconscious.
If you are taking oral medication for your diabetes notify your doctor or nurse if blood sugars are running less than 80 mg. or if you have a severe low blood sugar.
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Nighttime Low Blood Sugar
While low blood sugar can happen at any time during the day, some people may experience low blood sugar while they sleep. Reasons this may happen include:
- Having an active day.
- Being physically active close to bedtime.
- Taking too much insulin.
- Drinking alcohol at night.
Eating regular meals and not skipping them can help you avoid nighttime low blood sugar. Eating when you drink alcohol can also help. If you think youre at risk for low blood sugar overnight, have a snack before bed.
You may wake up when you have low blood sugar, but you shouldnt rely on that. A continuous glucose monitor can alert you with an alarm if your blood sugar gets low while youre sleeping.
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.
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Complications From Spells Of Hypoglycemia
Mildly low blood sugar levels are somewhat common for people with diabetes however, severely low blood sugar levels can be life threatening. They may lead to seizures and nervous system damage if left untreated long enough. Immediate treatment is critical.
Its important to learn to recognize your symptoms and treat them fast. For people at risk for low blood sugar, having a glucagon kit a medication that raises blood sugar levels is important. Talk with your doctor for more information.
You may also want to talk with friends, family members, exercise partners, and co-workers about how to care for you if your blood sugar drops too low.
Its important for them to learn to recognize low blood sugar symptoms and know how to use the glucagon kit, as well as understand the importance of calling 911 if you lose consciousness.
Wearing a medical identification bracelet is a good idea. It can help emergency responders care for you properly if you need emergency attention.
Treat low blood sugar as soon as possible. Avoid driving if you are experiencing low blood sugar, as it can increase your risk for having an accident.
There are several ways that you can prevent low blood sugar.
Low Blood Sugar And Nausea
Whether people have diabetes or not, when they have mild low blood sugar, they may feel extremely hungry, often also nauseated. This symptom combination is the first sign of low blood sugar and is caused by the release of the stress hormone epinephrine, also known as adrenaline.
When your blood sugar drops, it triggers the fight-or-flight response, causing a surge of adrenaline. This flood of adrenaline functions as a helper, moving stored glucose into the bloodstream quickly. However, this surge isnt without effects. Other symptoms like sweating, shakiness, and anxiousness can also be caused by this process.
That said, people with diabetes shouldnt assume their nausea is always related to low blood sugar. The only way to know for certain is to measure your blood sugar. If your levels are within the normal range, other factors may be contributing to your nausea.
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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.
What Is Glucose And Why Is It So Important
Glucose is a simple sugar, a component of the carbohydrates found in most foods. When broken down, glucose is the main form of energy for the body, particularly for our muscles and brain its the fuel that the brain runs on. Though glucose is necessary for the body, the amount of glucose in the blood must be tightly regulated: too much or too little glucose in the blood can lead to hypoglycemia, hyperglycemia, and long-term health complications. As glucose circulates in the blood and comes into contact with muscle and fat cells, insulin is required to allow glucose to enter the cells to be used or stored for energy. Between meals, the liver produces glucose to fuel the body.
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What Causes Hypoglycemia
If you have diabetes, there are common triggers to avoid. If youre diabetic and experience any of the above low blood sugar symptoms after any the following behaviors, its important to alert your physician to see whether you have dangerously low blood sugar.
- Too few carbohydrates. As carbohydrates are your bodys main source of glucose, not having enough of them can cause a drop in blood sugar.
- Skipping meals. Just like consuming too few carbohydrates, skipping meals can prevent your body from receiving the energy it needs from glucose.
- Strenuous physical activity. Exercising more than usual, especially if you haven’t eaten enough carbohydrates at a meal, can cause a hypoglycemic episode.
- Excessive drinking. Alcohol can interfere with your bodys ability to metabolize glucose.
- Not eating soon enough after insulin treatment. If you take insulin as prescribed during mealtimes, but delay eating, this can cause hypoglycemia.
- Too much insulin. If you take too much insulin, this can cause your blood sugar to crash.