Low Blood Sugar



Blood sugar testing kit

Most healthy people maintain a blood-sugar level above 70 mg/dL; anything lower would be considered as low blood sugar or hypoglycemia - medical term, literally means "under-sweet blood."



Signs and Symptoms

Most hypoglycemia symptoms would start developing when the blood sugar levels go below 65 mg/dL. The principal problems develop from an insufficient supply of sugar to the brain, resulting in compromised brain function.

Low blood sugar can produce a variety of symptoms, ranging from vaguely "feeling bad" to seizures, unconsciousness, permanent brain damage or death. See hypoglycemia symptoms for a more detailed clarification.

 

Diagnosis

It can be difficult to determine if the symptoms are caused by low blood glucose, or are only incidental. Principles applied in the Whipple's Triad are therefore used to determine a diagnosis of hypoglycemia. 

Whipple's Triad

Whipple's Triad:

  1. Symptoms known or are likely caused by hypoglycemia.
  2. Low plasma glucose measured at the time of the symptoms.
  3. Reversal or improvement of the symptoms when the glucose is restored to normal.


Causes of Low Blood Sugar

The most common occurrence of low blood sugar is due to complications of diabetes treatment. However, hypoglycemia can also  occur for many other reasons, as expanded on this non-diabetic hypoglycemia page.

When taking medication, orally or injections, that increase insulin, the amount of glucose present must match the available insulin. So, if your meals are not in sync with your insulin medications, hypoglycemia can develop. 

Increasing your physical activity beyond your normal routine is accompanied by a greater demand for glucose that can last up to 24 hours after the activity. Stored glycogen might not be enough to cope with the higher glucose demand. The liver might also not be able to keep up with the glycogen conversion to glucose needed to supply the larger glucose requirement.

Alcohol affects the stability of blood-glucose  levels, especially if taken without having enough food in the stomach. In addition, alcohol makes you insensitive to the symptoms of low blood sugar, which can lead to severe hypoglycemia. When unconscious from hypoglycemia with alcohol detected on the breath, treatment for hypoglycemia could be delayed long enough to cause permanent brain damage.

When you are ill and are unable to keep the food down or not eat enough, adjust your medication accordingly to avoid low blood sugar.


Treatment for Hypoglycemia

When you notice/feel one or more hypoglycemia symptoms, check your blood-glucose. Even if you are unsure about the symptom, check anyway. When the reading is low, (below 70 mg/dL) ingest some carbohydrates. Wait 15 minutes and re-check your blood-glucose levels, if it is still down, rinse and repeat. 

Carbohydrate sources to try, are glucose tablets or gel, fruit juice (not low calorie variety), soda (not diet soda), raisins, sugar, honey or corn syrup. Where there are medications involved that slows down digestion, like Acarbose or Miglitol, pure glucose (tablets or gel) must be used. Other sources of carbohydrate will take too long to reverse your hypoglycemia.

This is where your knowledge of your own body is invaluable. You must know how much and type of carbohydrate your body requires to raise your blood glucose to acceptable levels. 

It is vital that the people normally around you are knowledgeable about your disease. They must know how to recognize the symptoms and what to do when it appears, and you are in denial or are unable to respond. It is up to you to inform/teach/train them; nobody else will, and it is after all your life that is on the line. Discuss with your doctor, as to what/how they must know.


Preventing Low Blood Sugar

Keep a complete record of all your hypoglycemic episodes, how you felt and what you done about it. This information would be valuable when meeting with your doctor to find ways of preventing hypoglycemia.

The key to preventing hypoglycemia is understanding what caused previous events and avoiding the same circumstances. With the assistance of your health care team, adjust medications as needed and/or modify your diet and activity routine.

Find much more detail on preventing hypoglycemia in Dr. Bernstein's Diabetes Solution

An ounce of prevention is worth a pound of cure

Learn what can cause low blood-glucose levels for you and pro-actively handle it, before it develops into hypoglycemia.

Check your blood glucose regularly, to anticipate possible low levels, especially before driving.

Always have your glucose test kit available, as well as "quick-fix" foods and drinks. Glucose tablets and/or gel are convenient to carry around and superb for quick blood sugar boosts. 


Hypoglycemia Unawareness

With low blood sugar, the body releases stress hormones, such as epinephrine, which causes early warning signs like sweating, anxiety, hunger and shakiness. Frequent episodes of hypoglycemia will eventually cause the reduction of stress hormones.

When the body stops producing the stress hormones, you will not know that you have low blood glucose, which leads to more dangerous and severe hypoglycemia episodes; a vicious cycle.

However, preventing hypoglycemia occurring over several weeks can restore the body's ability to produce the stress hormones once more and hypoglycemia unawareness is nullified. The hypoglycemia unawareness can be activated again with repeated hypoglycemia events.


For Contemplation

Whenever you suspect that your blood sugar is low, test and correct the problem right away.

Always have blood sugar foods available.


You cannot cheer from the side-lines on your own life, you have to be an active participant

When correcting low blood sugar, have some "quick-fix" food, wait 15 minutes and test again. Continue until your blood glucose level is above 70 mg/dL.

Be extra careful when driving. If you are at risk for hypoglycemia, test before driving and frequently when driving long distance.



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