Warning Signs of Hypoglycemia

If you are a type 2 diabetic, or live with one, you should make sure you know the warning signs of hypoglycemia, or low blood sugar.

What is hypoglycemia?

Hypoglycemia is low blood sugar, or low blood glucose.  It occurs when blood glucose levels drop below 70 mg/dL.

Unfortunately, low blood sugar is a common occurrence in diabetics.  It is a side effect of some diabetic medications and insulin, and can occur under a wide variety of circumstances.  One of the first things you need to do as a diabetic is familiarize yourself with the symptoms of hypoglycemia.

Hypoglycemia occurs when blood sugar is lower than 70 mg/dL.  If you get this reading on your home monitor, and have no symptoms of low blood sugar, you should immediately do another test, and also check to make sure you have coded your meter correctly.  If you get a second low blood sugar reading, immediately take action.

Causes of Low Blood Sugar?

Your blood sugar levels are constantly changing throughout the day.  Glucose is the body’s main form of fuel.  As you digest food and beverages, your body converts these into fuel.  As your body uses up its fuel, your blood sugar decreases.  Hypoglycemia occurs under a variety of circumstances:

• If you skip a meal
• If you take too much medication / insulin
• If you eat too small a meal
• If you increase your physical activity
• If you consume alcoholic beverages.

Unfortunately hypoglycemia is a relatively common occurrence in people with diabetes. If you have diabetes and are taking any of the following diabetes medications, you are at risk for low blood sugar:

• acetohexamide (Dymelor)
• chlorpropamide (Diabinese)
• glimepiride (Amaryl)
• glipizide (Glucotrol, Glucotrol XL)
• glyburide (Micronase)
• mitiglinide
• nateglinide (Starlix)
• repaglinide (Prandin)
• sitagliptin (Januvia)
• tolazamide
• tolazamide (Tolinase)
• tolbutamide
• tolbutamide (Orinase)

Oral combination therapy can also cause instances of hypoglycemia, these include:

• Glipizide and metformin (Metaglip)
• glyburide and metformin (Glucovance)
• pioglitazone and glimepiride (Duetact)
• rosiglitazone and glimepiride (Avandaryl)
• sitagliptin and metformin (Janumet)

And of course, if you are taking insulin there is always the risk of a hypoglycemic event.

What to Do If You Have Low Blood Sugar?

If you think your blood sugar is too low, you should immediately check your numbers with a home blood glucose meter.  If the level is below 70 mg/dL, you should eat one of the quick-fix foods noted below.  This will immediately raise your blood glucose.  After consuming on of these foods you should check your meter to ensure the glucose levels are above 70 mg/dL.

Quick-Fix Foods for Hypoglycemia:

• 3 or 4 glucose tablets
• 1 serving of glucose gel—the amount equal to 15 grams of carbohydrate
• 1/2 cup of any fruit juice
• 1/2 cup of a regular—not diet—soft drink
• 1 cup of milk
• 5 or 6 pieces of hard candy
• 1 tablespoon of sugar or honey

If you have repeated these steps and you are still unable to get your blood sugar over 70, immediate medical attention should be sought.

If you will not be eating a meal for an hour or more after you’ve gotten your blood sugar to 70 mg/dL or higher, then you should eat a planned snack.

In the event of severe hypoglycemia, you will very likely have passed out or will be unable to treat yourself.  This is much more likely to occur in people with type 1 diabetes.  Ask your physician for a plan of action.  Usually an injection of glucagon, which can be administered by another person, will rapidly bring your blood sugar back to normal.

What are the Symptoms of Hypoglycemia?

When blood glucose levels drop too low, the body releases stress hormones.  Reaction to these hormones is an indication that you may be suffering from hypoglycemia, and you should test your blood immediately.

Warning Signs of Hypoglycemia Include:

• Cold sweats
• Convulsions
• Double vision or blurry vision
• Fast or pounding heartbeat
• General discomfort, uneasiness, or ill feeling (malaise)
• Headache
• Hunger
• Irritability (possible aggression)
• Nervousness
• Shaking or trembling
• Sleeping difficulty
• Tingling or numbness of the skin
• Tiredness or weakness
• Unclear thinking

You may not always recognize the hypoglycemia signs and / or symptoms of low blood sugar, or you may have a hypoglycemic event and not exhibit any symptoms.  If your blood sugar gets too low, you may:

• Faint
• Have a seizure
• Go into a coma

It is a good idea to wear a medical alert bracelet or necklace if you are diabetic.  Also, you should work with your physician to develop a plan in the event that you do suffer a hypoglycemic attack.  While hypoglycemia can be serious, if you can recognize low blood sugar symptoms, it can be easily managed.