What Causes 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 people who do not have any metabolic problems can complain of symptoms that resemble low blood sugar, true hypoglycemia usually occurs in people with diabetes mellitus . People with pre-diabetes or insulin resistance also can have low blood sugars on occasion if their high circulating insulin levels are further challenged by a prolonged period of fasting. There are other rare causes for the condition, such as insulin-producing tumors and certain medications.
These uncommon causes of hypoglycemia will not be discussed in this article, which will primarily focus on the condition occurring with type 1 or 2 diabetes and its treatment.
Causes Of Low Blood Sugar
Low blood sugar is common for people with type 1 diabetes and can occur in people with type 2 diabetes taking insulin or certain medications. The average person with type 1 diabetes may experience up to two episodes of mild low blood sugar each week, and thats only counting episodes with symptoms. If you add in lows without symptoms and the ones that happen overnight, the number would likely be higher.
What Drinks And Foods Raise Blood Sugar Fast
- 4 teaspoons of sugar
- 1/2 can of regular soda or juice
Many people like the idea of treating low blood sugar with dietary treats such as cake, cookies, and brownies. However, sugar in the form of complex carbohydrates or sugar combined with fat and protein are much too slowly absorbed to be useful in acute treatment.
Once the acute episode has been treated, a healthy, long-acting carbohydrate to maintain blood sugars in the appropriate range should be consumed. Half a sandwich is a reasonable option.
If the hypoglycemic episode has progressed to the point at which the patient cannot or will not take anything by mouth, more drastic measures will be needed. In many cases, a family member or roommate can be trained in the use of glucagon. Glucagon is a hormone that causes a rapid release of glucose stores from the liver. It is an injection given intramuscularly to an individual who cannot take glucose by mouth. A response is usually seen in minutes and lasts for about 90 minutes. Again, a long-acting source of glucose should thereafter be consumed to maintain blood sugar levels in the safe range. If glucagon is not available and the patient is not able to take anything by mouth, emergency services should be called immediately. An intravenous route of glucose administration should be established as soon as possible.
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Treating Low Blood Glucose If You Take Medicines That Slow Down Digestion
Some diabetes medicines slow down the digestion of carbohydrates to keep blood glucose levels from rising too high after you eat. If you develop low blood glucose while taking these medicines, you will need to take glucose tablets or glucose gel right away. Eating or drinking other sources of carbohydrates wont raise your blood glucose level quickly enough.
What Are The Signs And Symptoms Of Hypoglycemia
Hypoglycemia tends to present as a cluster of symptoms, and they often occur together. The most common signs of dangerously low blood sugar include:
- Dizziness, disorientation, light-headedness, and an inability to think clearly
- Hunger, especially if youve just eaten
- Heightened irritability, confusion, and anxiety
- Clamminess and sweating, with cold hands and feet
- Drastic mood swings
If you have one or more of these symptoms contact your doctor.
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Preventing A Low Blood Sugar Level
If you have diabetes, you can reduce your chance of getting a low blood sugar level if you:
- Check your blood sugar level regularly and be aware of the symptoms of a low blood sugar level so you can treat it quickly.
- Always carry a sugary snack or drink with you, such as glucose tablets, a carton of fruit juice or some sweets. If you have a glucagon injection kit, always keep it with you.
- Do not skip meals.
- Be careful when drinking alcohol. Do not drink large amounts, check your blood sugar level regularly, and eat a carbohydrate snack afterwards.
- Be careful when exercising eating a carbohydrate snack before exercise can help to reduce the risk of a hypo. If you take some types of diabetes medicine, your doctor may recommend you take a lower dose before or after doing intense exercise.
- Have a carbohydrate snack, such as toast, if your blood sugar level drops too low while you’re asleep
If you keep getting a low blood sugar level, talk to your diabetes care team about things you can do to help prevent it.
If A Person Is Unconscious
If a person loses consciousness because of severe hypoglycaemia, they need to be put into the recovery position and given an injection of the hormone glucagon . The injection will raise their blood glucose level.
The injection should be carried out by a friend or family member who knows what theyre doing, or by a trained healthcare professional.
You should dial 999 to request an ambulance if:
- a glucagon injection kit isnt available
- theres nobody available whos trained to give the injection
- the injection is ineffective after 10 minutes
Never try to put food or drink into the mouth of someone whos unconscious as they could choke.
If youre able to give a glucagon injection and the person regains consciousness, they should eat some longer-acting carbohydrate food, such as a few biscuits, a cereal bar or a sandwich.
You should continue to monitor the person for signs of recurring symptoms in case they need to be treated again.
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Tips For Keeping Blood Sugar Steady
The best way to address your personal concerns and needs is to discuss your diet, medication, and lifestyle with your healthcare team. They can diagnose any underlying conditions, adjust or change your medications, and advise you on the best ways to prevent hypoglycemia.
Tips that apply across the board to keep blood sugar stable include:
- Eating a balanced diet
- Planning meals
- Getting adequate sleep
People with diabetes may face more challenges when managing blood sugar levels, but it is possible to stay healthy.
How Is Hypoglycemia Diagnosed
If you suspect you have low blood sugar, its important to check your blood sugar right away. If you dont have a blood glucose meter and youre on diabetes medications that increase insulin, talk with your doctor about getting a meter.
If you experience low blood sugar often say, a few times a week see your doctor right away to find out why. Your doctor will begin your visit by requesting your medical history, asking questions about your eating habits, and learning more about the symptoms youre experiencing.
If you dont have diabetes but suspect you have hypoglycemia, talk with your doctor about your symptoms. Your doctor will use three criteria, sometimes referred to as Whipples triad, to diagnose low blood sugar:
- Signs and symptoms of low blood sugar. Your doctor may require you to fast, or abstain from drinking and eating for an extended period of time, so they can observe your low blood sugar signs and symptoms.
- Documentation of low blood sugar when your signs and symptoms occur. Your doctor will order a blood test to analyze your blood sugar levels in a laboratory.
- Disappearance of the signs and symptoms of low blood sugar. Your doctor will want to know whether the signs and symptoms go away when your blood sugar levels are raised.
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Blood Sugar And Insulin Response
When you eat carbohydrates, your blood sugar, or blood glucose level, goes up. When your blood sugar level goes up, it sends signals to your pancreas to release the hormone insulin. Insulin then attaches to the sugar, or glucose, molecules and either carries them into your cells where theyre used for immediate energy or stored in the liver for use later. As insulin carries glucose out of your blood, your blood sugar levels go down. When your blood sugar levels go down, it signals your pancreas to release less insulin.
Its All About Balance Moderation And Consistency
The sugar high is all fun and games until the resulting sugar crash affects the quality of your day.
The term refers to the sudden drop in energy levels after consuming a large amount of carbohydrates. This can include pastas and pizza but is usually more common after eating simple carbohydrates, also known as simple sugars, such as desserts.
A sugar crash often causes undesired symptoms that can disrupt productivity and energy levels throughout the day.
Kelsey Herrick, senior dietitian at Sanford Health, suggests balance, moderation and consistency are the most effective ways to avoid these crashes. Herrick shares her knowledge on sugar crashes, how to avoid them and what to do if you get one.
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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.
Alcohol And Blood Sugar When You Have Diabetes
The livers functionality is an important part of understanding how alcohol affects blood sugar. Your liver is a key component when it comes to regulating your blood sugar levels throughout the day. When you drink, it impacts the liver and, more specifically, its ability to release glucose into your bloodstream as its supposed to. Alcohol impairs liver function and can keep your liver from releasing enough glycogen to keep your blood glucose levels from going too low. So, if you have diabetes, drink alcohol and take insulin as a medicine, you may experience hypoglycemia.
With alcohol and blood sugar, blood sugar can increase, then decrease to a dangerous point. This occurs because alcohol is high in sugar, causing an initial spike. Your body releases insulin to bring this high sugar level down and inhibits the release of more sugar from the liver. This causes your blood sugar to initially spike, then to decrease. This can be especially dangerous if you are using insulin or other diabetes medications because it can lead to hypoglycemia.
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What About The Glycemic Index
Your daily carb total, spread steadily across the day, is one key to good blood sugar control. Some people also use the glycemic index , a rating of how individual foods raise blood sugar levels. Beans and whole-grain breads and cereals have a lower GI than white bread and regular pasta. Juice has a higher GI than whole fruit. Craving a high-GI food? Eat it along with a lower-GI choice to help control your levels.
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Is Sugar Bad For You
If you love sweets, don’t despair. You don’t have to give them up forever. Sugar will raise your blood sugar levels more quickly than other carbs, but diabetes experts now say the total amount of carbs is most important. So keep your serving sizes small and take into account the total carbs and calories.
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What Should I Do If I Experience A Hypoglycemia
Low blood sugar can be treated quickly with fast-acting glucose. If you are at risk for lows, you should always have something fast and sweet with you. Glucose tabs, for example, are available at any pharmacy, are relatively affordable, and are designed to digest quickly and raise blood glucose fast.
Other options are fruit juice, regular soda, candies , or other . It is important that whatever you use to treat the low does not contain a lot of fat or fiber, which slows digestion and takes longer to raise blood sugar.
The general guidelines are to eat 15-20 grams of glucose or simple carbohydrates then check your blood sugar again in 15 minutes. If you are still low, repeat.
If you experience low blood sugars often, talk to your doctor. Together, youâll be able to figure out why they are happening and then make adjustments, so they donât happen so often.
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What To Do When Your Blood Sugar Drops
Well, one of the best ways is to eat to get blood sugar up. If you are suffering from diabetes and you think that you have hypoglycemia, it is important to check your blood sugar levels. If you feel that the blood sugar levels drop after you eat a meal, you need to change the diet you are following. You need to avoid taking any foods that are high in sugar content and stick to eating small meals during the day.
If you are having low blood sugar levels even when you havent eaten anything, you can try having a snack before hitting the bed. You can eat a snack that is rich in protein or complex carbohydrate.
In case the doctor finds out that too much if insulin is causing trouble, he/she might as well reduce the dose and observe the levels. Do follow the below mentioned routine when you have low blood sugar levels.
Test The Sugar Levels Well, this goes without saying. But, remember that the value less than 70 milligrams per deciliter means you have low blood sugar.
Try To Eat or Even Drink Some Fast Acting Carbs When you are suffering from low blood sugar, you certainly need to act quickly. You need to consume at least 15 gms of carbs. You can try taking about 4 ounces of juice or just have a tablespoon of sugar with water.
Glucose Tablets or Gel You can as well take glucose tablets or opt for the glucose gel. Medical experts say that people who take medications for diabetes need to carry glucose tablets with them for sure.
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What To Do If You Have Low Blood Sugar Symptoms
If you have diabetes and are experiencing mild to moderate hypoglycemia symptoms, you need to immediately eat or drink 15 grams of easily digestible carbohydrates.
Very low blood sugar is a medical emergency. If you or someone else with diabetes is experiencing severe symptoms, such as unconsciousness, its important to administer a medication called glucagon and contact emergency services immediately.
If youre at risk for low blood sugar, its important to talk with your doctor about getting a prescription for glucagon.
You should never give an unconscious person anything by mouth, as it could cause them to choke. If you have diabetes, make sure your family and friends know not to do this if you lose consciousness.
Low blood sugar can occur for a number of reasons. Its usually a side effect of diabetes treatment.
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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