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Beware The Perils Of Severe Hypoglycemia

Beware The Perils Of Severe Hypoglycemia

Over 80 years ago, famed diabetologist Elliot Joslin said about the treatment of patients with type 1 diabetes: “Ketoacidosis may kill a patient, but frequent hypoglycemic reactions will ruin him.” Unfortunately, hypoglycemia continues to be the most difficult problem facing most patients, families, and caregivers who deal with the management of type 1 diabetes on a daily basis. Frequent hypoglycemia episodes not only can “ruin,” or adversely impact the quality of life for patients, but also, when severe, can cause seizures, coma, and even death. A Tragic Case Recently, our group published a case report in the journal Endocrine Practice describing a tragic death from hypoglycemia that occurred while the patient slept in his own bed. Our patient, a 23-year-old man with type 1 diabetes who had a history of recurrent severe hypoglycemia, was using an older model insulin pump and wearing a separate, non-real-time continuous glucose monitoring (CGM) system. He was given the CGM in 2005 for the purpose of tracking his nocturnal (nighttime) blood glucose values and making further insulin pump adjustments. After he was pronounced dead in the emergency room, our diabetes nurse removed the pump and CGM to help us understand what happened. His insulin pump was found to have been working correctly. What we learned was that after supper, he had a heavy workout at a gym, followed by a late snack. Between 8 pm and midnight, he “stacked” five boluses of insulin, totaling 7.35 units (33% of his basal dose), in an attempt to keep his glucose values in “tight” control. The downloaded sensor demonstrated that his glucose values fell from about 200 mg/dL at midnight to under 50 mg/dL by 2:00 am, and to under 30 mg/dL by 5:00 am – three hours before he was found by his pare Continue reading >>

Blood Sugar 911

Blood Sugar 911

CBN.com - After experiencing periods of increased jittery nerves, violent trembling, and fainting – all signs of severely low blood sugar – author Dennis Pollock was on a mission to change his diet. Christmas Scare It should have been a pleasant night. It was the Christmas season, and we had just returned from our annual Christmas trip to Grandma’s house. We were sitting in our living room, watching a videotape that was one of my sons’ Christmas presents. I wasn’t having fun. It was happening again. Less than three hours after we had eaten supper I could feel that cold chill on my arms and those jittery telltale indicators that my blood-sugar levels were falling way too low. I quietly slipped out of the room and went into the bathroom to check my blood sugar with my glucometer—a device I had been totally ignorant of a year earlier but was now all too familiar with. As I suspected, my blood-sugar level was dangerously low, so low I knew I needed to take action fast. Grabbing a can of Coke, I drank the entire contents in under a minute. Now my blood sugar went the other way. Another test revealed the level had gone from 40 mg/dl to about 170 in a very short time. 1 (The normal range is 80 to 120.) My body began to tremble violently. I tried to go back into the living room and watch the movie, hoping no one would notice the trembling, but I realized the shaking wasn’t going to go away very soon. I slipped into the bedroom, put on a music CD, and got under the covers. As I trembled and shook, I could only think, What in the world is wrong with me? Looking Back The Christmas scare was not my first encounter with blood-sugar problems. As I look back over my life now, I realize I have had blood-sugar issues going back to the mid-1980s. In the early days I could n Continue reading >>

5 Foods That Lower Your Blood Sugar Quickly

5 Foods That Lower Your Blood Sugar Quickly

Eating a whole foods, plant-based diet is one of the simplest ways to manage your blood sugar and elevate your health to a whole new level. Your blood sugar controls several different hormonal responses in the body, all of which contribute to your energy, your mood, and even your hunger levels. Healthy blood sugars are also vital to prevent or manage Type 2 diabetes, hypertension, and hypoglycemia. Eating a diet that supports your blood sugar can also help prevent obesity. Plant-based foods are jam-packed with fiber, which is the main reason they’re so supportive of blood sugar levels. Fiber slows down the release of sugar within the bloodstream, which helps steady insulin levels. This prevents those blood sugar “ups and downs” that foods high in refined sugars, animal foods, and highly- processed foods can cause. To take care of your blood sugar, all you have to do is prioritize higher fiber sources of whole foods versus foods lower in fiber, such as foods with refined or added sugars, animal products (which dramatically raise insulin), and most processed foods. To keep things easy and simple, focus on eating foods that do support your blood sugar instead of focusing on those that don’t. As you’ll see, there are some pretty delicious plant-based foods and meals you can make with them that support your blood sugar. These foods will keep you energized, satisfied, provide your body with vitamins, minerals, fiber, healthy fats, and even some protein too! 1. Magnesium-Rich Leafy Greens All leafy greens such as: kale, spinach, romaine, arugula, collards, turnip greens, all lettuces, Swiss chard, dandelion greens, and any other green you can think of, are absolutely wonderful for your blood sugar. However, a few are especially rich in magnesium, which is acts like a Continue reading >>

Hypoglycemia - Low Blood Sugar

Hypoglycemia - Low Blood Sugar

What is Hypoglycemia (Low Blood Sugar)? 1. The brain requires glucose (blood sugar) for normal functioning, and unlike many other organs, the brain has a very limited ability to store glucose. As such, the brain is the organ that is most affected when blood sugar gets too low. 2. Low blood sugar can cause seizures 3. Puppies - especially small breed puppies - are particularly susceptible to low blood sugar because their liver is not able to store sufficient amounts of glycogen, as compared with older dogs. 4. Hypoglycemia can be a life-threatening - even fatal - condition, and is known to be a cause of canine seizures. The occurrence of symptoms depends on how far, and how fast, the blood sugar has dropped 5. Treating Hypoglycemia (Low Blood Sugar): During an attack of hypoglycemia your goal is to stay calm, to bring the blood glucose back to a safe level, to continue to observe your dog. You can contact your veterinarian if you feel you need to. These are general guidelines for treating hypoglycemia. Ask your veterinarian for information that is specific to your dog. Severe hypoglycemia: If your dog is severely hypoglycemic, especially if it is having seizures or unconscious, you must give Haggen-Dazs vanilla ice cream immediately. Carefully rub small amounts of ice cream on the inside of the cheeks and gums. Do not put a lot of liquid in the dog's mouth, and be sure the dog does not choke. Do not stick your fingers inside the teeth of a dog that is having seizures - you may get bitten. Then, call your veterinarian if you feel you need further guidance. If your dog continues to be unconscious your dog should be taken to the veterinary emergency room immediately. Moderate hypoglycemia: Haggen-Dazs plain vanilla ice cream should be given, either alone, or combined with f Continue reading >>

Dealing With Low And High Blood Sugar

Dealing With Low And High Blood Sugar

Having low or high blood sugar doesn't feel the same to everyone. No matter how you feel, most likely you won't feel like your normal self. It's important to get to know how your body feels when your blood sugar is high and when it's starting to get too low. When you start to have these feelings, check your blood sugar right away to make sure it's really too high or dropping too low. That will help you decide what to do to fix it. Low Blood Sugar Common signs of low blood sugar include: Shakiness Sweating Fatigue Hunger pangs Irritability or confusion Faster heartbeat Blurry vision Numbness or tingling in your mouth and lips Causes and solutions The most common reasons people get low blood sugar are: Taking too much diabetes medicine Skipping meals or not eating enough carbohydrates at mealtime Getting more exercise than usual For most people, a blood sugar level under 70 is considered too low. What's too low for you might be different. Ask your doctor how low your blood sugar should be before you need to correct it. To correct low blood sugar, eat or drink a fast-acting carbohydrate right away. Glucose tablets or drinks with sugar are quick and work well. Fruit juice, regular soda (not sugar-free), a ripe banana, or a carbohydrate-containing energy bar (not a protein bar) are some good choices. How much carbohydrate you'll need to correct your low blood sugar depends on how low your blood sugar is. Don't overdo it. Eating more carbohydrate than you need to correct the low can make your blood sugar swing the opposite direction and get too high. You can raise your blood sugar about 50 milligrams per deciliter with 15 grams of fast-acting sugar. Some examples include 4 glucose tablets, 1/2 cup of fruit juice, 6 or 7 Lifesavers candies, or 1/2 cup of regular soda. If it's Continue reading >>

The 4 Foods That Will Steady Your Blood Sugar

The 4 Foods That Will Steady Your Blood Sugar

Wondering what blood sugar has to do with you, if you don’t have diabetes? Keeping your blood sugar levels as steady as possiblenow may help you avoid getting diabetes later. “As you get older, your risk for type 2 diabetes goes up,” says Alissa Rumsey, Registered Dietitian and Spokesperson for the Academy of Nutrition and Dietetics. “Since you can’t modify your age, it is important to take other steps to lower your risk, including maintaining a healthy weight, getting enough exercise, and balancing your diet to prevent spikes in blood sugar.” Controlling your blood sugar will also just make you feel better. “It’s best to control blood sugar—it keeps your energy stable,” says Leann Olansky, M.D., an endocrinologist at the Cleveland Clinic. “If your blood sugar doesn’t vary that much before and after a meal, that’s a healthier way to be.” Unrelated to diabetes, symptoms of occasional high blood sugar aren’t life-threatening, but rather unpleasant and only potentially dangerous if you suffer from other health problems. “When your blood sugar is too high, it can make you feel sluggish,” says Dr. Olansky. “When it’s higher still, it can lead to dehydration and make your blood pressure unstable, and cause you to urinate more often, especially at night.” But when your blood sugar remains chronically high, insulin, a hormone that’s supposed to help your body store sugar as energy, stops working as it should. “Prolonged high blood sugar levels can lead to insulin resistance, meaning your body isn’t able to use insulin properly,” says Rumsey. “Over time this insulin resistance can develop into diabetes, when insulin isn’t able to keep your blood sugar within normal levels.” Current research reveals an association between spik Continue reading >>

We Train Diabetes Assist Dogs To Help People With Type I Diabetes.

We Train Diabetes Assist Dogs To Help People With Type I Diabetes.

Diabetes Assist Dogs are trained to monitor smells in the air for a specific scent on the human breath that is related to rapidly dropping or low blood sugar levels. They are then trained to “alert” the person with diabetes, usually by touching them in a significant way such as pawing or nudging them. This alerts the person to check his or her blood sugar level. It also informs them that they should get something to eat to prevent hypoglycemia, or their blood sugars getting to a dangerous level. The canine partner can also be trained to retrieve juice or glucose tabs, get an emergency phone, or get help from another person in the house. Diabetes Assist Dogs wear a backpack identifying them as an assistance dog. This backpack has pockets where medical information, a sugar source, and emergency contact information can be stored. This provides an extra safety net in case the person with diabetes is unable to get help in time. Anyone finding the person unconscious or acting abnormally would know it may be a medical emergency and know how to get help. How can a dog detect low blood sugar? The dogs are evaluated throughout “puppy-hood” for a willingness to work and a sensitive nose. Once we have identified their interest in smells, they begin scent training. A person experiencing hypoglycemia produces a particular scent, found on the breath, due to chemical changes in their body. All people produce the same scent when they have low blood sugar. Our training methods are similar to those used to train drug sniffing or search and rescue dogs trained to find people. Due to the generosity of supporters like you all of our assistance dogs are provided to clients free of charge. LEARN MORE AND APPLY FOR A DIABETES ASSIST DOG Continue reading >>

The Night My Blood Sugar Dropped And I Thought I Was Going To Die

The Night My Blood Sugar Dropped And I Thought I Was Going To Die

I’d been out with friends, I think, for a walk and a meal. As my boyfriend drove us home, I remember feeling exhausted. It had been a bad blood day. I’m a type one diabetic, and I was diagnosed when I was 19. For the last five years I’ve survived on injections of insulin to cover my food, finger pricks to check my blood sugar, and, when that drops too low, a supply of emergency sugar… all to try and keep my sugar levels between those magic numbers, four through seven, which were produced by someone who is good friends with their pancreas. This day had been “one of those days.” I had dropped low (below four) before dinner and corrected with a coke. I injected for my meal. Despite my confidence that I’d managed my sugars correctly and coped well, the stark drop and subsequent rise of my blood sugar had physically taken its toll. As my boyfriend and I arrived at home, I was looking forward to crawling into bed. As always, before I sleep, I had my long-acting nighttime insulin and checked my blood sugar one last time – 3.8. Annoyed, I had another drink of Coke and turned off the light. After about half an hour of restlessness, I checked my sugar again. It was at 2.7, accompanied by a downward-facing arrow on my meter, meaning my blood sugar was dropping fast. Not wanting to disturb my boyfriend, whose sleep is often disrupted by my blood sugar, I hauled myself out of bed and onto the sofa. I remember sitting there, sweating and shaking, in what became the scariest two hours of my life. No matter what I ate, what I drank, I could not get my blood sugar safely above a four. I was confused, I was irritated and I was exhausted. But drifting off to sleep, which would have been so easy, wouldn’t have been safe. Diabetics can lose consciousness from untreated low Continue reading >>

Diabetes Safety First! Recognizing And Preventing Low Blood Sugar

Diabetes Safety First! Recognizing And Preventing Low Blood Sugar

Blood glucose (sugar) goes up and down in a small range throughout the day. In people with diabetes, the range can be much wider. It is important to understand the fine balance between treating the high sugars and avoiding the low sugars. If you have diabetes and take certain diabetes drugs or insulin, you may experience low blood sugar (hypoglycemia [hy-po-gly-SEE-me-uh]) from time to time. Hypoglycemia is a blood sugar of less than 70 mg/dL. However, some people have symptoms of low blood sugar even at higher blood sugar levels. This can happen when blood sugar is dropping too quickly or if the person has had very high blood sugars for a long time. Severe hypoglycemia means the person needs someone to treat them, which is a very serious condition! Even mild hypoglycemia symptoms are hard on your body and on your emotions. By learning more about the signs and causes of low blood sugar, you can take steps to keep it from happening again. Frequent low blood sugars are serious because the body becomes less able to show the warning signals of a low blood sugar. The blood sugar can then fall to dangerously low levels. What causes low blood sugar and what are the symptoms? Low blood sugar is usually caused by eating less or later than usual, changing your physical activity or taking a diabetes medicine that is not right for your needs. Even mistakes in dosing can lead to hypoglycemia. For example, you could mistake one insulin for another or forget that you had already taken your diabetes pills! A recent large study showed that the most common causes of hypoglycemia were smaller than usual food intake, delay in eating, or skipping a meal. Common symptoms of low blood sugar are: Feeling dizzy, shaky, or lightheaded Feeling nervous or anxious Having a fast heart beat Sweating Continue reading >>

Are My Daily Low Blood-sugar Spells Dangerous?

Are My Daily Low Blood-sugar Spells Dangerous?

I tend to get low blood sugar at times throughout the day. I work out on a regular basis and have difficulty knowing when to eat, what to eat, how much to eat before a workout. So, information on that would be helpful. Also I am curious what kind of internal damage, if any, am I doing each time I experience low blood sugar? Dear Beth: Thanks for your question. Many people worry about low blood sugar, but in reality this is rarely a problem for other than diabetics under tight blood sugar control. Those few nondiabetics can usually avoid it with small frequent snacks containing carbohydrates. In order to be considered hypoglycemic the person has to have: 1) Symptoms of hypoglycemia, 2) A documented low blood sugar (less than 60 mg/dl) using a laboratory measurement -- not a personal glucometer -- and 3) relief of the symptoms after consumption of sugar. The symptoms of low blood sugar are sweating, trembling, a sensation of warmth, anxiety, nausea, palpitations, a fast heart rate and hunger. Most true hypoglycemic people have three or four of these symptoms and not all of them. Very low blood sugar can cause fatigue, dizziness, headache, visual disturbances, drowsiness and ultimately loss of consciousness and seizures. Again, all people with very low blood sugar will most likely not have all symptoms. Occasionally, people get hypoglycemia because they're taking certain drugs such as aspirin-like drugs, quinine-like drugs and antipsychotics such as haloperidol, or consuming alcohol. Extreme exercise also can lead to this condition. By far the most common cause of hypoglycemia is treatment of diabetes that is too strict. Some diabetics can actually get hypoglycemic by missing a meal or having a meal with fewer starches and carbohydrates than expected. Very rarely, hypoglyc Continue reading >>

When To Test Blood Sugar After Meals

When To Test Blood Sugar After Meals

For some reason the past week brought me a bunch of emails all asking the same question: Are we supposed to test our blood sugar one hour after we start or end a meal? As is true with everything involving diabetes the answer is not simple due to variations in individual blood sugar responses. The reason we test one hour after a meals is to learn how high our blood sugar goes in response to the specific meal. So we want to be testing at the moment when our blood sugar is at its peak. Studies tell us something about the average time it takes for the carbohydrate in our food to turn into blood sugar (carbohydrates are the main nutrient that causes elevated blood sugars). Such studies suggest that most Americans who eat our meals fairly quickly will see a peak somewhere between one hour and seventy-five minutes after we start eating. But because studies only come up with averages, they don't take into account individual variations--and you are, of course, an individual. And when we move from group averages to individual response we learn that when the blood sugar peak occurs depends on a multitude of factors that include how fast we eat our meals, how much we eat at each meal, how tightly bound the glucose is in the carbohydrates we eat, and how efficient our digestive system is at digesting the carbohydrate bound in our food. That explains why the same meal consumed at the same time by two different people may peak at different times--and why I can't tell you exactly when to test. That's why you might try varying the time at which you test a carefully chosen test meal to see if your personal peak is later than average. Choose a simple meal that contains a known quantity of carbohydrate--a single measured portion of something rather than a meal where you have to guess what Continue reading >>

Non-diabetic Hypoglycemia

Non-diabetic Hypoglycemia

WHAT YOU NEED TO KNOW: What is non-diabetic hypoglycemia? Non-diabetic hypoglycemia is a condition that causes the sugar (glucose) in your blood to drop too low. This can happen in people who do not have diabetes. The 2 types of non-diabetic hypoglycemia are fasting hypoglycemia and reactive hypoglycemia. Fasting hypoglycemia often happens after the person goes without food for 8 hours or longer. Reactive hypoglycemia usually happens about 2 to 4 hours after a meal. When your blood sugar level is low, your muscles and brain cells do not have enough energy to work well. What causes non-diabetic hypoglycemia? Fasting hypoglycemia: Certain medicines or herbal supplements such as fenugreek, ginseng, or cinnamon Alcohol Exercise Medical conditions such as liver disease, hypothyroidism, and tumors Eating disorders or malnutrition Stomach surgery or hemodialysis Reactive hypoglycemia: The causes of reactive hypoglycemia may be unknown. Hyperinsulinism Meals high in refined carbohydrates such as white bread or foods high in sugar Prediabetes Any surgery of the digestive system What are the signs and symptoms of non-diabetic hypoglycemia? Blurred vision or changes in vision Dizziness, lightheadedness, or shakiness Fatigue and weakness Fast or pounding heartbeat Sweating more than usual Headache Nausea or hunger Anxiety, Irritability, or confusion How is non-diabetic hypoglycemia diagnosed? Blood tests are done to measure your blood sugar levels. These tests may also be done to find the cause of your hypoglycemia. Fasting tests may be done. You may have an overnight fasting test or a 72-hour fasting test. After you have fasted overnight, your blood sugar levels will be tested 2 times. For a 72-hour fasting test, you will not be given food for a period of up to 72 hours. During th Continue reading >>

Blood Sugar: What Causes High Blood Sugar Levels In The Morning

Blood Sugar: What Causes High Blood Sugar Levels In The Morning

There are two reasons why your blood sugar levels may be high in the morning – the dawn phenomenon and the Somogyi effect. The dawn phenomenon is the end result of a combination of natural body changes that occur during the sleep cycle and can be explained as follows: Your body has little need for insulin between about midnight and about 3:00 a.m. (a time when your body is sleeping most soundly). Any insulin taken in the evening causes blood sugar levels to drop sharply during this time. Then, between 3:00 a.m. and 8:00 a.m., your body starts churning out stored glucose (sugar) to prepare for the upcoming day as well as releases hormones that reduce the body's sensitivity to insulin. All of these events happen as your bedtime insulin dose is also wearing off. These events, taken together, cause your body's blood sugar levels to rise in the morning (at "dawn"). A second cause of high blood sugar levels in the morning might be due to the Somogyi effect (named after the doctor who first wrote about it). This condition is also called "rebound hyperglycemia." Although the cascade of events and end result – high blood sugar levels in the morning – is the same as in the dawn phenomenon, the cause is more "man-made" (a result of poor diabetes management) in the Somogyi effect. There are two potential causes. In one scenario, your blood sugar may drop too low in the middle of the night and then your body releases hormones to raise the sugar levels. This could happen if you took too much insulin earlier or if you did not have enough of a bedtime snack. The other scenario is when your dose of long-acting insulin at bedtime is not enough and you wake up with a high morning blood sugar. How is it determined if the dawn phenomenon or Somogyi effect is causing the high blood sug Continue reading >>

Hypoglycemia And

Hypoglycemia And "insulin Shock"

Significantly, the most common problem diabetics experience today is not "high blood sugar" but "low blood sugar!" Diabetes medications are powerful but imprecise, and today's blood glucose testing cannot always guarantee you'll stay out of "too low." The Diabetes Control and Complications Trial, completed in 1993, proved that the major diabetes complications: retinopathy, nephropathy, neuropathy, and diabetic heart disease, all follow elevated blood glucose. Diabetics who keep their numbers down cut the risk of complications. But in the rush to cut blood glucose, and keep it down, sometimes we fall too far. Why is immaterial: missed meals, improper medication dosage, departure from scheduling, abnormal exercise, consumption of alcohol, stress, or even "no reason in particular." Sometimes the numbers just drop too far. What happens next? A person going into a "low" can appear to be drunk. They can sweat, talk confused, become disoriented, stumble, lose their bearings, become aggressive, even "feisty," sometimes obscene, or pass out... But they're NOT drunk— and it is no fun they're having. The brain isn't getting the nourishment it needs, and the person can't function. Depending on severity, and depending on the individual, the person can be light-headed, unconscious, comatose... or dead. A hypoglycemic event is an emergency, and intervention is necessary. When You're Low: You have two lines of defense. One is your schedule. Know what your body needs, and keep to it! Take your medications on time, eat the right amount on time, and get the appropriate exercise—on time. The second line is your blood glucose monitor. The more you test, the better idea you have about where your sugars are. If your numbers are dropping dangerously, your monitor will reveal it. This means Continue reading >>

How Can I Tell If I Have Hypoglycemia And Can It Happen Without Warning Symptoms?

How Can I Tell If I Have Hypoglycemia And Can It Happen Without Warning Symptoms?

Question: How can I tell if I have hypoglycemia and can it happen without warning symptoms? Answer: When blood sugar levels fall below their usual values, the body elicits a hormonal response to try to bring those blood sugar levels back up to normal. Those same hormonal responses also lead to a number of symptoms. Those symptoms include palpitations, rapid heart rate, nervousness, and sweating. For some individuals, the sweating predominates. For other individuals, it's the rapid heart rate and palpitations, but what distinguishes hypoglycemia and the symptoms associated with hypoglycemia from those same symptoms by other causes, is that when you take carbohydrate to bring blood sugar levels back up, the symptoms resolve. So, we normally understand that patients with hypoglycemia will respond quickly to carbohydrate, and their blood sugar returns to normal. There are a very few individuals who, over time -- and I stress that this is really over time in a very rare number of patients -- the symptoms of hypoglycemia that we just talked about don't occur. In those individuals, blood sugar levels fall to a level where their ability to respond normally to their activities of daily living is impaired. We call that hypoglycemic unawareness. Next: What Things And Actions Are Most Likely To Cause Hypoglycemia? Previous: What Is 'Diabetes Overwhelmness' And How Can I Handle It? Continue reading >>

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