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Low Blood Sugar With Type 2 Diabetes: Is It Possible

Lower Blood Sugar Without Medication | Cyrus Khambatta, PhD, Exam Room Live Q& A

6/26/2015 by mySugr

Can you have low blood sugar with type 2 diabetes? The answer is yes! People with type 2 diabetes who take certain types of medication are more at risk for lows . But dont worry, if you know about the reasons, symptoms, and treatment, theres no need to be afraid!

Which Is More Dangerous Blood Sugar Too High Or Too Low

A persons blood sugar levels can be high, but can also below, depending on their lifestyle and diet. Which is more dangerous?

Blood sugar is medically the definition of the amount of sugar content or glucose substances in the blood. Maintaining sugar levels in the body is not only important for diabetics, but also for healthy people.

Because normal blood sugar levels are important for your bodys performance and health. If it is too high or too low, there will be a disturbing complaint. Know which conditions are more dangerous so you can be more alert.

Evening Meals With Fat And Carbohydrates

Meals full of both fat and carbohydrates may require a longer time for digestion, resulting in higher glucose readings several hours after eating.

One study with young, healthy participants showed that eating a late dinner composed of 50% carbs, 35% fat, and 35% of total daily calories caused a prolonged glucose intolerance and reduced fatty acid oxidation< sup> 2< /sup> during sleepâparticularly in those who hit the hay earlierâand an increase in cortisol. Researchers hypothesized that these same metabolic reactions could contribute to obesity if repeated consistently.

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Whats Considered A Normal Glucose Level

Your doctor will likely test your blood glucose levels as a screening test for diabetes during a standard yearly check-up. Additionally, many people track their glucose at home with an over-the-counter finger-prick test. When you check blood glucose , either at a doctors office or with a home finger stick glucose monitor, the results are in milligrams of glucose per deciliter of blood.

One of the most common glucose measurements is fasting plasma glucose or fasting blood glucose , and its found by checking blood glucose levels after not having any calories at least eight hours before the test. According to the American Diabetes Association , people can be classified into three categories depending on their fasting plasma glucose levels: normal, prediabetes, and diabetes. To be considered normal, fasting glucose must be under 100 mg/dl.

Of note, CGM devices measure interstitial glucose levels compared to blood/plasma glucose levels measured in the FPG tests. While interstitial glucose and blood/plasma glucose levels correlate highly, they are not precisely the same, and diagnoses are not made from interstitial measurements.

Below is a summary overview of data about 24-hour glucose trends in nondiabetic individuals wearing CGM to gain a better understanding of whats normal.

Severe Low Blood Sugar

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As your low blood sugar gets worse, you may experience more serious symptoms, including:

  • Having difficulty walking or seeing clearly.
  • Acting strange or feeling confused.
  • Having seizures.

Severe low blood sugar is below 54 mg/dL. Blood sugar this low may make you faint . Often, youll need someone to help you treat severe low blood sugar.

People with diabetes may experience low blood sugar as often as once or twice a week, even when managing their blood sugar closely. Knowing how to identify and treat it is important for your health. Learn how to treat low blood sugar.

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What Causes Low Blood Glucose In People With Diabetes

Low blood glucose levels can be a side effect of insulin or some other medicines that help your pancreas release insulin into your blood. Taking these can lower your blood glucose level.

Two types of diabetes pills can cause low blood glucose

  • sulfonylureas, usually taken once or twice per day, which increase insulin over several hours
  • meglitinides, taken before meals to promote a short-term increase in insulin

The following may also lower your blood glucose level

When Blood Sugar Is Too High What To Do

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The longer blood sugar levels stay high, the .

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Average Blood Sugar Levels

140 mg/dL 2 hours after eating
180 mg/dL 1 hour after drinking glucose
155 mg/dL 2 hours after drinking glucose
140 mg/dL 3 hours after drinking glucose
95 mg/dL after fasting for glucose-tolerance test for pregnant women

The results of blood sugar tests vary by testing method and lab but generally doctors consider a fasting blood sugar of up to 100 mg/dL to be within the average range. From blood drawn 2 hours after a person eats, doctors consider a level of up to 140 mg/dL to be average. In a glucose-tolerance test for pregnant women, a level of 95 mg/dL after fasting is considered to be the, ‘target,’ level. A doctor who is concerned might order additional testing at 1,2 and 3 hours after a person drinks glucose. The target levels for those tests are 180 mg/dL, 155 mg/dL and 140 mg/dL. Gestational diabetes is indicated if 2 or more of the 4 levels equal or go over the desired target level.

Is Blood Sugar Of 97 Too Low

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Regular insulin is fast acting and starts to work within minutes, with its peak glucose lowering effect about two hours after it is injected NPH and Lente insulin are intermediate acting, starting to work inside one to 3 hours and lasting up to hours Ultra lente is a long acting type of insulin that starts Is Blood Sugar Of 97 Too Low to work within four to eight hours and lasts hours A lowered efficacy of oral antidiabetic medicine has been reported in African American topics.

Blood samples can even even be sourced from alternate sites such because the earlobe, heel, forearm, palm Alternate website testing supplies related outcomes to finger prick testing, especially within the fasting and two hour submit meal occasions Using alternate sites may be much less painful however may have a deeper lance Check with the manufacturer of the glucometer if the machine could additionally be used for alternate website testing Is Blood Sugar Of 97 Too Low When sufficient beta cells are gone, your pancreas stops making insulin or makes so little insulin that you need to take insulin to stay.

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What To Do When Blood Sugar Is Low

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Several Factors May Cause A Persons Postprandial Blood Sugar To Remain Elevated

Smoking after the meal: Studies show that smoking raises blood sugar levels in people with diabetes. Extreme stress: Stress produces the bodys fight-or-flight response triggering the release of stress hormones such as cortisol. These hormones cause the body to release the glucose it has previously stored for energy. Eating or drinking after the meal and before testing the blood sugar: Continuing to eat will keep blood sugars closer to their immediate post-meal levels.

Studies show that 15 to 20 minutes of moderate exercise, such as walking, shortly after a meal may improve glucose metabolism and reduce postprandial glucose levels.

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Can A Continuous Glucose Monitor Help With Low Blood Sugar

A continuous glucose monitor measures the bodys glucose levels in real-time by sensing the glucose present in tissue fluid . A CGM typically provides your glucose level every five minutes, which can be really helpful for tracking and finding patterns in how your glucose changes throughout the day. With CGM you can see how much time you spend in your target glucose range each day , notice trends, and develop strategies to improve your diabetes management.

CGMs can sound alerts when glucose levels drop below a certain threshold or are predicted to do so soon. This can be especially helpful for people who experience hypoglycemia unawareness, nighttime low blood sugar, or frequent hypoglycemic events. CGMs also allow you to share your glucose readings with your loved ones and care-partners in real time, so that they can let you know or help you out if your blood sugar starts to drop.

If you are interested in trying CGM, ask your healthcare team if the technology is available to you. You can also try ten-days of CGM for free.

Treating Severely Low Blood Sugar

Health Correlator: Exercise and blood glucose levels: Insulin and ...

Blood sugar below 55 mg/dL is considered severely low. You wont be able to treat it using the 15-15 rule. You also may not be able to check your own blood sugar or treat it by yourself, depending on your symptoms. Make sure your family members, friends, and caregivers know your signs of low blood sugar so they can help treat it if needed.

Injectable glucagon is the best way to treat severely low blood sugar. A glucagon kit is available by prescription. Speak with your doctor to see if you should have a kit. Be sure to learn how and when to use it. Let family members and others close to you know where you keep the glucagon kit and make sure theyve been trained in how to use it too.

Its important to contact a doctor for emergency medical treatment immediately after receiving a glucagon injection. If a person faints due to severely low blood sugar, theyll usually wake up within 15 minutes after a glucagon injection. If they dont wake up within 15 minutes after the injection, they should receive one more dose. When the person is awake and able to swallow:

  • Feed the person a fast-acting source of sugar .
  • Then, have them eat a long-acting source of sugar .

Its also important that friends, family, co-workers, teachers, coaches, and other people you may be around often know how to test your blood sugar and treat severely low blood sugar before it happens.

If any of the following happens, your friend, relative, or helper should call 911:

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What Are The Symptoms Of Prediabetes

Many people have no symptoms of prediabetes, often for years. Prediabetes may be invisible until it develops into Type 2 diabetes.

Some people with prediabetes may experience:

A1c Goals Should Be Individualized

A1c goals should be individualized based on the individual capabilities, risks, and prior experiences, explains Gary Scheiner, MS, CDE, founder of Integrated Diabetes, and author of Think Like a Pancreas.

For example, we generally aim for very tight A1c levels during pregnancy and more conservative targets in young children and the elderly.

However, Scheiner highlights important factors that could justify aiming for a higher A1c, like hypoglycemia unawareness, which is described as when a person with diabetes no longer feels the oncoming warning signs of low blood sugar. This can put you at significant risk for severe low blood sugars resulting in seizures or death. To reduce that risk, you would aim for higher target blood sugar ranges.

Someone with significant hypoglycemia unawareness and a history of severe lows should target higher blood glucose levels than someone who can detect and manage their lows more effectively, adds Scheiner. And certainly, someone who has been running A1cs in double digits for quite some time should not be targeting an A1c of 6% better to set modest, realistic, achievable goals.

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Preventing Low Blood Sugar

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 reducing insulin doses on days that you exercise.
  • Ask your provider if you need a bedtime snack to prevent low blood sugar overnight. Protein snacks may be best.

Do not drink alcohol without eating food. Women should limit alcohol to 1 drink a day and men should limit alcohol to 2 drinks a day. Family and friends should know how to help. They should know:

  • The symptoms of low blood sugar and how to tell if you have them.
  • How much and what kind of food they should give you.
  • When to call for emergency help.
  • How to inject glucagon, a hormone that increases your blood sugar. Your provider will tell you when to use this medicine.

If you have diabetes, always wear a medical alert bracelet or necklace. This helps emergency medical workers know you have diabetes.

What Is The Dawn Effect

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The dawn effect, sometimes called the dawn phenomenon, is when your body naturally releases a surge of glucose into your bloodstream in the early hours of the morning. It usually takes place sometime between 3 a.m. and 8 a.m.

  • People without diabetes may see this increase in glucose, but the body will release insulin to bring blood sugar back to normal.
  • People with diabetes may struggle to control their blood sugar in the morning since their bodies have difficulty producing or using insulin to manage the glucose surge.

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What Is Considered Low Blood Sugar

For the average person with diabetes, low blood sugar means anything under 80 mg/dL .

Very low blood sugars are any readings under 40 mg/dL. Anything under 40 mg/dL is considered extremely dangerous and potentially fatal.

A person is at a significantly higher risk of falling into a diabetic coma if they cannot get their blood sugar above 40 mg/dL for several hours.

If a person is experiencing a severe low, and they are unable to chew food or swallow liquids, they will require an emergency shot of Glucagon .

What Does My A1c Mean

An A1C test result is reported as a percentage. The number represents the portion of hemoglobin proteins that are glycated, or holding glucose. The higher the percentage, the higher your blood sugar levels have been over the last few months.

For diagnosing purposes, an A1C level of:

  • Less than 5.7% means you dont have diabetes.
  • 5.7% to 6.4% signals prediabetes.
  • 6.5% or higher usually indicates Type 2 diabetes .

If you already have diabetes, an A1C result is a glimpse into how well your management plan has been working over the last three months. Management may involve oral pills, taking insulin, monitoring blood sugar levels and/or lifestyle changes, such as diet and exercise. Your A1C can help you and your provider determine if you should adjust any part of your treatment plan.

Its important to remember that your A1C is just an average measurement of your blood sugar over a few months. Its not a grade or the ultimate determiner of whether youre living a healthy life. Know that your A1C will change over your lifetime and that there are steps you can take to improve your diabetes management and A1C level, if needed.

A1C and estimated average glucose

Some laboratories report your A1C results as a percentage in addition to the corresponding estimated average glucose .

For example, an A1C level of 7% equates to an eAG of 154 mg/dL . An A1C level of 9% equates to an eAG of 212 mg/dL .

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