Treatment Plan For Lows
*** Remember that IOB calculations CANNOT be accurate unless your Active Insulin Time or Duration of Insulin Action time is set to at least 4.5 hours or LONGER!
More grams of carbs than these will likely be needed:
- If you forget and take 2 boluses/injections for a meal, or
- If you took a meal bolus but never ate the meal .
Quick treatment reduces stress hormone release and the chances of your glucose rising sharply afterward. Plus youll quickly feel better and your brain, muscles, and cells will thank you for resupplying the fuel that shortens their misery.
Check Your Blood Sugar Often
Talk with your provider about when you should check your blood sugar every day. People who have low blood sugar need to check their blood sugar more often.
The most common causes of low blood sugar are:
- Taking your insulin or diabetes medicine at the wrong time
- Taking too much insulin or diabetes medicine
- Taking insulin to correct high blood sugar without eating any food
- Not eating enough during meals or snacks after you have taken insulin or diabetes medicine
- Skipping meals
- Waiting too long after taking your medicine to eat your meals
- Exercising a lot or at a time that is unusual for you
- Not checking your blood sugar or not adjusting your insulin dose before exercising
- Drinking alcohol
For People With Diabetes
Check your blood sugar when you start to experience symptoms. If it’s below 70 milligrams per deciliter, eat 15 to 30 grams of fast-absorbing carbohydrates. Wait 15 minutes, then recheck your blood glucose level.
If your reading is below 100 milligrams per deciliter, eat another 15 grams of quick-absorbing carbohydrates. After waiting another 15 minutes, recheck to see if it’s within the target range your doctor outlined for you. Repeat these steps if necessary.
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Alcohol And Hypoglycemic Attacks
Drinking alcohol has been shown to trigger hypoglycemic attacks even in individuals with diabetes who have taken their insulin hours before. People with diabetes should be very aware of this possible problem if they drink.
If you are at risk of hypoglycemic episodes, you can avoid delays in treating attacks by closely monitoring your symptoms and sharing this knowledge with friends and family members. Not only can they help you if you are feeling ill, but they can also remind you to engage in health-positive behaviors when you fall off the wagon or forget. The risk for hypoglycemia is lower if you:
- Eat at regular times during the day
- Never skip meals
- Maintain a consistent exercise level
In rare circumstances, a healthcare provider may prescribe a glucagon emergency kit for non-diabetic people who have a history of becoming disoriented or losing consciousness from hypoglycemia.
If you have been diagnosed with diabetes, there are ways to prevent hypoglycemia:
An increasing body of evidence suggests that hypoglycemia is harmful to people with diabetes both immediately and over time, as it may have negative impacts on the heart and blood vessels.
Symptoms of hypoglycemia may be vague or mimic other conditions, so you may be unaware of its harmful effects until its too late, underscoring the importance of regulating ones glucose levels even if you are not feeling terribly sick.
Treatment For Severe Hypoglycaemia
In cases of severe hypoglycaemia the person cannot treat themselves, and needs the help of someone else. Call triple zero for an ambulance immediately.
If the person can’t swallow or follow instructions do not give them any treatment by mouth.
If you are trained in how to prepare and inject glucagon and feel comfortable injecting it, then this can be administered.
Ambulance paramedics have the resources to manage severe hypoglycaemia.
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Follow Your Diabetes Meal Plan
Make a diabetes meal plan with help from your health care team. Following a meal plan will help you manage your blood glucose, blood pressure, and cholesterol.
Choose fruits and vegetables, beans, whole grains, chicken or turkey without the skin, fish, lean meats, and nonfat or low-fat milk and cheese. Drink water instead of sugar-sweetened beverages. Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. Learn more about eating, diet, and nutrition with diabetes.
Work With Your Health Care Team
Most people with diabetes get health care from a primary care professional. Primary care professionals include internists, family physicians, and pediatricians. Sometimes physician assistants and nurses with extra training, called nurse practitioners, provide primary care. You also will need to see other care professionals from time to time. A team of health care professionals can help you improve your diabetes self-care. Remember, you are the most important member of your health care team.
Besides a primary care professional, your health care team may include
- an endocrinologist for more specialized diabetes care
- a registered dietitian, also called a nutritionist
- a nurse
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How Can I Treat Low Blood Sugar Quickly
If you feel symptoms of low blood sugar, test your levels with a blood glucose monitor as soon as possible. If your sugar levels are low , you can follow the 15-15-15 Rule:
Eat 15 g of a fast-acting carbohydrate . Common examples of 15 g include: a half cup of fruit juice, 6 to 8 hard candies, or 3 to 4 glucose tablets.
After 15 minutes, retest your sugar levels.
If they are still low, eat 15 g more.
If you are having a severe hypoglycemic attack or are unable to treat yourself, you may need a trained person to administer an emergency injection from your glucagon kit or a nasal spray of Baqsimi. If needed, you can eat 15 g of a fast-acting carbohydrate right after. If, after 15 minutes, you are still feeling confused or unconscious, have someone call 9-1-1.
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 Should I Do If My Blood Sugar Is Low
A ‘hypo’ is usually defined as a blood glucose below 4 mmol/L. A useful way to remember it is ‘Five, don’t drive four is the floor’. In other words, if your blood glucose is below 5 mmol/L, you shouldn’t drive. If it’s below 4 or you have symptoms of a hypo:
- Stop what you’re doing .
- Check your blood glucose if you haven’t already.
- Immediately eat some glucose tablets or sugary sweets or drink fruit juice or a sugary drink – the standard recommended amount is 15-20 grams of fast-acting carbohydrate.
- Warn anyone you’re with about what’s happening, so they can help if your symptoms get worse.
- Relax for 15 minutes or so while your blood glucose rises.
- Check your blood glucose again. Don’t drive until at least 45 minutes after it has risen above 5 mmol/L.
- You may also need to eat another snack, or a meal if it’s due – your medical team can advise.
When To Call The Doctor
If signs of low blood sugar do not improve after you have eaten a snack that contains sugar, have someone drive you to the emergency room or call your local emergency number . DO NOT drive when your blood sugar is low.
Get medical help right away for a person with low blood sugar if the person is not alert or cannot be woken up.
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Symptoms Of A Low Blood Sugar Level
A low blood sugar level can affect everyone differently. You’ll learn how it makes you feel, although your symptoms may change over time.
Early signs of a low blood sugar level include:
- a fast or pounding heartbeat
- becoming easily irritated, tearful, anxious or moody
- turning pale
If a low blood sugar level is not treated, you may get other symptoms, such as:
- unusual behaviour, slurred speech or clumsiness
- feeling sleepy
- seizures or fits
- collapsing or passing out
A low blood sugar level, or hypo, can also happen while you’re sleeping. This may cause you to wake up during the night or cause headaches, tiredness or damp sheets in the morning.
What Are The Symptoms Of Hypoglycemia
Changes in blood sugar affect everyone differently. According to the American Diabetes Association , some common symptoms of hypoglycemia include:
- Shakiness or jitteriness
- Feeling sleepy, weak, or lethargic
- Tingling in lips or cheeks
In cases of severe hypoglycemia, these symptoms can lead to confusion, impaired vision, loss of consciousness, or seizures. If someone passes out, or has a seizure from low blood sugar, you should call 911 immediately.
Most people have felt the effects of low blood sugar from time to timewhen youre really really hungry, or if you exercised on an empty stomach. But, if you are experiencing symptoms of hypoglycemia several times a week, this signals that you should seek medical care, explains Soma Mandal, MD, an internist at Summit Medical Group in Berkeley Heights, New Jersey.
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What Number Is Low Blood Sugar
Most endocrinologists/diabetes doctors believe that below 70 mg/dl blood sugar is an alert level. Yet, clinically important biochemical low blood sugar is blood sugar below 54mg/dl. American Diabetes Association has defined hypoglycemia in patients with diabetes as all episodes of an abnormally low plasma glucose concentration that can potentially be harmful.
On the other hand, in some cases, a diabetic person with diabetes reports typical symptoms of hypoglycemia but has a measured glucose level > 70 mg/dL. This category reflects the fact that patients with chronically poorly controlled diabetes can experience symptoms of hypoglycemia as glucose levels fall into the more normal range.
What Is Normal Blood Sugar
When we eat, glucose — which is our body’s main source of energy — enters our bloodstream from our food. Then our pancreas secretes a hormone called insulin in just the right amount to help the glucose go from the bloodstream to our body’s various cells to be used as energy. This process usually keeps the glucose in our bloodstream in a healthy range, being neither too high, nor too low.
This range is measured in milligrams of blood glucose per deciliter, or mg/dL. Dr. Saleh Aldasouqi, Chief of Endocrinology at Michigan State University, explains to CNET: “Normal blood sugar is defined as anywhere from 70 to 110 mg/dL within a healthy physiology, as a person without diabetes or other related diagnosed condition. Sugar below 70 is generally considered low, and above 110 is considered high .”
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Guidelines And Glycemic Targets
Hypoglycemia in the treatment of diabetes is addressed throughout the ADAs guideline, Standards of Medical Care in Diabetes2018, particularly in three of its chapters: 6, Establishing the Glycemic Target 11, Older Adults and 14, Diabetes Care in the Hospital.5
The A1C threshold for prediabetes is 5.7% and that for diabetes is 6.5% both of these are risk factors for cardiovascular disease. The most common A1C goal is < 7% for most patients with cognizance to avoid hypoglycemia. However, A1C goals are determined on a patient-by-patient basis those at higher risk for hypoglycemia and its negative consequences should have a considerably relaxed A1C goal in order to avoid hypoglycemia. This is because evidence to date has established the break-even point for benefit-versus-risk balance in this range, mostly based on patient-specific risk factors for hypoglycemia and its consequences, including CV events. Several recent clinical trials have demonstrated improved CV outcomes with drugs in certain drug classes that typically carry a low risk of hypoglycemia however, these data do not support lower-than-currently-recommended glycemic targets.6
List Of Diabetic Drugs That Do Not Cause Hypoglycemia
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Thoughts On The Link Between Diabetes And Hormones
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Please share this article to help as many patients as you can.
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Check Your Blood Glucose Levels
For many people with diabetes, checking their blood glucose level each day is an important way to manage their diabetes. Monitoring your blood glucose level is most important if you take insulin. The results of blood glucose monitoring can help you make decisions about food, physical activity, and medicines.
The most common way to check your blood glucose level at home is with a blood glucose meter. You get a drop of blood by pricking the side of your fingertip with a lancet. Then you apply the blood to a test strip. The meter will show you how much glucose is in your blood at the moment.
Ask your health care team how often you should check your blood glucose levels. Make sure to keep a record of your blood glucose self-checks. You can print copies of this glucose self-check chart . Take these records with you when you visit your health care team.
Can Hypoglycemia Occur Without Diabetes
While hypoglycemia is commonly associated with diabetes mellitus, there are other medications and conditions that cause itbut hypoglycemia without diabetes is quite uncommon, according to Satjit Bhusri, MD, founder of Upper East Side Cardiology in New York City.
Diabetes is defined by excess sugar in the blood, or hyperglycemia. Hypoglycemia is defined by insufficient sugar in the blood.
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