When To Seek Care
Its essential that you get immediate medical attention if your blood sugar drops and you have severe symptoms, like seizures or loss of consciousness.
If you have diabetes and your blood sugar drops, and the usual quick-fix treatments dont help raise your blood sugar above 70 mg/dL, its also important to get medical care as soon as possible. This happens more commonly with taking too much long-acting insulin or sulfonylurea diabetes pills.
Also, be sure to get medical care if you dont have diabetes but have symptoms of hypoglycemia that dont go away or get worse after youve eaten at least 15 grams of carbohydrates.
What Complications Can Be Caused By Hypoglycemia
Passing out from low blood sugar because you have not recognized the early signs and symptoms is called hypoglycemia unawareness, and can be quite dangerous depending on where you are, explains Dr. Klonoff. As doctors are required to report such incidents to the Department of Motor Vehicles, it can also mean a suspended drivers license.
If this is something youre worried about, Wearing a continuous glucose monitor with an alarm for hypoglycemia can alert a person who is prone to developing low blood sugar levels that their blood glucose concentration is becoming dangerously low, so appropriate preventive action can be taken before they lose consciousness, explains Dr. Klonoff.
Signs And Symptoms Of Low Blood Sugar
Each person’s reaction to low blood sugar is different. Learn your own signs and symptoms of when your blood sugar is low. Taking time to write these symptoms down may help you learn your own symptoms of when your blood sugar is low. From milder, more common indicators to most severe, signs and symptoms of low blood sugar include:
- Feeling shaky
- Color draining from the skin
- Feeling sleepy
- Feeling weak or having no energy
- Blurred/impaired vision
- Tingling or numbness in the lips, tongue or cheeks
- Nightmares or crying out during sleep
The only sure way to know whether you are experiencing low blood sugar is to check your blood sugar, if possible. If you are experiencing symptoms and you are unable to check your blood sugar for any reason, treat the hypoglycemia.
A low blood sugar level triggers the release of epinephrine , the fight-or-flight hormone. Epinephrine is what can cause the symptoms of hypoglycemia such as thumping heart, sweating, tingling and anxiety.
If the blood sugar level continues to drop, the brain does not get enough glucose and stops functioning as it should. This can lead to blurred vision, difficulty concentrating, confused thinking, slurred speech, numbness, and drowsiness. If blood sugar stays low for too long, starving the brain of glucose, it may lead to seizures, coma and very rarely death.
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Monitoring Sugars Is Vital
When youre ill or just dont feel like eating much, its important to monitor your blood sugar levels more closely than ever. How often depends on whether you have Type 1 or Type 2 diabetes and what medications you take.
For Type 1 diabetes: Be sure to monitor your blood sugar before meals and before bedtime, typically four times per day, says Garvey.
Beyond that, check your blood sugars if you notice symptoms of low blood sugar. Those symptoms include:
For Type 2 diabetes: If youre taking a sulfonylurea medication, check your blood sugars at least twice a day in the morning and at bedtime.
Its important to keep in mind that sulfonylureas may cause your blood sugar to drop during the day if you dont eat anything after taking your medication, Garvey says.
If your only treatment is metformin, you may not need to check your blood sugar more than once a day. This medication doesnt typically cause hypoglycemia.
Its important to be aware of the symptoms associated with low blood sugars, says Garvey. Be ready to check your blood sugar and eat or drink 15 grams of simple sugar such as glucose tablets or 4 ounces of juice to correct a low blood sugar if needed. This treatment is also recommended for Type 1 diabetes, she says.
Its Strange That Blood Sugar In A Diabetic Can Rise Despite Not Having Eaten Anything Since Typically Eating Causes Blood Sugar To Go Up
But its no uncommon occurrence that in diabetes, glucose or blood sugar levels can actually rise in the absence of eating.
When we dont take food into our body for energy, our liver will try to help us by releasing glucose into our blood so we have the energy we need to stay alive, says Lucille Hughes, RN, CDE, director of diabetes education at South Nassau Communities Hospital in Oceanside, NY.
For people with diabetes, the liver may release too much glucose, causing blood sugar to go up.
This is why its so important for diabetics to regularly take blood sugar readings, even if they feel fine.
The liver has hundreds of jobs. One of those jobs is to release glucose into the bloodstream for energy because the body requires energy to function, even when at rest.
Basic bodily functions require energy and glucose provides that energy.
In diabetes, things are out of whack in the body. The liver in the diabetic may sometimes overestimate how much sugar to release into the bloodstream.
Or, to put it another way, the liver over-corrects the problem.
The only way that a diabetic can stay ahead of this curve is to monitor their glucose levels on a regular basis throughout the day to make sure that the sugar level doesnt sneak its way into getting into a dangerously high range.
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What Causes A Low Blood Sugar Level
In people with diabetes, the main causes of a low blood sugar level are:
- the effects of medicine especially taking too much insulin, medicines called sulfonylureas , medicines called glinides , or some antiviral medicines to treat hepatitis C
- skipping or delaying a meal
- not eating enough carbohydrate foods in your last meal, such as bread, cereals, pasta, potatoes and fruit
- exercise, especially if it’s intense or unplanned
- drinking alcohol
Sometimes there’s no obvious reason why a low blood sugar level happens.
Very occasionally, it can happen in people who do not have diabetes.
How Can I Stop My Blood Sugar From Crashing
Here are a few ways to avoid hypoglycemic episodes:
- Get in the habit of self-monitoring your blood glucose. Keeping track of when your blood sugar drops can help you recognize aspects of your routine that may be contributing to your hypoglycemia. Dr. Klonoff recommends a continuous glucose monitor. Its the best tool for automatically checking your blood glucose levels around the clock, he says.
- Change your meal plan. When, what, how much, and how often you eat all play a big part in your blood glucose levels. A dietitian can teach you about healthy, well-balanced food choices that will make it easier for you to maintain an acceptable blood sugar range.
- Keep a stash of glucose tablets on hand. With your doctor’s recommendation, make sure you always have glucose tablets with you. You can stick them in your briefcase, purse, car, desk, school locker, etc. You may also want to keep snacks nearbyfor example, cheese or peanut butter crackers, although doctors suggest over-the-counter glucose tablets for more accurate dosage. Do not eat a healthy sugar-free candy bar during hypoglycemia, warns Dr. Klonoff. Its lack of sugar means that it will not raise your blood glucose level sufficiently when you want it to.
- Certain drinks can help get your blood sugar up as well. Try 8 oz. of fruit juice, a soft drink , or a cup of milk.
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Should People With Diabetes Avoid Fruit Juice
Fruit juices can be high in natural sugars and because they have less fibre than the whole fruits, they are not as beneficial.Because you can get through a lot of juice within a relatively short period of time, compared to eating the actual fruit, you may end up loading up with a lot of carbs over that period. Depending on how your diabetes is managed, this can result in your blood glucose levels going up, and may affect your weight in the long term as well.That is why you are better off eating the actual fruit and avoiding juices. If you want to drink fruit juice, limit it to a maximum of a small glass, once a day. Drinking more than that will only increase your blood glucose levels and make you gain weight.If you drink juice with your a meal, look at how to reduce the carbohydrate in that meal. So, for example, if you usually have a couple of slices of bread with your breakfast, on the day that you decide to have a small glass of juice with your breakfast, you may be better off sacrificing one slice of bread to make room for the extra carbs from the juice. You don’t need to do this every day, but it is an option. And it will stop you having to deal with high blood glucose levels as a result of the juice.
What Are The Complications Of Low Blood Glucose
Mild-to-moderate low blood glucose can be easily treated. But severely low blood glucose can cause serious complications, including passing out, coma, or death.
Repeated episodes of low blood glucose can lead to
- high blood glucose levels, if worry or fear of low blood glucose keeps you from taking the medicines you need to manage your diabetes8
- hypoglycemia unawareness, a condition in which you dont notice any symptoms of low blood glucose until your blood glucose level has dropped very low
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How Can I Prevent Low Blood Sugar
Your best bet is to practice good diabetes management and learn to detect hypoglycemia so you can treat it earlybefore it gets worse.
Monitoring blood sugar, with either a meter or a CGM, is the tried and true method for preventing hypoglycemia. Studies consistently show that the more a person checks blood sugar, the lower his or her risk of hypoglycemia. This is because you can see when blood sugar levels are dropping and can treat it before it gets too low.
If you can, check often!
- Check before and after meals.
- Check before and after exercise .
- Check before bed.
- After intense exercise, also check in the middle of the night.
- Check more if things around you change such as, a new insulin routine, a different work schedule, an increase in physical activity, or travel across time zones.
What Causes Hyperglycemia In People With Diabetes
- The dose of insulin or oral diabetes medication that you are taking is not the most helpful dose for your needs.
- Your body isnt using your natural insulin effectively .
- The amount of carbohydrates you are eating or drinking is not balanced with the amount of insulin your body is able to make or the amount of insulin you inject.
- You are less active than usual.
- Physical stress is affecting you.
- Emotional stress is affecting you.
- You are taking steroids for another condition.
- The dawn phenomenon is affecting you.
Other possible causes
- Pancreatic diseases such as pancreatitis, pancreatic cancer and cystic fibrosis.
- Certain medications .
- Gestational diabetes, which happens in 4% of pregnancies, and is due to decreased insulin sensitivity.
- Surgery or trauma.
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What If I Have Severe Low Blood Glucose And Cant Treat Myself
Glucagona hormone that raises blood glucose levelsis the best way to treat severely low blood glucose. Available as an injection or a nasal spray, glucagon will quickly raise your blood glucose level. Your doctor can prescribe you a glucagon kit for use in case of an emergency.
If your blood glucose level drops very low, you wont be able to treat it by yourself. Be prepared to address severely low blood glucose by
- talking with your doctor or health care team about when and how to use a glucagon emergency kit. If you have an emergency kit, regularly check the date on the package to make sure it hasnt expired.
- teaching your family, friends, and coworkers when and how to give you glucagon. Tell them to call 911 right away after giving you glucagon or if you dont have a glucagon emergency kit with you.
- wearing a medical alert identification bracelet or pendant. A medical alert ID tells other people that you have diabetes and need care right away. Getting prompt care can help prevent the serious problems that low blood glucose levels can cause.
How Are Low Blood Sugar Levels Treated
Your diabetes health care team will give you guidelines for treating low blood sugar levels, depending on your symptoms. If you can, try to test your blood sugar levels to make sure that your symptoms are because of hypoglycemia. If you can’t test blood sugar immediately, don’t delay in treating your symptoms you can always check your blood sugar after you’ve taken steps to get your blood sugar back up into the normal range.
When blood sugar levels are low, the goal is to get them back up quickly. To do that, you should take in sugar or sugary foods, which raise the blood sugar level quickly. Your health care team might suggest that you:
- Eat, drink, or take something that contains sugar that can get into the blood quickly. Your doctor may tell you to have really sugary foods or drinks or might give you glucose tablets or gel to take all of these can help to raise your blood sugar level fast, which is what you need to do when it’s low.
- Wait about 10 minutes to let the sugar work.
- Recheck your blood sugar level with a glucose meter to see if blood sugar levels are back to normal.
- Get a glucagon shot , if your symptoms are severe or get worse after you eat, drink, or take glucose.
Sometimes, blood sugar levels can get so low that you may not be awake enough to eat or drink something to get them back up. When this happens, you may need a glucagon shot.
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Dietary Changes To Help Lower Your Blood Pressure
Tips like starting the day with a nutrient-rich smoothie, enjoying fresh fruits, and ensuring adequate water intake can help control cravings and might keep you from eating processed sugar.
Choose a diet that’s rich in the following:
- Nuts and legumes
- Nontropical vegetable oils
Be sure to limit your intake of saturated and trans fats, sodium, red meat , and sweets and sugar-sweetened beverages.
There is some evidence to suggest that supplementing your diet with L-glutamine may be beneficial. One study demonstrated that, in overweight people and those with obesity, the effect of L-glutamine supplementation on gut microbiota was similar to that of weight loss programs.
Does Blood Sugar Rise If You Dont Eat
Skipping a meal is typically no big deal. But if youre a person with diabetes, skipping meals or a lack of meal structure could result in dangerously low or high blood sugar levels. It is important to know your numbers especially when taking certain medications to lower blood sugar levels. 4
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Studies On Blood Sugar And Fasting
Not all studies show that intermittent fasting is a magic wand when it comes to reducing your blood sugar levels. Research indicates daily caloric restriction and diets that mimic fasting also have a positive effect on blood glucose levels.
A 12-month study that compared alternate-day fasting to daily caloric restriction found both methods of calorie reduction lowered fasting glucose levels. Other studies also support the theory that its the caloric restriction that reduces fasting glucose and the risk for atherosclerosis.
However, intermittent fasting may still be among the easiest ways to restrict your caloric intake. You may find its easier to limit your calories for a few hours or a few days per week versus every day.
If you already have insulin resistance, or if your intermittent fasting protocol causes you to stress, fasting can cause an increase in your blood sugar.
A Brazilian study suggests the stress of fasting might increase the production of free radicals. These stress-induced free radicals can harm the cells in your pancreas, which is the organ responsible for insulin production. Damage to your pancreas can inhibit your ability to reduce glucose in your bloodstream and can lead to an increase in your belly fat. The Brazilian study, however, is an outlier.
The Role Of Insulin In Protein Synthesis
Aside from regulating the absorption and breakdown of ingested proteins, insulin also plays a part in protein synthesis. The hormone encourages cells to take in alanine, arginine, and glutamine. Note that the process will only happen when the above-mentioned amino acids are present in sufficient quantities in your body. The rate of protein synthesis only increases when amino acid delivery to the muscle cells speeds up .
An interesting thing to note is that BCAAs, being essential amino acids, were once thought to influence muscle protein synthesis. But scientific evidence says otherwise.
According to the American Journal of Physiology-Endocrinology and Metabolism, insulin does not stimulate muscle protein synthesis when more BCAAs are present than usual. This suggests that other non-BCAA essential amino acids, for example, tryptophan and threonine, may be the triggers for insulin-induced protein synthesis. Another possible reason may be that insulin also stimulates protein absorption after eating. This lowers the concentration of non-BCAA amino acids, making it more unlikely for protein synthesis to occur. Further findings also confirm that when there are enough non-BCAA essential amino acids, insulin will initiate muscle protein synthesis in the presence of increased BCAAs.
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