Hypoglycemia (Low blood Sugar)

Hypoglycemia is dangerous because the brain is almost entirely dependent on glucose for normal functioning. If levels drop too low, it starts to work less well and produces the following symptoms:

1. Feeling sweaty
2. feeling weak with shaking or trembling hands and fingers.
3. Tingling around your lips
4. Feeling hungry
5. Blurred vision
6. Feeling upset or angry
7. Unable to concentrate
8. Looking pale
9. Feeling drowsy
10. Sometimes, people suffering from low blood glucose may behave oddly, so that others may suspect them of being drunk!
11. If the level drops even lower unconsciousness (coma) may result.

What are the reasons behind these attacks of hypoglycemia?

• Eating later than you had expected or planned: If you’ve had your insulin injection and then can't eat for some reason, you should eat a small carbohydrate snack (such as an apple or some crackers), which you ought to have handy at all times. Glucose tablets are often useful and people who are prone to such reactions should always carry a convenient source of glucose.
• Sudden unexpected exercise: such as running for a bus.
• Drinking too much alcohol: When your liver has to break down excessive quantities of alcohol, it can't produce glucose at the same time. This is why you are advised not to drink too much if you're on insulin or taking sulfonylureas.

How to protect yourself from attacks of hypoglycemia?

Performing a blood glucose test at home means you can find out quickly and easily whether your level is getting too low and take action if necessary. One of the most important aspects of caring for patients with diabetes is trying to ensure that they don’t suffer from hypoglycemic reactions. This involves the individual concerned discussing their treatment and adjusting it if necessary to fit in with their lifestyle, especially with their meal and work patterns. Most people who are taking insulin can use their symptoms as a signal that they need to have some food fairly quickly.

However, just which symptoms you get and how severe they are is an individual thing. Some people feel hungry before noticing anything else, others experience tingling round the lips or shakiness, for example. You may not experience all of these symptoms, but it is usual to have a headache after hypoglycemia

You usually have to accept that there is no alternative to sticking to regular mealtimes, however inconvenient you may find it. However with the wide range of different insulins and types of injection device, it is usually possible to arrive at a treatment program that will suit you.

Having frequent hypoglycemic attacks is a sign that you need to go back to your doctor or diabetic team to see how your treatment and/or your eating pattern can be adjusted to prevent them happening.

What should you do when you experience hypoglycemia?

A mild hypoglycemia can usually be dealt with simply a glass of juice. It's important to remember that diet soft drinks contain artificial sweetener rather than sugar, so they are of no use to you in this situation. Make sure too that, wherever you are, you always carry some sort of readily available sugars. This is especially important if you're about to take some form of vigorous exercise. Some steps you should do when you develop hypoglycemia:

1. Take some quick-acting carbohydrate, such as glucose tablets or a glucose drink
2. As soon after as you can, eat some slower-acting carbohydrate such as sandwiches or toast
3. Check your blood glucose level if possible
4. Take more glucose if your symptoms persist
5. If you're due to have a meal or a snack, eat something as soon as you can
6. If your symptoms still don't disappear, seek medical advice

In severe hypoglycemia you may find that your blood glucose level drops so rapidly that you don’t have time to take the corrective action described above. You may become drowsy or unconscious, and might even have an epileptic seizure. This is obviously a frightening prospect both for you and for those close to you, and you need to take action to make sure it doesn't happen again. This means getting advice from your medical team to sort out the problem. There are various ways of dealing with a person who is having a severe hypoglycemic reaction:

• When you're not in a state to eat or drink anything, a sugary gel can be squirted into your mouth or rubbed on your gums. This should not be done if the person is having a seizure.
• A hormone called glucagon, which causes blood glucose to rise is available in injectable form. You may be given an injection into your arm or buttock to bring you round, so you can then have something to eat or drink.

Can I develop hypoglycemia while sleeping?

It’s natural for you and your family to worry that you might have a hypoglycemic reaction while you’re asleep, or even that you might have one and not wake up. This is an especially frightening prospect when you are the parent of a small child with type l diabetes. In reality, the problem is by no means so dramatic or serious. First, you are quite likely to be woken up by the symptoms of falling blood glucose. You may start sweating and feel restless or irritable. Occasionally, your restlessness may wake your partner even if you continue to be asleep.

It’s not unusual to sleep right through a severe hypoglycemic reaction. Your body mobilizes various hormones in response to the falling level of glucose which will stimulate the release of stored glucose to correct the situation. After a reaction like this, you will wake up with a headache and symptoms much like a bad hangover.

Sometimes, there may be a swing too far in the opposite direction, so that your blood glucose rises too far. If you regularly wake up feeling bad with these sorts of symptoms it’s a good idea to take a few early morning (2:00 a.m. through 4:00 a.m.) blood glucose tests to see if you are having hypoglycemic reactions which you’re not aware of at the time. At least then You will know why you’re feeling so bad and you need to talk to your doctor about whether your nighttime dose of insulin needs adjusting or altering to a different type.

Can hypoglycemia be avoided by constant high blood glucose levels?

Having persistently high blood glucose levels will avoid hypoglycemia, but unfortunately this dramatically increases the risk of developing the complications of diabetes. Maintaining the balance between risky hyperglycemia and troublesome hypoglycemia can be very difficult for patients on insulin, but is much easier these days with the different preparations and injection devices available.

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