Diabetes and Hypoglycemia
Hypoglycemia is defined as blood glucose levels dropping under 4 mmol/L
Hypoglycemia occurs when blood glucose levels fall below 4 mmol/L. Knowing the symptoms & causes of hypoglycemia can help you avoid a hypoglycemic attack.
What is hypoglycemia?
Hypoglycemia occurs when they level of glucose or sugar present in the blood falls below a set point - 4 mmol/L (millimoles per litre).
Some people get confused regarding the spelling of hypoglycemia. Hypoglycemia is the way it is spelt in the UK and hypoglycemia is the American spelling.
What are the symptoms of hypoglycemia?
The main symptoms associated with hypoglycemia include sweating, fatigue and feeling dizzy.
Symptoms of hypoglycemia can also include:
- being pale
- feeling weak
- feeling hungry
- a higher heart rate than usual
- blurred vision
- temporary loss of consciousness
- confusion
- convulsions
- and even coma (in serious cases)
What are the causes of hypoglycemia?
Hypoglycemia is caused by a variety of different factors, all of which diabetics need to be aware of.
Alcohol can cause hypoglycemia, as alcoholic drinks often lower blood sugar levels.
Taking too much insulin can also cause hypoglycemic episodes.
Hypos can also occur when the body needs more energy that the calories you have eaten can provide.
One of the things that you will hear a lot about if you have a diagnosis of diabetes is hyper (which is high) or hypo (which is low) -glycemia. Glycemia is to do with your blood sugar level. You want to try and find the balance in the middle where you're safe and functional and everything is working well.
Hypoglycemia (hypo is low) is when you have either too much insulin or too little sugar. Typically, most people feel symptoms. It's pretty much an insulin overdose. But as it's part of the rest of your body, there are other bits going on as well. As your body is reacting to a perceived 'threat', you may get a bit of adrenaline being kicked out as well. So, some of the symptoms you can put down to adrenaline rather as opposed to an insulin overdose.
What you will feel is probably: shaky, a bit confused, a little uncoordinated, sweaty, some peoples eyes go funny. The best thing possible is - if you keep your blood testing kit with you, is to do a blood test - to be certain that you have found yourself having a hypo.
There is a slight chance you could be confusing it with being nervous, for example. Again, it's that similar feeling of adrenaline kicking in. Having said that, when you're having a hypo, a blood test can be particularly tricky. I usually know when I'm having a hypo as when I'm trying to get the strips in and sometimes end up throwing it away - because you're losing it. Another factor with adrenaline and insulin is that you can get short tempered and snappy, and that can be another sign of a hypo.
It's important you can learn to recognise your symptoms. It's also important to keep having your symptoms. If you spend an awful amount of time having hypos you may start losing your sensitivity to your symptoms. Another thing that is really helpful is to let the people around you know you diabetes. They can be part of the help to get you out of your hypo. All you really need is some sugar in whatever form possible.
Liquid is sometimes easier than having to chew, if you're having a bad hypo. Anything under 4mmol/L would be borderline, but by the time you're 3.8mmol/L you're definitely having a hypo. Effectively, the lower you go, the more sugar you're going to need to pull yourself up and it may take a bit more time to come back up.
You want to address the hypo as soon as you can. If you've had diabetes quite a long time and had a few hypos; they are almost inevitable. The key is not to have too many and to always be prepared and have sugar handy. The people around you may say you're acting a bit funny or shaky - and they can be the people that help to identify a possible hypo if you can't recognise the symptoms yourself.
I've been using the phrase "going a bit wobbly". It's very commonly used. Not everyone says "I'm going a bit hypo" or "I'm going into hypo" and I don't know of anyone who uses the term hypoglycemia. Wobbly, dizzy - we all have our own ways of describing it.
Try not to overdo it when you're having a hypo. Your body, once it's recovered, it too will kick out sugars so you don't need to overdo it. The main thing is to try and keep your head if you can. Sit down and take some time. It should take 15-20 minutes to pull you away from a hypo.
You need to be very careful if you're driving. You should test before you drive to avoid a hypo. If you happen to be driving, pull over and if you're having a hypo - treat it and wait until your sugars are at least 5 mmol/L again. As far as treating it is concerned - keep things that don't go off, don't melt and are available in your bag, desk, glove compartment.
The only thing to do remember to do is if you use it when having a hypo is to replace it - so there is always one there.
How serious is hypoglycemia?
Hypoglycemic episodes can range from mild to sever. Mild hypoglycemia is generally able to be treated by the individual. However, severe hypoglycemia will need aid from a family member or doctor.
Impact on health of hypoglycemia
Hypoglycemia, as well as being frightening for yourself and those around, can lead to the following:
- Cognitive decline / impact on brain power
- Dead in bed syndrome
- Weight gain
Do symptoms always occur before hypoglycemia?
Most people experience some warnings before the onset of hypoglycemia.
However, some diabetics may experience little or no warning before the onset of sudden or severe hypoglycemia.
What is the best way to avoid hypoglycemia?
To avoid hypoglycemia, diabetes experts advise diabetics to keep a constant level of glucose in the blood, testing blood sugar levels regularly to make sure they are not rising or falling below the optimum level.
How is hypoglycemia diagnosed?
A diagnosis of hypoglycemia is made by measuring blood sugar levels with a glucose meter. Any blood glucose level below 4.0 mmol/L indicates that the individual has hypoglycemia. Urine tests do not detect hypoglycemia.
How do diabetics treat hypoglycemia?
A mild case of hypoglycemia can be treated through eating or drinking approximately 10-20g of sugar (i.e. carbohydrates). Some diabetics carry glucose tablets for this express purpose.
Serious hypoglycemia will require medical attention. In this instance, paramedics will use glucagon or provide glucose intravenously. Some diabetics have glucagons injections at home, in the form of glucagons kits.
This allows immediate treatment and the possibility of avoiding hospital. For those diabetics that experience regular hypoglycemia, blood sugar levels should be tested regularly.
How can I avoid and be prepared for hypoglycemia?
Knowing and being aware of the symptoms of hypoglycemia allow diabetics to get treatment quickly. Experts advise diabetics to always carry sugar (glucose tablets are effective). Measuring blood glucose levels regularly, and in accordance with one’s lifestyle, is also recommended.
Eating regularly and being aware of how food affects your blood sugar levels allows, as does taking care when doing exercise.
