Understanding Your Blood Sugar
The best way to understand how your blood sugar changes day-to-day is to regularly use a blood glucose meter to check your blood sugar level. If youre newly diagnosed, its also helpful to keep a food journal in addition to a blood sugar log, as well as tracking any physical activity.
Your blood sugar patterns are unique to you. Over time youll have a better understanding of which foods raise your blood sugars the most, as well as how your blood sugar responds to different types of exercise.
Some people with diabetes choose to use a continuous glucose monitor to monitor their blood sugar trends.
A continuous glucose monitor is a device with a sensor worn under the skin which measures blood sugar levels every 5-15 minutes. This is useful for identifying trends in blood sugar levels and can help predict and identify hypoglycemia sooner.
Using a CGM can reduce the amount of finger prick glucose tests needed each day, which is an added benefit.
Hypoglycemia Tests And Diagnosis
To diagnose nondiabetic hypoglycemia, your doctor will do a physical exam and ask questions about any medicines you take. Theyâll want to know all about your health and any history of diseases or stomach surgery.
Theyâll check your blood glucose level, especially when you are having symptoms. Theyâll also check to see if you feel better when your sugar goes back to a normal level.
If your doctor suspects hypoglycemia, you may have to fast until you start to have symptoms. Theyâll test your blood glucose level at different times throughout the fast.
To check for reactive hypoglycemia, you may have to take a test called a mixed-meal tolerance test . For this, you take a special drink that raises your blood glucose. The doctor will check your blood glucose levels over the next few hours.
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What Is The Outlook For People With Hypoglycemia
Hypoglycemia can be managed when you and your healthcare provider understand what causes your blood sugar to go down. Give your healthcare provider as much information as possible about any hypoglycemic episodes. Fixing the problem may be as simple as changing the times you take medication, eat and exercise. Minor changes to the types of food you eat may also help.
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What Are The Signs Of Hypoglycemia
An individual may frequently wake up in the middle of the night as a result of nighttime hypoglycemia. In other instances, though, people may know if they experienced hypoglycemia during their sleep if they notice the following symptoms:
- Waking up with a headache
- Waking up in a sweat
- Getting unusual feelings of tiredness throughout the day
- Experiencing anxiety or heart palpitations
- Feeling confused, dizzy or weak
When To Contact Your Doctor
Hyperglycemia can turn into a medical emergency like DKA and HHS that requires immediate intervention by your doctor or a local emergency department. If you have two blood sugar readings of 300 mg/dL or more, or have blood sugar above your target range for more than a week, seek immediate medical help.
Signs of hyperglycemia include:
- Ketones in your urine
- Stomach pain, nausea, or vomiting
- Shortness of breath
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How Do I Treat An Episode Of Hypoglycemia
The American Diabetes Association recommends the 15-15 rule for an episode of hypoglycemia:
- Eat or drink 15 grams of carbs to raise your blood sugar.
- After 15 minutes, check your blood sugar.
- If its still below 70 mg/dL, have another 15 grams of carbs.
- Repeat until your blood sugar is at least 70 mg/dL.
If you have symptoms of hypoglycemia but cant test your blood sugar, use the 15-15 rule until you feel better.
Note: Children need fewer grams of carbs. Check with your healthcare provider.
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.
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Your Hypoglycemia Action Plan
If you experience symptoms of hypoglycemia, its important to take action. Start with these steps:
Test your blood sugar. If you recognize any of these symptoms and believe your blood sugar may be too low, the first step you should take is to test your blood sugar with your glucose meter, Tan says. Anything less than 70 milligrams per deciliter is considered low blood sugar, according to the National Library of Medicine . However, target levels are often individualized, so talk with your healthcare provider about your optimal numbers, Tan adds.
Eat or drink fast-acting carbs. If you have low blood sugar, you need to take action right away. Your best bet is to consume about 15 grams of carbohydrates, the NLM says. Some options include:
- ½ cup or 4 ounces of orange juice
- ½ cup or 4 ounces of regular soda
- 1 tablespoon of sugar dissolved in water
- 1 tablespoon of honey or maple syrup
- 5 or 6 hard candies, jelly beans, or gumdrops
- 1 tablespoon of cake frosting
- 2 tablespoons of raisins
- ½ cup of applesauce
You can also take three to four glucose tablets or a tube of glucose gel. Everyone who takes medications for diabetes should always have glucose tablets with them, Galindo urges.
Wait, then retest. The next step is to wait 15 minutes, then test your blood sugar again. If blood sugar has reached 100 mg/dl or greater, youre fine. If not…
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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Foods To Eat In Moderation
You can eat the following foods in smaller quantities at meals, depending on your personal carb tolerance:
- Berries: 1 cup or less
- Plain, Greek yogurt: 1 cup or less
- Cottage cheese: 1/2 cup or less
- Nuts and peanuts: 12 ounces, or 3060 grams
- Flaxseeds or chia seeds: 2 tablespoons
- Dark chocolate : 30 grams or less
- Winter squash : 1 cup or less
- Liquor: 1.5 ounces, or 50 grams
- Dry red or white wine: 4 ounces, or 120 grams
Legumes, such as peas, lentils, and beans, are healthy sources of protein, though they do have carbs as well. Be sure to include them in your daily carb count.
Drastically reducing carbs usually lowers insulin levels, which causes the kidneys to release sodium and water .
Try to eat a cup of broth, a few olives, or some other salty low carb foods to make up for the lost sodium. Dont be afraid to add a little extra salt to your meals.
However, if you have congestive heart failure, kidney disease, or high blood pressure, talk to your doctor before increasing the amount of sodium in your diet.
What Are The Symptoms Of Hypoglycemia
Many symptoms can happen when a person experiences hypoglycemia. The sudden drop in blood sugar can cause both mild and severe symptoms. Most people will experience a few mild symptoms.
Appropriate action can then be taken to counter the hypoglycemia. There are also cases where patients experience more serious symptoms. In rare scenarios, these symptoms become life-threatening. When this happens, the patient needs urgent medical care.
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How Can I Be Better Prepared For Hypoglycemia
You can take some steps to be ready for hypoglycemia:
- Be aware of the symptoms and treat them early.
- Carry some fast-acting carbs with you all the time.
- Check your glucose levels frequently, especially around meals and exercise.
- Inform family, friends and co-workers so they know what do if you need help.
- Talk to your healthcare provider regularly to make and update your plan.
- Wear a medical bracelet that lets people know you have diabetes. Carry a card in your purse or wallet with instructions for hypoglycemia.
A note from Cleveland Clinic
Hypoglycemia is quite common in people with diabetes. If not treated, it can cause troubling symptoms, and even serious health problems. Fortunately, you can avoid hypoglycemic episodes by monitoring your blood sugar. You can also make small adjustments to eating and exercising routines.
Talk To Your Doctor Before Changing Your Diet
When carbs are restricted, theres often a dramatic reduction in blood sugar.
For this reason, your doctor will often reduce your insulin and other medication dosages. In some cases, they may eliminate your medication altogether.
One study reported that 17 of 21 study participants with type 2 diabetes were able to stop or reduce their diabetes medication when carbs were limited to 20 grams a day .
In another study, participants with type 1 diabetes consumed less than 90 grams of carbs each day. Their blood glucose improved, and there was less likelihood of low blood sugar because insulin dosages were significantly reduced .
If insulin and other medications arent adjusted for a low carb diet, theres a high risk of dangerously low blood glucose levels, also known as hypoglycemia.
Therefore, its important that people who take insulin or other diabetes medications speak with their doctor before starting a low carb diet.
In addition to following a low carb diet, physical activity can also help manage diabetes by improving insulin sensitivity.
A combination of resistance training and aerobic exercise is especially beneficial .
Quality sleep is also crucial. Research has consistently shown that people who sleep poorly have an increased risk for developing diabetes .
One recent observational study found that people with diabetes who slept 6.5 to 7.5 hours per night had better blood glucose management compared to those who slept for less or more time .
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How Do I Check My Blood Sugar
You use a blood glucose meter to check your blood sugar. This device uses a small drop of blood from your finger to measure your blood sugar level. You can get the meter and supplies in a drug store or by mail.
Read the directions that come with your meter to learn how to check your blood sugar. Your health care team also can show you how to use your meter. Write the date, time, and result of the test in your blood sugar record. Take your blood sugar record and meter to each visit and talk about your results with your health care team.
Why Is Insulin A Factor In Low Blood Sugar
Insulin is a hormone that allows glucose to enter the cells from the blood which lowers blood glucose/sugar levels. In people without diabetes, the pancreas knows how much insulin it needs to release in order to lower blood sugar.
But for people with diabetes when deciding themselves how much insulin is needed this is less straightforward. A person can have a good understanding of what the body might need, through calculations.
But there is a great deal to consider, which can be overwhelming sometimes. As a result, errors in calculating insulin can and do occur. Thats why diabetes applications like Hedia, wink, wink exist.
Hedias insulin calculator will take away the worries of figuring it out for yourself. You dont even need to enter your blood sugar readings yourself: they can be added wirelessly with certain NFC or Bluetooth glucose meters to Hedia!
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This should all lead to more accurate results. In turn, this means that a rapid drop in blood sugar should be less likely.
But its not only about human errors or miscalculations. Its also about the nature of insulin medication.
Specifically, many people with diabetes nowadays use rapid-acting insulin at mealtimes in order to counteract the rapid rise in blood sugar after eating.
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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.
Does Everyone Have Symptoms From Hypoglycemia
Some people dont have symptoms or dont notice them. Healthcare providers call that situation hypoglycemia unawareness. People with such a challenge arent aware when they need to do something about their blood sugar. Theyre then more likely to have severe episodes and need medical help. People with hypoglycemia unawareness should check their blood sugar more often.
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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.
How Do You Treat Hypoglycemia
Treatment for hypoglycemia involves both the immediate steps needed to raise your blood sugar level in addition with the later treatment or medication dose adjustment to prevent recurrence.
To immediately raise your blood sugar level, Dr. Shah advocates the rule of 15eating 15 grams of carbohydrates and then checking your blood sugar level 15 minutes later. Fast-acting carbohydrates include:
- 4 glucose tablets
- 4 ounces of fruit juices
Keep repeating these steps every 15 minutes until your blood sugar reaches above 70 mg/dL, he explains. Once your level has stabilized, its important to then eat a snack or even a full meal to maintain that balance, Dr. Shah adds.
If your symptoms are more severe and/or a person is unable to swallow, you may need an injection of glucagon, he says.
To prevent episodes of hypoglycemia in the future, Dr. Shah says that treatment may involve the changing of prescribed regimens and dosages or adjusting your meal plans.
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Overdose Of Diabetes Medication
A common cause of hypoglycaemia is taking too much insulin for your current needs. Insulin is a medication that helps control your blood glucose levels. Its commonly used to treat type 1 diabetes and is also recommended for some people with type 2 diabetes.
A fall in blood glucose levels can also occur after taking too much oral hypoglycaemia medication, such as sulphonylurea, which causes a release of insulin. This medication is often used to lower blood glucose levels in people with type 2 diabetes.