Low Blood Sugar level

[FractalFragger]

Hi,

Just a concern here but yesterday evening around 7:15pm i started t become very shaky and sweating a lot even though it was cool where i was. i took my blood sugar level reading as i was slightly concerned and it was down at 3.2. i understand that this is low?

anyways i immediately ate in order to bring them up (chocolate biscuits and cream :/) but i need to know if:

1. this is normal to happen to type 2's
2. should i eat sugary stuff if i do become low like that
3 if sugary stuff is a must then whats the best?

any information would be great to avoid this in future or to rectify it as soon as possible.

thanks
Mark

 

[oakdaledave]

Hi Mark, I am newly diagnosed so don't know much yet, but I do think your reading was low. I've read somewhere that 5 Jelly babies does the trick. I'm sure someone will come along soon with more knowledge to put you right.

 

[Yvonne8]

Hi there, I was under the impression that it would be very hard for a t2 on diet etc only to have a hypo when not using medication so I'd advise you to see your nurse or gp.

 

[borofergie]

1. this is normal to happen to type 2's
It can happen to everyone. Some non-diabetics run constantly at these kind of levels.

2. should i eat sugary stuff if i do become low like that
You can either eat some carbs or wait until your liver dumps (that's what it's there for).

 

[xyzzy]

Hi Mark

The general rule is if you are a T2 on no meds or just Metformin you will be no different to a non diabetic and non diabetics can get low sugars just like a T2. The level that low starts to effect you varies from person to person and from situation to situation so I've recorded a 3.2 and felt fine but on other occasions have got your symptoms at slightly higher levels as well. The speed your levels fall also has an effect.

If you get them the best approach is normally to eat but as a no meds T2 its probably best to eat something a bit carby (slice of bread, ritz crackers that kind of carbs) rather than a load of pure sugar or glucose.

In the end a no or minimal meds T2 should self correct. The body has a mechanism for doing this called a liver dump. At some point your brain will go "had enough of this" and tell your liver to dump a load of glucose at which point your levels will rise quite considerably. In the one case I've managed to measure the effect after doing some running I went from 3.4 to 7.1 in 5 minutes. Normally a liver dump is caused by doing stuff like strenuous exercise which will lower levels. Alternatively it can and does just happen if you slowly fall to a very low level. If you hadn't eaten anything since lunchtime then at 7.15pm you would likely be at the days lowest sugar level anyway. As a pretty newly diagnosed T2 your levels will be a bit all over the place anyway until your body begins to get use to the new levels of carbs etc. Even though we do self correct it doesn't alter the fact that sometimes you get the sickness dizziness thing before the dump would occur. If you are lucky like I was after running the liver dump occurs before you get any symptoms but sometimes you get the symptoms first. What you have to remember is that throughout your life this liver dump mechanism has probably cut it loads of times without you ever realising it.

In a T1 or insulin injecting diabetic or occasionally a diabetic who is on insulin stimulating drugs a true hypo can occur. In this case the normal cause is an over injection of insulin. This causes a rapid fall in levels that can simplistically override the bodies normal liver dump responses. In these cases nothing apart from orally taking on board extra glucose will stop the decline and is therefore very dangerous as under around 2.5 most people start to run the risk of falling unconscious. Even then the body has its own defences. It will try and keep important bits like the brain at a higher levels than non critical bits. Some T1's on the forum have been happily conscious and alert with readings in the high 1's.

The ADA (American Diabetes Association) says for an insulin injecting diabetic the hypo range begins under 4 but does not become dangerous until levels fall below 2.5. The key thing in that statement is insulin injecting.

Another way of looking at it is to realise being diabetic doesn't cause hypos. True hypos are caused by insulin injections or powerful diabetic drugs not the diabetic themselves.

Another thing for a newly diagnosed T2 to be aware of is that those dizziness and sickness symptoms can occur at levels far higher than 3 or 4. These are called false hypos and happen simply because that diabetics body has got use to running at very high sugar levels so their bodies object to having the sugar taken away. This is actually quite dangerous as it can act as a big disincentive to a T2 who is trying to get to normal levels as the level the false hypos can occur can be well above the recognised max safe level of 8. If the person doesn't realise what's happening then its quite likely they think their levels are too low and that they are "hypoing". They then eat a load of sugar and their body goes "thanks" and then continues to damage itself by having too high levels. If these occur you should try to bring your levels down slower but don't give up trying.

Here's what a moderator said a few weeks ago

Right... there needs to be a clear definition here... many non-diabetics regularly have blood glucose of below 4 mmol/l... if the mean fasting blood glucose of the general non-diabetic population is in the very low 4's then by definition some people are going to have fasting blood glucose in the mid - high 3's... (3.3 mmol/l is commonly citied as the 'lower level' of normal blood glucose). What you don't see is them regularly falling over or collapsing from hypo's because this is 'normal' blood glucose.

Anyone controlling their diabetes that doesn't use pancreas stimulating drugs or insulin is as likely as a non-diabetic to suffer from a hypo... i.e. yes you can still have them but you are going to have to have done something pretty daft to suffer from one... i.e. drink a lot... do a lot of exercise without eating... etc... This is exactly the reason why for instance the DVLA does not require these types of people to undergo the same level of scrutiny as insulin taking diabetics.. the risk to them is no greater than a normal member of the public.

If you take insulin then ofcourse you need to be much more aware of what your blood glucose are doing... as a type I diabetic of many years the danger from hypo's comes from the rapid change in blood glucose that insulin can produce.. Along with the fact that your body is not in control of the amount of insulin in effect... in a non-insulin controlled diabetic as your blood glucose drops lower your body stops producing insulin, your liver dumps glucose and all is well... in an insulin controlled diabetic that insulin keeps acting if there is too much insulin in your system them your livers glucose dump is not enough and your blood glucose continues to drop..

Therefore it is advised that you keep your blood glucose above 4 mmol/l... this ensures that you have some buffer to dangerously low blood glucose and also ensures that you maintain a hypo awareness (for most people)...

The point at which low blood glucose becomes dangerous is when it starts to effect brain function this is known as Neuroglycopenia.. Neuroglycopenia causes the majority of the symptoms that we associate with hypos... mood swings, fatigue, weakness, apathy, lethargy, confusion, amnesia, dizziness, delirium, etc... these symptoms typically present at between 2.0 - 2.4 mmol/l...

So in summary: If you are a diabetic who does not take pancreas stimulating drugs or insulin then a reading of between 3.3 - 4.0 mmol/l is nothing to be overly concerned about (you aren't about to drop into diabetic coma!.. indeed this may even be 'normal' for you). If you plan on exercising or drinking or any sort of activity that may effect your blood glucose or you have recently undertaken any of these activities then you may want to eat some carbs...

If on the other hand you are taking insulin or pancreas stimulating drugs and you get a reading that is sub 4 mmol/l then you should take it seriously and actively correct.

 

[Grazer]

This is quite a common theme regarding "hypos" for type 2's on diet only /metformin. There is a lot of confusion caused by the definition of a "Hypo"
"Hypo" is short for hypoglycaemia, which simply means low blood sugar. However, there is a massive difference between low blood sugar and the sort of hypo often referred to in relation to diabetes. Perhaps I can give my understanding.
Low blood sugar is not caused by diabetes. ANYONE, diabetic or non-diabetic, can get low blood sugar. Where energy demands are greater than the energy provided by the food (or drink) we've consumed, our blood sugar will continue to fall as demand is greater than supply. I've recorded 3.1 and I've known of people hitting the 2's (my athletic non-diabetic daughter - tested her once when she had an episode) This can lead to light-headedness or dizzy, feeling emotional, etc. Eventually, the liver will release Glycogen to compensate and bring BGs back up. The ONLY reason why a diabetic on diet only/metformin may be more likely to get this than a non-diabetic is because we are more likely to be on a diet and fall into the energy out being greater than the fuel in trap.
When referring to diabetic hypos, we are normally referring to the sort of dangerous hypo that can occur with an insulin dependant diabetic, or one on strong sugar-lolwering drugs (not metformin) Here, BGs can fall into the 1's and the individual could become comatose and, ultimately, die. Intervention by a third party to help is sometimes required. An aware Insulin dependant diabetic will solve the problem themself by taking on board some instant fuel (such as with glucose tablets) to raise BGs. This problem is caused by the intake of insulin being greater than that needed. Perhaps the individual miscalculated the dose needed, or didn't eat the expected food on schedule, or experienced greater exerciser than planned, or drank sugar lowering alcohol in quantities without adjustment. Whatever the cause, the insulin taken has dropped BGs greater than the expected need. This is why Metformin doesn't cause Hypos. It doesn't stimulate the release of insulin as some drugs do. It merely makes the liver release slightly less sugar after food than it normally would, and makes the insulin we DO produce (which occurs after food when our BG is rising) more effective. So it can stop our sugar level from rising quite as high as it would after food, but it doesn't LOWER it as insulin does.
So, in summary, diabetes doesn't cause hypos. Metformin doesn't cause hypos. Insulin can. Insulin-stimulating drugs can. Lack of food causes low blood sugar for either a diabetic or non diabetic (officially a hypo, but not dangerous and not requiring outside assistance). There is a big difference between low blood sugar and a dangerous hypo.
Hope this helps.