Diabetes and Hypoglycemia

Diabetes is a condition that involves the body’s ability to produce insulin. Patients that take medication to increase insulin levels may experience low blood sugar levels, leading to a condition called hypoglycemia. Hypoglycemia is characterized by blood sugar levels under 70 milligrams per deciliter.

In cases where low blood sugar is a complication of diabetes, the condition is referred to as diabetic hypoglycemia and is caused by excess insulin in the blood. Like with many conditions, proper treatment and prevention methods can help you reduce and manage your symptoms, while the lack of treatment can lead to serious complications.

Symptoms and Potential Complications

In the early stages of diabetic hypoglycemia, symptoms can include:

Shaking
Dizziness
Anxiety, nervousness or irritability
Headache
Hunger
Sweating

There are also cases where diabetic hypoglycemia occurs during sleep, which can include a few different symptoms:

Nightmares
Damp or wet sheets or clothes from sweating during sleep
Tiredness, irritability or confusion after waking up

When diabetic hypoglycemia is not detected early enough or isn’t treated properly, severe symptoms can result:

Muscle weakness, clumsiness or jerky movements
Drowsiness or unconsciousness
Confusion
Blurred or double vision
Trouble speaking
Convulsions or seizures
Death

Some of these serious symptoms can increase the likelihood of accidents, and treatment is a very important matter. Symptoms may vary between cases, so if you have diabetes, keep careful track of blood sugar levels. In severe cases where you become unconscious or unresponsive and cannot swallow, make sure close family members know a few basic tactics:

No food or fluids—they can cause choking
Injection of glucagon, a hormone that releases sugar into the blood
Emergency hospital treatment if glucagon is unavailable

Causes

People who take insulin for diabetes are more likely to develop diabetic hypoglycemia, although other oral medications can cause it as well. Other causes of diabetic hypoglycemia include:

Not eating enough, or skipping meals
Increasing exercise intensity levels without adjusting eating habits or medications
Alcohol consumption

Treatment

Treatment of diabetic hypoglycemia involves raising blood sugar to the appropriate levels. You’ll have a blood glucose meter if you have diabetes—check it regularly. If your levels are too low, eat or drink something high in sugar or carbohydrates to quickly increase your blood sugar level. Avoid chocolate and other high-fat foods, which don’t work as well. Good options include:

Four ounces of fruit juice or non-diet soda
Five or six pieces of hard candy
Three glucose tablets
One tablespoon of sugar, honey or jelly
A serving of glucose gel

In cases where you’re unable to check blood sugar levels to confirm the presence of hypoglycemia, simply assume it’s present. If your risk is high for hypoglycemia, you may want to carry a high-sugar snack with you at all times. Many diabetes patients wear bracelets that identify them as such, in the case of a medical emergency.

In situations where these strategies don’t manage hypoglycemia, speak to your doctor. They may recommend changes in your glucose goal range or prescribe glucagon.

Prevention

There are several specific steps you can take to prevent diabetic hypoglycemia:

Monitoring: Regular monitoring of blood sugar levels, including multiple checks per day, will help you be aware of any time your levels fall outside their expected range.
Meals and snacks: Don’t skip or delay eating, and stay as consistent as you can about meal timing and portion sizes.
Medication: Be precise with medication, both in dosage and the recommended schedule from your doctor. If you eat more snacks or increase physical activity in a given day, adjust medication accordingly—your doctor can give you specific recommendations here based on your common activities.
Alcohol: Avoid alcohol if possible, but if you do drink, try to accompany it with a snack or a meal to avoid drinking on an empty stomach, which can cause hypoglycemia.
Record: Keep a record of your glucose reactions to help with continuing treatment.
Identification: Bracelets and other basic forms of identification (such as necklaces or wallet cards) can let other people know you have diabetes in case of an emergency.

If you’re developing the symptoms of diabetic hypoglycemia, speak to your doctor.