Hypoglycemia

Sometimes blood glucose can drop too low, especially if you are using diabetes medications or insulin.

The definition of hypoglycemia—or “low blood glucose”—is a blood glucose level that falls below 70 mg/dL. Some situations that can result in hypoglycemia include:

• You eat too little, so you don’t have enough glucose in your system.
• You exercise too much, so that you use up your glucose.
• You use a diabetes medication or insulin incorrectly, taking more than you need at one time, for example.
• You aren’t managing your diabetes well, and don’t stick to a balanced plan for your diet, activity, and medications.

Hypoglycemia is also called an “insulin reaction,” although you don’t need to be taking insulin in order to experience it. Regardless of the cause, hypoglycemia must be treated immediately before it gets worse. Most people can feel when a bout of hypoglycemia is coming on. The signs and symptoms generally are:

• Shakiness
• Dizziness
• Sweating
• Hunger
• Headache
• Pale skin color
• Difficulty paying attention
• Clumsiness
• Sudden moodiness or confusion
• Tingling sensations around the mouth
• Loss of consciousness

At the first sign you feel a reaction coming on, stop what you are doing and test your blood glucose. If your glucose meter is not available, don’t take chances. It can be best to assume you are low and treat yourself.

The “15-15” rule

It’s easy to remember how to treat hypoglycemia with the 15-15 rule. Eat 15 grams of carbohydrates, wait 15 minutes, and then test again to see if you are on your way up to a normal blood glucose level. If not, take a second dose of 15 grams and test again. You want to get safely up to 100 mg/dL. Fifteen grams of carbohydrates should bring up your glucose by about 50 mg/dL. It is often recommended that people use hard candies or glucose tablets, or drink some fruit juice. Fifteen grams of carbohydrates looks like this:

• 5-6 hard candies
• 3-4 glucose tablets
• ½ cup juice

Don’t forget: One candy or tablet will raise your glucose by only 10 mg/dL or so. You are likely to need several!

Precautions

• After you feel better, you might need a snack to carry you over until the next meal, if that meal is more than an hour away. You don’t want to slip back toward a low glucose situation.
• If you are on medication that could cause low blood glucose, be sure to always carry a source of carbs with you. Place glucose tablets, a juice box or candy in your glove compartment, purse, desk drawer, golf bag and briefcase. It never hurts to be prepared.
• If you treat your diabetes by injecting insulin, hypoglycemia must be treated quickly because it can get worse fast and you could lose consciousness.
• Glucagon is a hormone that is normally secreted by the pancreas to raise blood glucose levels. It is the opposite of insulin, which lowers blood glucose. An injection of glucagon is an emergency treatment for people who are becoming unconscious from hypoglycemia and are unable to chew or swallow a glucose source. Instructing friends, family and co-workers on how and when to give you an emergency injection of glucagon may save your life. Ask your physician to prescribe it for you and make sure you are instructed on how to use it so you can instruct others.
• If you have an insulin reaction and lose consciousness, and glucagon is not available, someone should call 911 for immediate medical assistance.