Hypoglycemia

Hypoglycemia, also called low blood glucose or low blood sugar, occurs when blood glucose drops below normal levels. Glucose, an important source of energy for the body, comes from food. Carbohydrates are the main dietary source of glucose. Rice, potatoes, bread, tortillas, cereal, milk, fruit, and sweets are all carbohydrate-rich foods.

Symptoms of hypoglycemia

Hypoglycemia causes symptoms such as

• hunger
•   shakiness
•   nervousness
•   sweating
•   dizziness or light-headedness
•   sleepiness
•   confusion
•   difficulty speaking
•   anxiety
•   weakness

Hypoglycemia can also happen during sleep. Some signs of hypoglycemia during sleep include

• crying out or having nightmares
•   finding pajamas or sheets damp from perspiration
•   feeling tired, irritable, or confused after waking up

Causes of hypoglycemia in people with diabetes

Hypoglycemia can occur as a side effect of some diabetes medications, including insulin and oral diabetes medications—pills—that increase insulin.

In people on insulin or pills that increase insulin production, low blood glucose can be due to

• meals or snacks that are too small, delayed, or skipped
•   increased physical activity
•   alcoholic beverages

Preventing hypoglycemia

Diabetes treatment plans are designed to match the dose and timing of medication to a person’s usual schedule of meals and activities. Mismatches could result in hypoglycemia. For example, taking a dose of insulin—or other medication that increases insulin levels—but then skipping a meal could result in hypoglycemia.

To help prevent hypoglycemia, people with diabetes should always consider the following:

•   Their diabetes medications. A health care provider can explain which diabetes medications can cause hypoglycemia and explain how       and when to take medications. For good diabetes management, people with diabetes should take diabetes medications in the          recommended doses at the recommended times. In some cases, health care providers may suggest that patients learn how to        adjust medications to match changes in their schedule or routine.

•     Their meal plan. A registered dietitian can help design a meal plan that fits one’s personal preferences and lifestyle. Following one’s       meal plan is important for managing diabetes. People with diabetes should eat regular meals, have enough food at each meal, and       try not to skip meals or snacks. Snacks are particularly important for some people before going to sleep or exercising. Some snacks       may be more effective than others in preventing hypoglycemia overnight. The dietitian can make recommendations for snacks.

•      Their daily activity. To help prevent hypoglycemia caused by physical activity, health care providers may advise         

• checking blood glucose before sports, exercise, or other physical activity and having a snack if the level is below 100 milligrams       per deciliter (mg/dL)
•adjusting medication before physical activity
•checking blood glucose at regular intervals during extended periods of physical activity and having snacks as needed
•checking blood glucose periodically after physical activity

  Their use of alcoholic beverages. Drinking alcoholic beverages, especially on an empty stomach, can cause hypoglycemia, even a        day or two later. Heavy drinking can be particularly dangerous for people taking insulin or medications that increase insulin        production.Alcoholic beverages should always be consumed with a snack or meal at the same time. A health care provider can        suggest how to safely include alcohol in a meal plan.

•     Their diabetes management plan. Intensive diabetes management—keeping blood glucose as close to the normal range as        possible to prevent long-term complications—can increase the risk of hypoglycemia. Those whose goal is tight control should talk        with a health care provider about ways to prevent hypoglycemia and how best to treat it if it occurs.

Treating hypoglycemia

When people think their blood glucose is too low, they should check the blood glucose level of a blood sample using a meter. If the level is below 70 mg/dL, one of these quick-fix foods should be consumed right away to raise blood glucose:

3 or 4 glucose tablets
•   2 tbsp of sugar—the amount equal to 15 grams of carbohydrate
•   1/2 cup, or 4 ounces, of any fruit juice
•   1/2 cup, or 4 ounces, of a regular—not diet—soft drink
•   1 cup, or 8 ounces, of milk
•   5 or 6 pieces of hard candy
•   1 tablespoon of sugar or honey

Recommended amounts may be less for small children. The child’s doctor can advise about the right amount to give a child.

The next step is to recheck blood glucose in 15 minutes to make sure it is 70 mg/dL or above. If it’s still too low, another serving of a quick-fix food should be eaten. These steps should be repeated until the blood glucose level is 70 mg/dL or above. If the next meal is an hour or more away, a snack should be eaten once the quick-fix foods have raised the blood glucose level to 70 mg/dL or above.