Ut University Health Services
- dizzy
- confused
For some people, a blood sugar below 90 mg/dL can make them feel like this. For others, it takes a lower blood sugar to cause these symptoms.
You must watch your blood sugar level closely. Regular testing of your blood sugar may allow you to detect and treat hypoglycemia before it causes serious symptoms. You may be able to prevent ever having low blood sugar.
Some high blood pressure medicines called beta blockers hide the symptoms of hypoglycemia. If you are taking medicine for high blood pressure, ask your healthcare provider if the medicines you are taking could have this effect.
You should know the difference between the symptoms of low blood sugar and high blood sugar . High blood sugar doesn’t always cause symptoms, but when it does the symptoms may include blurry vision, extreme thirst, and a lot of urination.
Q: I Have Type 2 Diabetes And Take Insulin Injections If My Blood Sugar Is Low Should I Still Take My Insulin
A: Let me say that if you are experiencing a low blood sugar with symptoms, you should always treat first, worry about your insulin later. Common symptoms of hypoglycemia, the official term for low blood sugar, are confusion, heart racing, vision changes, being uncoordinated, and feeling cold, clammy, or sweaty. If hypoglycemia continues without treatment, it can lead to a loss of consciousness.
We define hypoglycemia as a blood sugar below 70 mg/dL regardless of symptoms. Many people experience blood sugars much lower than this without concern but for someone on insulin, it can be quite dangerous to keep your blood sugar that low.
Ideally, we would like to see blood glucose kept in a relatively normal range of 80 to 120 mg/dL. If you can do that safely, without hypoglycemia, then you are well controlled! If there are reasons your provider has counseled against this guideline, educate yourself about the reasons and follow their guidance.
When we are counseling someone on insulin usage and blood glucose, we try to focus on teaching the rhythm that insulin and blood glucose follow as it relates to time of day, when and what you last ate, or when you exercised. Managing your blood sugar is like playing soccer. You need to guess where the ball is going, so you can plan to meet it. When you check your blood sugar before a meal or an activity, or even at bedtime, youre measuring where the ball is now, which isnt helpful.
When Blood Sugar Is Too Low
Hypoglycemia is the medical word for low blood sugar level. It needs to be treated right away. Why? Because glucose, or sugar, is the body’s main fuel source. That means your body including your brain needs glucose to work properly.
When blood sugar levels go lower than they’re supposed to, you can get very sick. Your parents and your diabetes health care team will tell you what your blood sugar levels should be and what to do if they get too low.
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Causes Of Low Blood Sugar
There are many reasons why you may have low blood sugar, including:
- Taking too much insulin.
- Not eating enough carbs for how much insulin you take.
- Timing of when you take your insulin.
- The amount and timing of physical activity.
- Drinking alcohol.
- How much fat, protein, and fiber are in your meal.
- Hot and humid weather.
- Unexpected changes in your schedule.
- Spending time at a high altitude.
- Going through puberty.
- Menstruation.
What Do I Do About Low Blood Glucose At Nighttime
It is a good idea to keep small boxes or cans of juice at your bedside to treat low blood glucose in the middle of the night. Make sure to follow up with a snack of 15 grams of complex carbohydrate and protein before going back to bed. Cheese and crackers are a good choice. You do not need to eat a full meal.
| Important to Remember |
| Remember, if blood glucose is below target before a meal, treat before you eat. When blood glucose is above 70 mg/dl, take your insulin before you eat a meal or another snack. |
| If you have signs of low blood glucose, but cannot test your blood, you should treat for low blood glucose anyway. Use the 15/15 Rule, giving yourself 15 grams of carbohydrate and checking your blood glucose in 15 minutes. |
| Have a signal for your teacher or your coach that lets them know you are having signs of low blood glucose. |
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Random Glucose Testing And Exercise
Exercise can play a role in your random glucose test results. Generally, exercise will lower glucose levels. It may even require you to adjust your insulin regimen if youre on intensive insulin therapy.
This shouldnt discourage you from exercising. Exercise is one of the best ways you can help control diabetes. Most people with diabetes gain benefits from even moderate exercise.
Exercise increases your bodys ability to use insulin. It also burns extra glucose in your bloodstream. In the long term, exercise will lead to more stable random glucose test results.
Low Blood Glucose During Sleep
Your blood glucose level can drop while you sleep and stay low for several hours, causing serious problems.7 Symptoms of low blood glucose while you sleep can include
- crying out or having nightmares
- sweating enough to make your pajamas or sheets damp
- feeling tired, irritable, or confused after waking up
Although you may not wake up or notice any symptoms, low blood glucose can interfere with your sleep, which may affect your quality of life, mood, and ability to work. Having low blood glucose during sleep can also make you less likely to notice and respond to symptoms of low blood glucose during the day.
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Who Should Do The Test
According to the American Diabetes Association, screening for diabetes is recommended in people over 45 , or at any age if you have certain risk factors, including :
- Being overweight, obese, or physically inactive
- Having a close relative with diabetes
- Belonging to a certain race/ethnic group
- Having signs of insulin resistance or conditions associated with insulin resistance, such as high blood pressure , low good cholesterol and/or high triglycerides , and polycystic ovary syndrome
- Having had diabetes in pregnancy
Understand Nutrition And Adjust Your Diet
What you choose to eat and drink can have a major impact on not only your waistline, mood, and well-being, but also on your blood sugar levels.
All macronutrients can affect the blood sugar to some degree so developing a good understanding of how they affect your blood sugar will enable you to be proactive and prevent blood sugar swings.
Carbohydrates
Carbohydrates have the greatest impact on your blood sugar, which is why many people with diabetes can benefit from following a low- to medium-carb diet . The fewer carbs you eat, the less insulin you need to take, which makes diabetes management easier.
However, you dont have to follow a low-carb diet if it doesnt work for you physically or mentally. As I wrote in my post about which diet is best for people with diabetes, it is very possible to have great blood sugar control on a medium carb diet, as long as you experiment, take notes, and learn to take the right amounts of insulin for the carbs you are eating.
It is very important to realize that we all react differently to carbs so you have to find the diet and foods that are right for you.
As an example, people react very differently to carbs like oats or sweet potato. Some people can eat oats with only a small increase in blood sugar while others see a quick spike. By simply knowing this, people struggling with a certain type of carb can choose to reduce their consumption or cut it out of their diet altogether.
Protein & fats
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Can You Prevent Low Blood Sugar
Hypoglycemia might sound a little scary, so you might wonder if you can avoid it. No matter how well they take care of themselves, kids with diabetes will sometimes have low blood sugar levels. But taking these steps can help:
- Try to eat all your meals and snacks on time and don’t skip any.
- Take the right amount of insulin.
- If you exercise longer or harder than usual, have an extra snack.
- Don’t take a hot bath or shower right after an insulin shot.
- Stick to your diabetes management plan.
What else can you do? Wear a medical identification bracelet or necklace that says you have diabetes. Then, if you are not feeling well, whoever’s helping you even if the person doesn’t know you will know to call for medical help. Medical identification also can include your doctor’s phone number or a parent’s phone number. The quicker you get help, the quicker you’ll be feeling better.
Nighttime Low Blood Sugars
You may experience a low blood sugar night. The low blood sugar might wake you up and your symptoms might be similar to those you have during the day. However, the symptoms may be different. You might have nightmares, sleep poorly, perspire, or feel hot and cold. In the morning you may have a headache, feel nauseated, or feel confused. Notify your doctor if this happens. Check your blood sugar at the time you have the symptoms.
Treatment for a low blood sugar that occurs at night is the same as described earlier.
Your doctor may request that you check a 3:00 a.m. blood sugar 1 to 2 times per week in order to detect any low blood sugars during the night.
Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health care professional.
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Factors That Increase Your Risk Of Prediabetes
While mainstream media often depicts type 2 diabetes as the result of being overweight, not exercising, and eating unhealthy food, it is significantly more complex.
There are actually two pathways that lead to prediabetes and type 2 diabetes.
The first is basic insulin resistance, which means your body needs more and more insulin in order to maintain healthy blood sugar levels. At a certain point, the pancreas cant keep up with the demand, and blood sugars begin to rise.
The second is a genetic disposition that results in the gradual dysfunction and destruction of your pancreas beta-cells. Beta-cells play the leading role in insulin production, and many people with type 2 diabetes struggle to actually produce normal amounts of insulin.
Determining which group you are in isnt easy, or even possible for the average patient.
For patients in this second group, reversing diabetes isnt likely possible, but that doesnt mean you cant take steps towards improving your health isnt worthwhile.
The most important factors that increase your risk of prediabetes are:
What Is A Normal A1c
Now that you have your A1c number, lets look at what that number actually tells you. The American Diabetes Association has established the following guidelines:
This does NOT mean that you need an A1c of less than 5.7% if youre living with diabetes. It means that if you do NOT live with diabetes, your A1c is expected to be below 5.7%. There are different recommendations for what an appropriate A1c is for people living with diabetes.
I had a chance to asked Dr. Anne Peters, MD, Director, USC Clinical Diabetes Program and Professor of Clinical Medicine Keck School of Medicine of USC as well as Gary Scheiner, MS, CDE, owner and Clinical Director of Integrated Diabetes Services and author of Think Like a Pancreas, what their perspectives are on a good A1c target:
Dr. Peters:
The A1c target should be whatever is best given the persons clinical situation. For athletes, too many lows can limit performance, for someone who is pregnant it should be < 6%, for an older person the target should be higher. I generally think an A1c target of 6.0 7.0% is ideal and data shows that going below 7% has fairly little impact on complications. Basically, Id rather see someone with an A1c of 6.9% and low blood sugar variability than an A1c of 6.2% with lots of variability
Gary Scheiner, MS, CDE:
To learn more about blood sugar levels, please read What are Normal Blood Sugar Levels.
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Can Your A1c Be Too Low
As described above, the answer to this question depends almost entirely on how often you experience hypoglycemia . If you never experience hypoglycemia, your A1c technically cannot be too low. Some people achieve A1c levels below 5% by following a very strict diabetes management and diet regimen and have almost no blood sugar fluctuations.
HOWEVER, if you often experience hypoglycemia, that will result in an artificial low A1c reading because your hypoglycemia events are lowering your blood sugar average. In that case, focusing on increasing time-in-range is much more important than further lowering your A1c. In fact, you may even benefit from a slightly higher A1c with fewer blood sugar fluctuations.
Its also important to note that lowering your A1c below the recommended range of 6-7% hasnt been proven to provide any health benefits. Therefore, a very low A1c shouldnt be a goal in itself.
How Do I Treat Low Blood Glucose
If you begin to feel one or more symptoms of low blood glucose, check your blood glucose level. If your blood glucose level is below your target or less than 70 mg/dL, follow these steps
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Is It Weird To Have Blood Sugar Levels In The 80’s 1 Hr After Eating
Is it weird to have blood sugar levels in the 80’s 1 hr after eating? Today after lunch and dinner my bs were 86 and 88. For lunch I had 1 piece of whole wheat bread with 1 serving of meat loaf on top, some ketchup and green beans on the side. Carbs totaled 40 and protien was 30. The same meal a few days ago I tested at 128 after 1 hr. Dinner was tacos 2 corn shells, meat, cheese, lettuce and milk. Carbs totaled 41 and protien 31. And I tested at 1 hr 88. I don’t know much more than what ive Been able to read here, I havnt talked much with my dr about #s because I have not e had my glucose screening yet, he is just having me check my #s because ive had several symptoms and have a family history. It’s confusing to me to go from 128 with the same meal to 86.Continue reading > >
What Should You Do In An Emergency
If mild or moderate hypoglycemia isn’t treated right away, it can turn into severe hypoglycemia. People with severe hypoglycemia usually pass out. If you pass out, someone should 911 right away.
If you have a health problem that tends to cause low blood sugar, it’s a good idea to teach your family, friends, and coworkers about what symptoms to watch for and what to do. You may also want to wear a medical alert bracelet or necklace.
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My Perspective On A1c As A Person Living With Diabetes
I have a very ambivalent relationship with my A1c myself. Ive been living with type 1 diabetes for over 20 years, and my A1c is not something I think about in my daily life. However, every three months when I see my endo, I get a little anxious because receiving your A1c can feel a lot like getting your diabetes report card.
And, quite honestly, thats really silly. My A1c number doesnt reflect whats been going on in my life for the last three months. It doesnt tell me how much effort Ive put into managing my diabetes and it does not define me as a person. Its a good source of information, nothing more.
Still, we tend to look at it and judge, good or bad, how weve done with our diabetes management. But we really shouldnt!
That doesnt mean that I think we shouldnt get our A1c checked. I absolutely think we should, but we also need to understand what it means as well as why we should look beyond the A1c number. I hope this guide has given you the knowledge and tools to do so!
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