Hypoglycemia (low Blood Sugar) In Type 1 Diabetes
I was diagnosed with type 1 diabetes in 1968, at the age of 8 years old. At the time, there were no fingerstick blood sugars available for use. One had to regulate diabetes by measuring urine sugars, a very imprecise way to monitor blood sugar control. I recently obtained copies of my medical records from that 12-day stay, and found the following comment in the discharge summary: “He had one mild episode of shocking without loss of consciousness or convulsion.” I remember that episode. I could not have known that it was to be the first of hundreds of low blood sugar reactions that I would experience over the next 46 years. Though a hypoglycemia episode is always disruptive and never a pleasant experience, most were mild, ones that I could treat myself. But occasionally they were severe, requiring assistance from family or co-workers, or 911 calls. I was driven to achieve ‘tight control’ and prevent the long-term complications of diabetes, which I have managed to do. But there was a high price. I felt like I was playing a game of Russian roulette with hypoglycemia. I could no longer tell when I was low. Hypoglycemia unawareness had developed. I was fortunate enough to have developed T1D at a time when treatment for it has steadily improved. I started on an insulin pump in January 1982, and that helped me to reduce my frequency of hypoglycemia. The availability of insulin glargine (Lantus) and insulin detemir (Levemir) were great advances over older basal insulins (NPH, lente, ultralente) that had more intense and less predictable peaks, a very real problem at night. While I have not used them, because they became available after I started on a pump, better basal insulins have helped many T1Ds reduce night time hypoglycemia. Faster insulins (insulin lispro/Humalog 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 >>
Diabetes - Low Blood Sugar - Self-care
Low blood sugar is called hypoglycemia. A blood sugar level below 70 mg/dL (3.9 mmol/L) is low and can harm you. A blood sugar level below 54 mg/dL (3.0 mmol/L) is cause for immediate action. You are at risk for low blood sugar if you have diabetes and are taking any of the following diabetes medicines: Insulin Glyburide (Micronase), glipizide (Glucotrol), glimepiride (Amaryl), repaglinide (Prandin), or nateglinide (Starlix) Chlorpropamide (Diabinese), tolazamide (Tolinase), acetohexamide (Dymelor), or tolbutamide (Orinase) Know how to tell when your blood sugar is getting low. Symptoms include: Weakness or feeling tired Shaking Sweating Headache Hunger Feeling uneasy, nervous, or anxious Feeling cranky Trouble thinking clearly Double or blurry vision Fast or pounding heartbeat Sometimes your blood sugar may be too low even if you do not have symptoms. If it gets too low, you may: Faint Have a seizure Go into a coma Talk with your health care provider about when you should check your blood sugar every day. People who have low blood sugar need to check their blood sugar more often. The most common causes of low blood sugar are: Taking your insulin or diabetes medicine at the wrong time Taking too much insulin or diabetes medicine Not eating enough during meals or snacks after you have taken insulin or diabetes medicine Skipping meals Waiting too long after taking your medicine to eat your meals Exercising a lot or at a time that is unusual for you Not checking your blood sugar or not adjusting your insulin dose before exercising Drinking alcohol Preventing low blood sugar is better than having to treat it. Always have a source of fast-acting sugar with you. When you exercise, check your blood sugar levels. Make sure you have snacks with you. Talk to your provider about r Continue reading >>
Why Low Blood Sugar Is Dangerous
Hypoglycaemia, or low blood sugar, is often known as a 'hypo'. It can make you feel unwell and affect your ability to drive. Simple steps will reduce the risk, and allow you to treat a hypo early, before it causes more serious complications. Blood sugar - what's normal? Under normal circumstances, your body does a remarkable job of keeping your blood sugar (in the form of glucose) stable. Usually your body releases a hormone called insulin, produced by your pancreas, in response to rises in blood sugar. Your body's cells need glucose as fuel to allow them to function. Insulin acts as a 'key', opening the door of your cells to allow glucose in. Another hormone helps raise your blood sugar if it gets too low. Your blood sugar, which is measured in millimoles per litre or mmol/L, is usually maintained between 4 and 6 mmol/L when you're fasting, and up to 7.8 mmol/L two hours after a meal. Diabetes is diagnosed on the basis of raised blood glucose. Hypos - what causes them? People with type 1 diabetes need insulin in injection form, because they don't produce any insulin of their own. People with type 2 diabetes sometimes need insulin if their blood sugar can't be controlled with other tablets. If you're using insulin injections, the amount of insulin you need depends on lots of factors, including how much food you've eaten. More insulin than you need can drop your blood sugar below normal levels, causing a 'hypo'. So too can some tablets used in type 2 diabetes, particularly sulfonylureas, nateglinide and repaglinide, which act by making your body produce more insulin. What symptoms do hypos cause? If your blood sugar drops below about 4 mmol/L, you may experience: Feeling weak or tired and hungry. Feeling shaky and sweaty, with cold, clammy skin. Irritability and poor con Continue reading >>
Type 1 Diabetes
Whether you have type 1 diabetes, are a caregiver or loved one of a person with type 1 diabetes, or just want to learn more, the following page provides an overview of type 1 diabetes. New to type 1 diabetes? Check out "Starting Point: Type 1 Diabetes Basics," which answers some of the basic questions about type 1 diabetes: what is type 1 diabetes, what are its symptoms, how is it treated, and many more! Want to learn a bit more? See our “Helpful Links” page below, which provides links to diaTribe articles focused on type 1 diabetes. These pages provide helpful tips for living with type 1 diabetes, our patient-perspective column by Adam Brown, drug and device overviews, information about diabetes complications, and some extra pages we hope you’ll find useful! Starting Point: Type 1 Diabetes Basics What is the risk of developing type 1 diabetes if it runs in my family? What is Type 1 Diabetes? Type 1 diabetes is disease in which the body can no longer produce insulin. Insulin is normally needed to convert sugar (also called glucose) and other food sources into energy for the body’s cells. It is believed that in people with type 1 diabetes, the body’s own immune system attacks and kills the beta cells in the pancreas that produce insulin. Without insulin, the body cannot control blood sugar, and people can suffer from dangerously high blood sugar levels (called hyperglycemia). To control their blood glucose levels, people with type 1 diabetes take insulin injections. Before the discovery of insulin, type 1 diabetes was a death sentence (and it still is for patients with poor access to insulin). Can Type 1 Diabetes Be Prevented? Unfortunately, the genetic and environmental triggers for the immune attack that causes type 1 diabetes are not well understood, althoug Continue reading >>
10 Ways To Treat Low Blood Sugar With Real Food
10 Ways to Treat Low Blood Sugar with Real Food Medically reviewed by Natalie Olsen, RD, LD, ACSM EP-C on March 21, 2018 Written by Mary Ellen Phipps, MPH, RDN, LD Health and wellness touch each of us differently. This is one persons story. Shaky. Fuzzy. Sleepy. Tired. Low. Crashing. These are all words I used growing up as a type 1 diabetic , to describe how I was feeling when my blood sugar was low. I was diagnosed when I was 5. So I came up with some interesting ways to describe how I was feeling to my parents and other adults in my life. I remember one time when I was in kindergarten, I was describing how I felt to a PE teacher, and she thought I was just trying to get out of having to do the activity. I nearly had a hypoglycemic seizure because I didnt have access to proper attention or treatment. (In her defense, she was a substitute and hadnt been told I had diabetes.) So, what is the proper treatment for low blood sugar? To answer that question, we first need to know whats considered low blood sugar, or hypoglycemia . The American Diabetes Association (ADA) defines hypoglycemia as anytime your blood sugar is lower than normal. This can be different for each person with diabetes, but it usually means blood sugar less than 70 mg/dL. Symptoms to look out for include: Ive sometimes described it to my nondiabetic friends as an almost out of body experience. Once you start to feel these symptoms, its important to immediately test your blood sugar to confirm if you are, in fact, experiencing hypoglycemia. Some of these symptoms are also characteristic of high blood sugar levels, or hyperglycemia . You may also feel these symptoms anytime you experience a rapid drop in your blood sugar. For example: If your blood sugar is high, and you take insulin to bring it down, yo Continue reading >>
Hyperglycemia And Hypoglycemia In Type 1 Diabetes
Hyperglycemia occurs when blood sugar levels are too high. People develop hyperglycemia if their diabetes is not treated properly. Hypoglycemia sets in when blood sugar levels are too low. This is usually a side effect of treatment with blood-sugar-lowering medication. Diabetes is a metabolic disease with far-reaching health effects. In type 1 diabetes, the body only produces very little insulin, or none at all. In type 2 diabetes, not enough insulin is released into the bloodstream, or the insulin cannot be used properly. We need insulin to live. Without it, sugar (glucose) builds up in the blood because it cannot be taken out and used by the body. Very high blood sugar, known as hyperglycemia, leads to a number of symptoms. If blood sugar levels are too low, it is called hypoglycemia. When is blood sugar considered to be too high or too low? Slight fluctuations in blood sugar levels are completely normal and also happen on a daily basis in people who do not have diabetes. Between around 60 and 140 milligrams of sugar per deciliter of blood (mg/dL) is considered to be healthy. This is equivalent to blood sugar concentrations between 3.3 and 7.8 mmol/L. “Millimole per liter” (mmol/L) is the international unit for measuring blood sugar. It indicates the concentration of a certain substance per liter. If type 1 diabetes is left untreated, people’s blood sugar levels can get very high, sometimes exceeding 27.8 mmol/L (500 mg/dL). Blood sugar concentrations below 3.3 mmol/L (60 mg/dL) are considered to be too low. As you can see in the illustration below, there are no clear-cut borders between the normal range of blood sugar and high and low blood sugar. Signs of hyperglycemia Signs of very high blood sugar levels in type 1 diabetes may include the following: If you o Continue reading >>
How To Treat A Low Blood Glucose
A blood glucose of less than 70 mg/dl in general is considered a low blood glucose. Because you may feel some of the symptoms of low blood glucose when your glucose is normal, be sure, if possible, to check your blood glucose when you think it is low. The symptoms of a low blood glucose are: Sweaty and shaky Weak Headache Confused Irritable Hungry Pale Rapid heart rate Uncoordinated If your blood glucose is low, follow the steps below to treat: Follow the 15-15 rule: Eat or drink something from the list below equal to 15 grams of carbohydrate (carb). Rest for 15 minutes, then re-check your blood glucose. If it is still low, (below 70), repeat step 1 above. If your next meal is more than an hour away, you will need to eat one carbohydrate choice as a snack to keep your blood glucose from going low again. If you can't figure out why you have low blood glucose, call your healthcare provider, as your medicine may need to be adjusted. Always carry something with you to treat an insulin reaction. Use food from the list below. Foods equal to One Carbohydrate Choice (15 grams of carb): 3 Glucose tablets or 4 Dextrose tablets 4 ounces of fruit juice 5-6 ounces (about 1/2 can) of regular soda such as Coke or Pepsi 7-8 gummy or regular Life Savers 1 Tbsp. of sugar or jelly Call your doctor Call your doctor or healthcare provider if you have a low blood glucose reaction and do not know what caused it. If you pass out If you have type 1 diabetes and you do not take care of low blood glucose, you may pass out. If you do, a drug called glucagon should be injected into your skin, like you do with insulin. This can be done by a family member or friend who has been taught how to do it. Since glucagon may cause you to vomit, you should be placed on your side when the injection is given. I Continue reading >>
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Type 1 Diabetics Worry About Low Blood Sugar During Exercise
A study looked at survey results from Type 1 Diabetes Exchange’s patient community, Glu, and found most people with type 1 diabetes struggle with managing low blood sugars from exercise. The survey involved 502 adults with type 1 diabetes. Researchers analyzed the exercise preparations and the management techniques used before and after exercise and tried to find out the affect different technologies had on managing blood sugars for exercise. The Struggles of Exercise and Hypoglycemia in People with Type 1 Diabetes Researchers indicated in their study abstract that 79 percent of survey respondents said they increased carbohydrate intake before exercise while 66 % said they increased carb intake after exercise. Fifty-three percent of respondents lowered their meal boluses before exercise and 46 percent did after exercise. Seventy-seven percent said they stuck to a target blood sugar level before starting exercise. Even with all these changes, 70 percent of survey respondents reported low blood sugar levels after exercise. Among those using both an insulin pump and a continuous glucose monitor (CGM) 55 percent said they reduced basal insulin around exercise. Those using other devices such as only a meter or only a cgm or only an insulin pump reported less basal insulin adjustments around exercise. Users of both an insulin pump and a CGM said exercise makes blood sugar levels harder to control and makes them feel less able to predict their blood sugar levels while exercising. Combined insulin pump and CGM users also agreed that fear of low blood sugar levels keep them from exercising. The study authors concluded, “These findings highlight the need for exercise-management strategies tailored to individuals’ overall diabetes management, for despite making exercise-spec Continue reading >>
Hypoglycemia In Children With Type 1 Diabetes
Hypoglycemia, or low blood glucose (blood sugar), is a common complication that can occur with diabetes. The challenge for parents of children with type 1 diabetes is to know how to detect the symptoms of hypoglycemia and effectively treat it. This article addresses both those considerations. But first, it's important to have a solid understanding of hypoglycemia. EndocrineWeb has a comprehensive article series on this complication—and we invite you to read them to learn more. Below is a selection of hypoglycemia resources to get you started: Detecting Hypoglycemia Hypoglycemia occurs when your child's blood glucose levels fall below his or her target range. Target ranges are determined by your child's doctor and are unique to each child. For instance, your child may feel fine with a blood glucose reading of 70, but another child could show hypoglycemia symptoms with a reading slightly above 70.1 Knowing your child's target range and ensuring his or her blood glucose level stays within it is the main objective. If hypoglycemia isn't detected early on, it can cause serious problems, such as seizure or loss of consciousness. So what can you do to prevent your child's hypoglycemia from becoming a potentially serious problem? First and foremost, you should understand the symptoms. These include: Sweating Hunger Dizziness and difficulty concentrating Shakiness Headache Fatigue Pale skin Irritability Make sure that you, your family, and your child can identify the most common hypoglycemia symptoms. Treating Hypoglycemia You should talk with your doctor for specific recommendations on how to treat your child if he or she experiences an episode of hypoglycemia. But, generally, if your child has a low blood glucose meter reading and is showing hypoglycemia symptoms, the goal i 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 >>
Dealing With Hypoglycemia
If you have diabetes, your concern isn’t always that your blood sugar is too high. Your blood sugar can also dip too low, a condition known as hypoglycemia. This occurs when your blood sugar levels fall below 70 milligrams per deciliter (mg/dl). The only clinical way to detect hypoglycemia is to test your blood sugar. However, without blood tests it’s still possible to identify low blood sugar by its symptoms. Early recognition of these symptoms is critical because hypoglycemia can cause seizures or induce a coma if left untreated. If you have a history of low blood sugar episodes, you may not feel symptoms. This is known as hypoglycemic unawareness. By learning to control your blood sugar, you can prevent hypoglycemic episodes. You also should take steps to ensure you and others know how to treat low blood sugar. Managing your blood sugar is a constant balancing of: diet exercise medications A number of diabetes medications are associated with causing hypoglycemia. Only those medications that increase insulin production increase the risk for hypoglycemia. Medications that can cause hypoglycemia include: Combination pills that contain one of the medications above may also cause hypoglycemic episodes. This is a reason why it’s so important to test your blood sugar, especially when making changes to your treatment plan. Some of the most common causes of low blood sugar are: skipping a meal or eating less than usual exercising more than usual taking more medication than usual drinking alcohol, especially without food People with diabetes aren’t the only ones who experience low blood sugar. If you have any of the following conditions, you may also experience hypoglycemia: weight-loss surgery severe infection thyroid or cortisol hormone deficiency Hypoglycemia affect Continue reading >>
Type 1 Diabetes Low Blood Sugar Symptoms
Type 1 diabetes in an autoimmune disease where a person’s pancreas doesn’t produce insulin—a hormone needed to convert food into energy. It affects children and adults, comes on suddenly, and it cannot be prevented or cured. Hypoglycemia, or low blood sugar, is a common and dangerous occurance with type 1 diabetes. If your blood sugar gets too low it may lead to insulin shock, which is life-threatening if not cared for. Low blood sugar can happen when your body has too little food—or glucose—or when it produces too much insulin. Type 1 diabetes hypoglycemia symptoms So what are the low blood sugar symptoms you should look out for? It’s important to realize that the signs of low blood sugar will vary depending on the person. However, people with type 1 diabetes—whether it’s been diagnosed or not—may experience one or more of the following: -Sweating and shaking -Blurry vision -Poor coordination -Dizziness or feeling lightheaded -Difficulty concentrating -Feeling anxious or irritable -Hunger or nausea -Erratic changes in behavior What to do if you experience low blood glucose symptoms Severely low blood-sugar levels can lead to hypoglycemic seizures, unconsciousness, coma, and death if left untreated. That’s why it’s important to see a doctor if you think you have low blood sugar so he or she can check your blood-glucose levels—look into whether type 1 diabetes may be a cause—and provide the necessary treatment. Your support is more critical than ever Continue reading >>
Low Blood Sugar: Causes, Warning Signs And Treatments
Low blood sugar: Causes, warning signs and treatments Low blood sugar, or hypoglycemia, is the most common and most dangerous condition for many people with type 1 diabetes (T1D). Very low blood sugar may lead to insulin shock, which can be life threatening if not treated promptly. Low blood sugar occurs when the body has too little food/glucose or too much insulin. The following are all potential reasons that a person with diabetes might have low blood sugar: Insulin was injected at a site on the body where the absorption rate is faster than usual Injecting extra insulin after forgetting about a previous dose The following is a list of general symptoms that indicate low blood sugar (the person with T1D may exhibit one or more of these and symptoms may change from event to event) Severesymptoms (symptoms as listed above, plus): A blood-glucose meter reading below the target range specified by the physician indicates low blood sugar. The following are general treatments for low blood sugar. The physician and parents (for a child) should determine what course to follow. Please note that people with T1D have symptoms of low blood sugar at various readings. Some people with T1D feel perfectly fine at readings below 70. Others begin to show low blood-sugar symptoms at readings somewhat above 70. If blood-sugar levels are slightly low and the person is alert and lucid, he or she should: Eat. After eating, check blood sugar level again to make sure it is within the target range. The person may require another snack later in the day. Continue to check blood sugar levels regularly. If blood-sugar levels are low and the person is showing signs of low blood sugar but is still able to eat: He or she should immediately eat or drink a fast-acting source of glucose (i.e., juice, gluc Continue reading >>
How Is Low Blood Sugar Related To Type 1 Diabetes?
People with type 1 diabetes need to be on the lookout for low blood sugar. You might think of diabetes as causing high blood sugar levels, and it does, but low blood sugar levels can also cause problems. People with type 1 diabetes take insulin to bring high blood sugar levels down. But depending on what you've eaten and how recently you've exercised, the insulin may bring your blood sugar down too low. Symptoms of low blood sugar include headache, hunger, nervousness, rapid heartbeat, shaking, sweating and weakness. Low blood glucose-also called hypoglycemia or low blood sugar-occurs when blood sugar levels become too low. This is something that needs to be managed on a daily basis when you have type 1 diabetes. Several things can affect blood glucose levels-including medication-diet-exercise-and your treatment plan. For example-eating a snack before bedtime can help prevent nighttime hypoglycemia. Talk to your doctor about what you can do to prevent low blood glucose. Continue reading >>