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Hypoglycemia- Managing Low Blood Sugar

Written by: Erica Whyte, Rite Aid Pharmacist and Diabetes Care Specialist in Washington and Waynesburg, Pennsylvania

Hypoglycemia is the term used for the condition of low blood sugar. Hypoglycemia can be a serious condition if not identified and treated properly. Learning to recognize the signs and symptoms of hypoglycemia and knowing how to treat it is important for everyone with diabetes, as well as those people who live and care for them.

Hypoglycemia may happen occasionally in people using certain medication or insulin to control their diabetes. In general, people experiencing low blood sugar will feel shaky, dizzy, and hungry. Often, they get a headache, start to sweat, and have a rapid heartbeat. Others may notice that they look pale, are confused, clumsy, or just seem moody. If the blood sugar continues to drop, a person could pass out, or have a seizure.

Hypoglycemia may occur when a person with diabetes has not eaten enough when taking their insulin or medication. Intense exercise may drop the blood glucose level too low. Alcohol can also cause hypoglycemia. Most people are able to gradually feel the symptoms of low blood sugar coming on and treat it by eating a snack rich in carbohydrates.

When experiencing the feelings of hypoglycemia a person with diabetes should:

1. Check their blood glucose. A blood glucose reading less than 70mg/dL indicates low blood sugar.
2. Have a quick snack that contains 15 grams of easily-absorbed sugar.
   
   A few examples are:
   • 1/2 can of regular soda
   • ½ cup fruit juice
   • 5-6 jellybeans or any hard candy
   • 3-4 glucose tablets

   *An important note to remember is if you use the diabetes medications Glyset or Precose, you must treat hypoglycemia with glucose tablets. These medications prevent other forms of carbohydrate from being absorbed quickly.

3. Wait 15-20 minutes and re-check your blood glucose, if there is no improvement repeat step 2. If your next scheduled meal is more than 2 hours away eat a snack containing protein like a peanut butter sandwich with a glass of milk.
4. If a person passes out they need immediate medical attention; call 911. Glucagon is an injection that raises blood glucose quickly. Glucagon can be prescribed for people who suffer from frequent low blood sugar to be given during times of extreme low blood sugar.

It is possible for a person with diabetes to experience hypoglycemia without feeling any of the symptoms of low blood sugar. The term for this is hypoglycemia unawareness Hypoglycemia unawareness is more common in people who have had diabetes for many years and have suffered from frequent episodes of low blood sugar. Their bodies no longer recognize the low blood sugar in the normal way of dizziness, sweating, and hunger. Hypoglycemia unawareness is also more common in people who suffer from neuropathy (nerve damage) or are taking certain blood pressure medications call beta-blockers that may lessen the symptoms of low blood sugar. If you or a person you know with diabetes ever experience low blood sugar readings below 50mg/dL without symptoms, please inform a healthcare professional.

Hypoglycemia can be serious but more importantly, it is preventable. Keeping a regular meal, medication, and monitoring schedule is essential to maintaining proper blood glucose readings. Never skip meals and always keep a snack handy. Remember to check your blood sugar often and especially if you are not feeling well. Teach family and friends the signs and symptoms of hypoglycemia and how to help you if needed.

References:

1. American Diabetes Association Position Statement "Hypoglycemia and Employment/Licensure". Diabetes Care. 2004; 27 Supplement 1
2. America Diabetes Association Home page (resources from the World Wide Web). Hypoglycemia. URL:http://www.diabetes.org Available from Internet. Accessed 2004 July 16.
3. Meyer, C. Hypoglycemia Unawareness- Can Beta Blockers Help? Diabetes Forecast May 2004 URL:http://www.diabetes.org Available from Internet. Accessed 2004 July 16.

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