Patient Education: Hypoglycemia (low Blood Sugar) In Diabetes Mellitus (beyond The Basics)
LOW BLOOD SUGAR OVERVIEW Hypoglycemia, also known as low blood sugar, occurs when levels of glucose (sugar) in the blood are too low. Hypoglycemia is common in people with diabetes who take insulin and some (but not all) oral diabetes medications. WHY DO I GET LOW BLOOD SUGAR? Low blood sugar happens when a person with diabetes does one or more of the following: Takes too much insulin (or an oral diabetes medication that causes your body to secrete insulin) Does not eat enough food Exercises vigorously without eating a snack or decreasing the dose of insulin beforehand Waits too long between meals Drinks excessive alcohol, although even moderate alcohol use can increase the risk of hypoglycemia in people with type 1 diabetes LOW BLOOD SUGAR SYMPTOMS The symptoms of low blood sugar vary from person to person, and can change over time. During the early stages low blood sugar, you may: Sweat Tremble Feel hungry Feel anxious If untreated, your symptoms can become more severe, and can include: Difficulty walking Weakness Difficulty seeing clearly Bizarre behavior or personality changes Confusion Unconsciousness or seizure When possible, you should confirm that you have low blood sugar by measuring your blood sugar level (see "Patient education: Self-monitoring of blood glucose in diabetes mellitus (Beyond the Basics)"). Low blood sugar is generally defined as a blood sugar of 60 mg/dL (3.3 mmol/L) or less. Some people with diabetes develop symptoms of low blood sugar at slightly higher levels. If your blood sugar levels are high for long periods of time, you may have symptoms and feel poorly when your blood sugar is closer to 100 mg/dL (5.6 mmol/L). Getting your blood sugar under better control can help to lower the blood sugar level when you begin to feel symptoms. Hypoglyc Continue reading >>
Low Blood Sugar
People with diabetes get hypoglycemia () when their bodies don't have enough sugar to use as fuel. It can happen for several reasons, including diet, some medications and conditions, and exercise. If you get hypoglycemia, write down the date and time when it happened and what you did. Share your record with your doctor, so she can look for a pattern and adjust your medications. Call your doctor if you have more than one unexplained low blood sugar reaction in a week. Most people feel symptoms of hypoglycemia when their blood sugar is 70 milligrams per deciliter (mg/dL) or lower. Each person with diabetes may have different symptoms of hypoglycemia. You'll learn to spot yours. Early symptoms include: Confusion Dizziness Feeling shaky Hunger Headaches Irritability Pounding heart; racing pulse Pale skin Sweating Trembling Weakness Anxiety Without treatment, you might get more severe symptoms, including: Poor coordination Poor concentration Numbness in mouth and tongue Passing out Ask your doctor if any of your medicines can cause low blood sugar. Insulin treatment can cause low blood sugar, and so can a type of diabetes medications called "sulfonylureas." Commonly used sulfonylureas include: Glibenclamide (Glyburide, Micronase) Gliclazide Older, less common sulfonlyureas tend to cause low blood sugar more often than some of the newer ones. Examples of older drugs include: You can also get low blood sugar if you drink alcohol or take allopurinol (Zyloprim), aspirin, Benemid, probenecid (Probalan), or warfarin (Coumadin) with diabetes medications. You shouldn't get hypoglycemia if you take alpha-glucosidase inhibitors, biguanides (such as metformin), and thiazolidinediones alone, but it can happen when you take them with sulfonylureas or insulin. You can get low blood sugar Continue reading >>
Annual Diabetes Checkup
Annual diabetes checkup It is important for all people with diabetes to get an annual check up with your doctor or specialist (your doctor or specialist may recommend you have more regular check ups). Some of the things that may be checked at your check up along with goal levels are below. It’s important to note that all targets should be individualized as appropriate for each person, but in general the following targets are recommended: Date Weight Blood Pressure (goal ≤ 130/80) HBA1c (goal ≤ 55 mmol/mol) Total Cholesterol (goal ≤ 4) HDL Cholesterol (goal ≥ 1) LDL Cholesterol (goal < 2 ) Triglycerides (goal < 1.7 ) Microalbuminuria (ratio < 3 ) Date of last eye examination (at least every 2 years) Foot check, sensation and pulses Understanding type 2 diabetes Type 2 diabetes is the most common form of diabetes. For many people (but not all) it can be prevented through following a healthy lifestyle. While type 2 diabetes cannot be cured, it can be managed and people with type 2 diabetes can and do live active and healthy lives. Diabetes is the result of the body not creating enough insulin to keep blood glucose (sugar) levels in the normal range. Everyone needs some glucose in their blood, but if it’s too high it can damage your body over time. In type 2 diabetes, either the body doesn’t produce enough insulin, or the cells in the body don’t recognise the insulin that is present. The end result is the same: high levels of glucose in your blood. For many people (but not all) type 2 diabetes can be prevented by making healthy food choices and staying active. There is a clear link between type 2 diabetes and high blood pressure (hypertension) and / or disordered levels of fats (cholesterol) in the blood (the medical name for this is dyslipidaemia). This com Continue reading >>
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No matter what we're doing, even during sleep, our brains depend on glucose to function. Glucose is a sugar that comes from food, and it's also formed and stored inside the body. It's the main source of energy for the body's cells and is carried to them through the bloodstream. When blood glucose levels (also called blood sugar levels) drop too low, it's called hypoglycemia. Very low blood sugar levels can cause severe symptoms that need immediate medical treatment. Blood sugar levels in someone with diabetes are considered low when they fall below the target range. A blood sugar level slightly lower than the target range might not cause symptoms, but repeated low levels could require a change in the treatment plan to help avoid problems. The diabetes health care team will find a child's target blood sugar levels based on things like the child's age, ability to recognize hypoglycemia symptoms, and the goals of the diabetes treatment plan. Low blood sugar levels are fairly common in people with diabetes. A major goal of diabetes care is to keep blood sugar levels from getting or staying too high to prevent both short- and long-term health problems. To do this, people with diabetes may use insulin and/or pills, depending on the type of diabetes they have. These medicines usually help keep blood sugar levels in a healthy range, but in certain situations, might make them drop too low. Hypoglycemia can happen at any time in people taking blood sugar-lowering medicines, but is more likely if someone: skips or delays meals or snacks or doesn't eat as much carbohydrate-containing food as expected when taking the diabetes medicine. This is common in kids who develop an illness (such as a stomach virus) that causes loss of appetite, nausea, or vomiting. takes too much insulin, ta Continue reading >>
Print Overview For people with diabetes, low blood sugar (hypoglycemia) occurs when there's too much insulin and not enough sugar (glucose) in the blood. Hypoglycemia is defined as blood sugar below 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L). Several factors can cause hypoglycemia in people with diabetes, including taking too much insulin or other diabetes medications, skipping a meal, or exercising harder than usual. Pay attention to early warning signs, so you can treat low blood sugar promptly. Treatment involves short-term solutions — such as taking glucose tablets — to raise your blood sugar into a normal range. Untreated, diabetic hypoglycemia can lead to seizures and loss of consciousness — a medical emergency. Rarely, it can be deadly. Tell family and friends what symptoms to look for and what to do in case you're not able to treat the condition yourself. Symptoms Early warning signs and symptoms Early signs and symptoms of diabetic hypoglycemia include: Shakiness Dizziness Sweating Hunger Irritability or moodiness Anxiety or nervousness Headache Nighttime symptoms Diabetic hypoglycemia can also occur while you sleep. Signs and symptoms, which can awaken you, include: Damp sheets or bedclothes due to perspiration Nightmares Tiredness, irritability or confusion upon waking Severe symptoms If diabetic hypoglycemia goes untreated, signs and symptoms of severe hypoglycemia can occur. These include: Clumsiness or jerky movements Muscle weakness Difficulty speaking or slurred speech Blurry or double vision Drowsiness Confusion Convulsions or seizures Unconsciousness Death Take your symptoms seriously. Diabetic hypoglycemia can increase the risk of serious — even deadly — accidents. Identifying and correcting the factors contrib Continue reading >>
Diabetic hypoglycemia is a low blood glucose level occurring in a person with diabetes mellitus. It is one of the most common types of hypoglycemia seen in emergency departments and hospitals. According to the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP), and based on a sample examined between 2004 and 2005, an estimated 55,819 cases (8.0% of total admissions) involved insulin, and severe hypoglycemia is likely the single most common event. In general, hypoglycemia occurs when a treatment to lower the elevated blood glucose of diabetes inaccurately matches the body's physiological need, and therefore causes the glucose to fall to a below-normal level. Definition A commonly used "number" to define the lower limit of normal glucose is 70 mg/dl (3.9 mmol/l), though in someone with diabetes, hypoglycemic symptoms can sometimes occur at higher glucose levels, or may fail to occur at lower. Some textbooks for nursing and pre-hospital care use the range 80 mg/dl to 120 mg/dl (4.4 mmol/l to 6.7 mmol/l). This variability is further compounded by the imprecision of glucose meter measurements at low levels, or the ability of glucose levels to change rapidly. Signs and symptoms Diabetic hypoglycemia can be mild, recognized easily by the patient, and reversed with a small amount of carbohydrates eaten or drunk, or it may be severe enough to cause unconsciousness requiring intravenous dextrose or an injection of glucagon. Severe hypoglycemic unconsciousness is one form of diabetic coma. A common medical definition of severe hypoglycemia is "hypoglycemia severe enough that the person needs assistance in dealing with it". A co-morbidity is the issue of hypoglycemia unawareness. Recent research using machine learning methods have proved to Continue reading >>
What is non-diabetic hypoglycemia? Hypoglycemia is the condition when your blood glucose (sugar) levels are too low. It happens to people with diabetes when they have a mismatch of medicine, food, and/or exercise. Non-diabetic hypoglycemia, a rare condition, is low blood glucose in people who do not have diabetes. There are two kinds of non-diabetic hypoglycemia: Reactive hypoglycemia, which happens within a few hours of eating a meal Fasting hypoglycemia, which may be related to a disease Glucose is the main source of energy for your body and brain. It comes from what we eat and drink. Insulin, a hormone, helps keep blood glucose at normal levels so your body can work properly. Insulin’s job is to help glucose enter your cells where it’s used for energy. If your glucose level is too low, you might not feel well. What causes non-diabetic hypoglycemia? The two kinds of non-diabetic hypoglycemia have different causes. Researchers are still studying the causes of reactive hypoglycemia. They know, however, that it comes from having too much insulin in the blood, leading to low blood glucose levels. Types of nondiabetic hypoglycemia Reactive hypoglycemia Having pre-diabetes or being at risk for diabetes, which can lead to trouble making the right amount of insulin Stomach surgery, which can make food pass too quickly into your small intestine Rare enzyme deficiencies that make it hard for your body to break down food Fasting hypoglycemia Medicines, such as salicylates (such as aspirin), sulfa drugs (an antibiotic), pentamidine (to treat a serious kind of pneumonia), quinine (to treat malaria) Alcohol, especially with binge drinking Serious illnesses, such as those affecting the liver, heart, or kidneys Low levels of certain hormones, such as cortisol, growth hormone, glu Continue reading >>
Diabetes And Seizures: What Are They? What Are The Symptoms?
Having a seizure is a very serious thing. It is dangerous for the person experiencing it, and it is also scary for those nearby. Seizures can be caused for several reasons. Some people have epilepsy, which is a disorder where seizures happen often. For those without epilepsy, they are often called “provoked seizures” because they were provoked, or brought on, by something reversible. Individuals with diabetes can experience these “provoked seizures” when their blood sugar drops too low. The following article explains the difference in these, how to prevent them, and how to care for someone that is having a diabetic seizure. The difference between epilepsy and seizures Epilepsy is a seizure disorder that happens because there is an electrical storm in the brain. People have recurrent seizures that involve loss of consciousness, convulsions, abnormal behavior, disruption of senses, or all of the above. Some have an “aura” before having a seizure and know when it is going to happen. Most causes of epilepsy are unknown, however they can be triggered by flickering light, loud noises, or physical stimulation. Treatment for this condition includes medications and sometimes diet changes. A “provoked seizure” happens because something abnormal is happening in the body. This can include low sodium, fever, alcohol, drugs, trauma, or low blood sugar. The same thing happens as with epilepsy, and there is unusual activity in the brain causing abnormal movements and behaviors. Unlike epilepsy though, where a seizure can happen for no reason, there is an actual cause for each one that occurs for “provoked seizure”. It is important to understand the cause of these so that preventative measures can be taken. There is no relationship between epilepsy and diabetes. One Continue reading >>
Can You Have Low Blood Sugar With Type 2 Diabetes?
back to Overview Know-how Type 2 A tag-team approach on low blood sugar with type 2 diabetes. Markus recently wrote an article on our German language blog talking about low blood sugar with type 2 diabetes. The question (“can I have low blood sugar with type 2 diabetes?”) is very common, and it’s easy to see why it’s of concern. So I’ve helped Markus bring his German post to life here in English. I hope it helps! Here’s Markus: Low blood sugar In 2014, results from the DAWN2 study were announced. It was the largest study of its kind (15,000 participants) on the “fears & needs of people with diabetes and their families.” One result stood out: The gravest fears are related to low blood sugars, especially at night. Up to 69% of the participants share this fear! So! Can you have low blood sugar with type 2 diabetes? Yes! Of course! But let’s think about who exactly is at risk – and why. It’s common to think: Type 1 diabetes = at risk for lows Type 2 diabetes = not at risk for lows But that isn’t correct at all, so we should wipe it from our mind. So… what do I need to know? Maybe it’s more accurate to say that people with type 2 diabetes who take certain types of medication are more at risk for lows. We’re getting closer! But to get to the truth, we should take a look at someone without diabetes. Is it possible for them to have lows, too? Theoretically yes, especially if doing long-lasting physical activities without proper food intake. Additionally, extreme stress and binge drinking are also common causes of low blood sugar for people without diabetes. However, it’s pretty rare because as soon as BG’s drop below 80 mg/dl (4.4 mmol/L), the natural counterregulatory system kicks in, raising blood sugar back to normal levels. I’ve never exp Continue reading >>
Type 2 Diabetes And Hypoglycemia (low Blood Sugar/insulin Shock)
People with type 2 diabetes are especially at risk for hypoglycemia, which is also called low blood sugar or insulin shock. Hypoglycemia develops if blood glucose levels fall below normal. This may be caused by insufficient intake of food, too much exercise or excessive alcohol intake. One of the most common causes of hypoglycemia is injecting too much insulin. People with diabetes who inject insulin are at high risk of developing hypoglycemia. But anyone with diabetes using hypoglycemic (blood sugar lowering) medications needs to watch for signs of hypoglycemia. Usually the condition is manageable, though occasionally it can be severe or even life-threatening, particularly if the victim fails to recognize the symptoms. Managing diabetes as effectively as possible to increase insulin sensitivity can greatly reduce the risk of hypoglycemia. It is also essential to manage exercise and food intake responsibly, as directed by your doctor. Mild hypoglycemia is common among people with type 2 diabetes. Severe episodes are rare, even among those who are taking insulin. However, everyone who is controlling glucose levels should be aware of warning symptoms. Persons with diabetes at highest risk for severe hypoglycemia are those who have a previous history of the disorder or those who develop "hypoglycemia unawareness." (1) This latter condition occurs when people become insensitive to hypoglycemic symptoms. In such cases, hypoglycemia appears without warning, and can escalate to a severe level. Even a single recent episode of hypoglycemia may make it more difficult to detect the next episode. But with vigilant monitoring and by rigorously avoiding low blood glucose levels, people with diabetes can often regain the ability to sense the symptoms. It is important to note that even Continue reading >>
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Low Blood Sugar Symptoms And Ranges
Low blood sugar (hypoglycemia) definition and facts Hypoglycemia is the medical term for low blood sugar. It typically occurs as a side effect of medications for diabetes. The normal range of blood glucose is from 70 to 100 mg/dL in an individual without diabetes, Most people will feel the effects and symptoms of low blood sugar when blood glucose levels are lower than 50 mg/dL. Low blood sugar is treated by giving a readily absorbed source of sugar, including soft drinks, juice, or foods containing sugar. If the hypoglycemia has progressed to the point at which the patient cannot take anything by mouth, an injection of glucagon may be given. Glucagon is a hormone that causes a fast release of glucose from the liver. Hypoglycemia or low blood sugar is syndrome that results from low blood sugar. The severity and symptoms of hypoglycemia can vary from person to person. Blood tests can diagnose low blood sugar, and symptoms resolve when the levels of sugar in the blood return to the normal range. The medical term for blood sugar is blood glucose. What can cause low blood sugar? Despite advances in the treatment of diabetes, low blood sugar episodes occur as a side effect of many treatments for diabetes. In fact, these episodes are often the limiting factor in achieving optimal blood sugar control, because many medications that are effective in treating diabetes carry the risk of lowering the blood sugar level too much, causing symptoms. In large scale studies looking at tight control in both type 1 and type 2 diabetes, low blood sugars occurred more often in the patients who were managed most intensively. This is important for patients and physicians to recognize, especially as the goal for treating patients with diabetes becomes tighter control of blood sugar. While peopl Continue reading >>
Hypoglycemia means low (hypo) glucose (gly) in the blood (emia). Your body needs glucose to properly function. Your cells rely on glucose for energy. Glucose comes from the foods you eat. Carbohydrates (e.g., fruit, bread, potatoes, milk, and rice) are the biggest source of glucose in a typical diet, and your body breaks down carbohydrates into glucose. The glucose is then transported in your blood to cells that need it; it gives your body energy. However, in order to use the glucose, your body needs insulin. This is a hormone produced by the pancreas. Insulin helps transport glucose into the cells, particularly the muscle cells. Sometimes, your blood glucose level can drop too low—that's hypoglycemia. It usually happens quite quickly, and it can be handled quite quickly, as well. People with type 1 diabetes do not make insulin to help their bodies use glucose, so they have to take insulin, which is injected under the skin. People with type 2 diabetes fall into two categories when it comes to insulin: either their body doesn't make enough, or their body is unable to use it well (insulin resistance). Normal Blood Glucose The American Diabetes Association published the Standards of Medical Care in Diabetes that provide recommended target blood glucose ranges for people with and without diabetes. The standard for measuring blood glucose is “mg/dL,” which means milligrams per deciliter. People without Diabetes After eating (called postprandial) 70 to 140 mg/dL Goals for People with Diabetes Type 2 diabetes (also called type 2 diabetes mellitus) is more common than type 1 diabetes. Around 90 to 95 percent of people with diabetes have type 2 diabetes. According to the Centers for Disease Control and Prevention’s National 2014 Diabetes Statistics Report, 29.1 million A Continue reading >>
What Is A Diabetic Seizure? Know The Signs And Symptoms
As people with diabetes, we should all be very familiar with hypoglycemia but for those who are not, what is hypoglycemia and how can it effect us? Hypoglycemia is the clinical syndrome that results from low blood sugar. The symptoms of hypoglycemia can vary from person to person, as can the severity as I’ve personally dealt with in the past when my severe low was accompanied with a seizure. This was the first time this as ever happened to me since being diagnosed as a type 1 diabetic over 10 years ago now. While I don’t remember the seizure itself, let’s just say we made it a memorable experience for the community as it happened at my sons fall soccer tournament. So what is a hypoglycemic seizure and what are the warning signs of having a seizure? Let’s take a closer look! What Is a Hypoglycemic Seizure So what causes a seizure? A hypoglycemic seizure may be triggered by injecting too much insulin, or failing to eat soon enough after using a fast acting insulin (exactly what happened to me); excessive use of alcohol, skipping meals, or exercising vigorously without adjusting insulin dosages or eating properly. A seizure may also be triggered by oral diabetes medications that cause the pancreas to produce more insulin. Whatever the cause of the seizure, it needs to be treated as a medical emergency. To identify the onset of a hypoglycemic seizure, look for the following warning signs of seizures and symptoms: Sweating Confusion Feeling faint or too sleepy Feeling cold or clammy Hallucinations Unexplained emotional behaviors Uncontrollable crying Unaware of surroundings Changes in vision Loss of ability to speak clearly Loss of muscle control Muscle weakness Anxiety So what happens during a seizure? If a diabetic seizure is untreated you may become unconscious, f Continue reading >>
Diabetic ketoacidosis and hyperosmolar hyperglycemic state have the same cause: insufficient insulin. There are two types of hyperglycemic emergencies: diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). These situations require emergency medical intervention, since they can lead to serious conditions such as coma, even death, if left untreated. Diabetic ketoacidosis and hyperosmolar hyperglycemic state have the same cause: insufficient insulin. These complications can arise in specific situations, during sick days, for example. Diabetic ketoacidosis Diabetic ketoacidosis mainly occurs in people with type 1 diabetes. It is characterized by hyperglycemia often greater than 20 mmol/L, with the presence of ketones in the blood or urine. Ketones are produced from the breakdown of fats. Their accumulation in the blood is toxic for the body. This situation arises when the body lacks insulin and must use its fat reserves for the energy it normally gets from glucose. Diabetic ketoacidosis can arise due to a forgotten or skipped insulin dose, an improper adjustment to the insulin dose, an insulin pump that stops working, or a serious medical problem (e.g., heart attack, pneumonia). The following symptoms are associated with diabetic ketoacidosis: deep, rapid breathing nausea, vomiting abdominal pain decreased consciousness, confusion, agitation, unusual behaviour Hyperosmolar hyperglycemic state Hyperosmolar hyperglycemic state occurs primarily in people with type 2 diabetes. This state is characterized by hyperglycemia often greater than 30 mmol/L, and severe dehydration. During a hyperglycemic episode, the accumulation of glucose in the blood increases the frequency and volume of urination. This can cause excessive water loss and significant dehydration. Th Continue reading >>
Low Blood Sugar (hypoglycaemia)
A low blood sugar, also called hypoglycaemia or a "hypo", is where the level of sugar (glucose) in your blood drops too low. It mainly affects people with diabetes, especially if you take insulin. A low blood sugar can be dangerous if it's not treated promptly, but you can usually treat it easily yourself. Symptoms of low blood sugar A low blood sugar causes different symptoms for everybody. You'll learn how it makes you feel if you keep getting it, although your symptoms may change over time. Early signs of a low blood sugar include: feeling hungry sweating tingling lips feeling shaky or trembling feeling tired becoming easily irritated, tearful, stroppy or moody turning pale If not treated, you may then get other symptoms, such as: weakness blurred vision difficulty concentrating unusual behaviour, slurred speech or clumsiness (like being drunk) feeling sleepy seizures (fits) collapsing or passing out Hypos can also occur while sleeping, which may wake you up during the night or cause headaches, tiredness or damp sheets (from sweat) in the morning. If you have a device to check your blood sugar level, a reading of less than 4mmol/L is too low and should be treated. Treatment for low blood sugar Treating a low blood sugar yourself Follow these steps if your blood sugar is less than 4mmol/L or you have hypo symptoms: Have a sugary drink or snack – try something like a small glass of non-diet fizzy drink or fruit juice, a small handful of sweets, or four or five dextrose tablets. Test your blood sugar after 10-15 minutes – if it's 4mmol or above and you feel better, move on to step 3. If it's still below 4mmol, treat again with a sugary drink or snack and take another reading in 10-15 minutes. Eat your main meal (containing carbohydrate) if you're about to have it or Continue reading >>