Hypoglycemia, commonly referred to as low blood sugar, occurs when blood glucose levels fall below 70 mg/dL (3.9 mmol/L). It is a potentially dangerous condition that primarily affects individuals with diabetes, but it can also occur in people without the disease due to a variety of factors. The most important thing when managing hypoglycemia is to recognize the signs early and know how to treat it effectively. In this article, we will delve into what hypoglycemia is, its symptoms, causes, and most importantly, what you should do when Hypoglycemia happens.
Understanding Hypoglycemia
Hypoglycemia occurs when there is not enough glucose in the bloodstream to provide adequate energy to the body’s cells, particularly the brain. Since glucose is the main source of energy for our brain, a lack of it can result in confusion, fainting, and even seizures or coma in severe cases.
This condition is most commonly associated with diabetes treatment. When individuals with diabetes take too much insulin or certain oral medications, skip meals, or exercise excessively, it can cause blood sugar levels to drop to dangerously low levels.
Non-diabetic hypoglycemia is much rarer but can occur in individuals due to conditions such as insulin overproduction, hormonal deficiencies, critical illnesses, or excessive alcohol consumption. Regardless of the cause, managing hypoglycemia requires timely intervention.
Symptoms of Hypoglycemia
Recognizing the symptoms of hypoglycemia is crucial for preventing a minor episode from becoming a serious medical emergency. Symptoms can vary from person to person, but common signs include:
- Shakiness or tremors
- Sweating
- Dizziness or lightheadedness
- Rapid or irregular heartbeat (palpitations)
- Anxiety or nervousness
- Irritability or mood swings
- Confusion or difficulty concentrating
- Blurred vision
- Headaches
- Fatigue
- Hunger or nausea
Severe hypoglycemia can lead to more serious symptoms, including:
- Inability to eat or drink
- Seizures
- Unconsciousness
If hypoglycemia is not addressed promptly, it can escalate to life-threatening levels, especially in individuals with diabetes who are dependent on insulin or medications that lower blood sugar. Therefore, knowing what to do when experiencing these symptoms is vital.
What Causes Hypoglycemia?
There are various causes of hypoglycemia, which can be categorized into two main types: diabetic hypoglycemia and non-diabetic hypoglycemia.
Diabetic Hypoglycemia
Diabetic hypoglycemia occurs when blood sugar levels drop too low in individuals with diabetes. Common causes include:
- Excessive Insulin or Medication Use: Taking more insulin or diabetes medication than needed can cause blood sugar to drop too low.
- Skipping or Delaying Meals: Eating less food or skipping meals can lead to hypoglycemia, particularly in those taking insulin or sulfonylureas (oral diabetes medications).
- Intense Physical Activity: Physical activity uses glucose for energy. Without proper adjustments to insulin or food intake, this can result in low blood sugar.
- Drinking Alcohol: Alcohol can interfere with the liver’s ability to release glucose into the bloodstream, causing hypoglycemia, especially when combined with diabetes medication.
Non-Diabetic Hypoglycemia
Although rare, non-diabetic hypoglycemia can be caused by:
Excessive Insulin Production: Conditions such as insulinomas (insulin-producing tumors) can lead to an overproduction of insulin, resulting in low blood sugar.
Hormonal Imbalances: Deficiencies in hormones such as cortisol or glucagon, which help regulate blood sugar, can cause hypoglycemia.
Critical Illnesses: Severe illnesses affecting the liver, kidneys, or heart may impair glucose production and result in hypoglycemia.
Reactive Hypoglycemia: This occurs when blood sugar drops after eating, typically due to excessive insulin release.
What to Do for Hypoglycemia
When you experience the signs and symptoms of hypoglycemia, it is important to act quickly to raise your blood sugar to a safe level. The following are steps you can take to effectively manage hypoglycemia:
1. Check Your Blood Sugar Levels
If you suspect hypoglycemia, the first step is to check your blood glucose levels using a blood glucose meter or continuous glucose monitor (CGM). This will confirm whether your blood sugar is indeed low and how severe the hypoglycemia is. A reading below 70 mg/dL (3.9 mmol/L) is considered hypoglycemia, though some people may experience symptoms at slightly higher levels, especially if their body is used to higher blood sugar levels.
If your blood sugar is below 70 mg/dL or you are experiencing symptoms, it’s time to take action. If testing equipment is not available and you are experiencing typical hypoglycemia symptoms, it’s still important to treat as though you have low blood sugar.
2. The 15-15 Rule
One of the most effective and widely recommended methods for treating hypoglycemia is the 15-15 rule. This approach involves consuming 15 grams of fast-acting carbohydrates and then waiting 15 minutes to recheck your blood sugar levels. Fast-acting carbohydrates are easily digestible and quickly raise blood glucose levels.
Here are examples of foods or drinks that provide 15 grams of fast-acting carbohydrates:
- 4 glucose tablets
- 1/2 cup (4 ounces) of regular (non-diet) soda
- 1/2 cup (4 ounces) of fruit juice
- 1 tablespoon of sugar or honey
- 5 to 6 pieces of hard candy (like jellybeans)
After consuming the 15 grams of carbohydrates, wait 15 minutes and check your blood sugar again. If it is still below 70 mg/dL, consume another 15 grams of fast-acting carbohydrates and recheck after another 15 minutes. Repeat the process until your blood sugar level returns to a safe range.
3. Follow Up with a Snack or Meal
After your blood sugar has returned to a safe level, it is important to eat a small snack or meal that contains a mix of carbohydrates and protein to help stabilize your blood sugar and prevent it from dropping again. This is especially important if your next meal is more than an hour away. Examples of snacks include:
- A peanut butter sandwich
- Crackers with cheese
- A small apple with peanut butter
- Greek yogurt with a handful of nuts
Avoid foods high in fat (such as chocolate) during an episode of hypoglycemia, as fat slows down the absorption of glucose, making it less effective for immediate blood sugar correction.
4. Avoid Overtreatment
While it’s important to raise your blood sugar quickly during a hypoglycemic episode, be careful not to overtreat by consuming too many carbohydrates. Overeating in response to low blood sugar can cause your levels to spike, leading to hyperglycemia (high blood sugar). Using the 15-15 rule helps prevent overtreatment by providing a structured way to raise your blood sugar incrementally.
5. Seek Emergency Help if Necessary
In some cases, hypoglycemia may become severe and require immediate medical attention. Severe hypoglycemia is defined as blood sugar so low that the person is unable to treat themselves. If someone with diabetes loses consciousness or has a seizure due to hypoglycemia, immediate action is necessary.
Glucagon Injection: If you are at risk of severe hypoglycemia, your healthcare provider may prescribe a glucagon kit, which contains a hormone that quickly raises blood sugar levels. Friends, family members, or coworkers should be trained on how to administer glucagon in case of an emergency. After receiving glucagon, the individual should recover within 15 minutes. However, they will still need to eat something to stabilize their blood sugar.
Emergency Services: If glucagon is not available or the individual does not respond to glucagon, call emergency services immediately. Severe hypoglycemia can be life-threatening, and professional medical care may be needed to stabilize the person.
6. Preventing Future Episodes of Hypoglycemia
Preventing hypoglycemia is a key part of diabetes management. Once an episode of hypoglycemia has been treated, it’s important to take steps to prevent future episodes from occurring. Here are some strategies to help reduce your risk of hypoglycemia:
1. Adjust Medications
If you experience frequent hypoglycemia, it may be a sign that your insulin or medication dosage needs to be adjusted. Talk to your healthcare provider about your treatment plan and discuss any adjustments that may be necessary. This could include:
- Reducing your insulin dose
- Switching to a different type of insulin with a more gradual onset
- Changing the timing of your medication or insulin doses
2. Eat Regularly
Regular meals and snacks are essential for maintaining stable blood sugar levels. Skipping meals or going too long without eating can increase your risk of hypoglycemia, especially if you are taking insulin or medications that lower blood sugar. Try to eat meals at consistent times each day and include a balanced mix of carbohydrates, proteins, and fats.
3. Monitor Blood Sugar Regularly
Regular blood sugar monitoring allows you to catch and treat low blood sugar before it becomes severe. If you use insulin or are at risk of hypoglycemia, checking your blood sugar before meals, before and after exercise, and before bedtime is important. If you experience frequent episodes of low blood sugar, consider using a continuous glucose monitor (CGM), which can alert you when your levels are dropping.
4. Be Cautious with Exercise
Physical activity can lower blood sugar, so it’s important to take precautions when exercising. Check your blood sugar before starting any exercise, and adjust your carbohydrate intake or insulin dose accordingly. Always carry a fast-acting carbohydrate with you during exercise in case your blood sugar drops.
5. Avoid Alcohol
Alcohol can interfere with your liver’s ability to release glucose into the bloodstream, increasing the risk of hypoglycemia. If you do choose to drink alcohol, make sure to eat a carbohydrate-rich meal or snack beforehand and monitor your blood sugar closely.
See also: What Are the Causes of Hypoglycemia in Non-Diabetics?
Conclusion
Hypoglycemia is a serious condition that requires immediate treatment to prevent complications. Recognizing the symptoms early and following the 15-15 rule for treatment can help you manage low blood sugar effectively. Additionally, making lifestyle adjustments, such as regular meals, careful medication management, and regular blood sugar monitoring, can help prevent future episodes. In severe cases, knowing how to administer glucagon and seeking emergency help are critical to ensuring a safe recovery. Managing hypoglycemia involves a proactive approach that combines timely treatment with long-term strategies for preventing future occurrences.
Related topics:
What Are the Different Types of Hypoglycemia?
