Common Cares

Hypoglycemia - A Side Effect in Diabetes

Glucose, a form of sugar, is an important fuel for the body that is obtained from our dietary intake, mainly from rice, potatoes, bread, cereals, milk, fruit, and sweets. After a meal, glucose is absorbed into the bloodstream and carried to the cells, with the help of insulin, where it is used for energy. An intake of excess glucose than what is required by the body at the time is stored in the liver and muscles in a form called glycogen. The body uses the stored glucose whenever it is needed for energy between meals, while extra glucose is converted to fat and stored in fat cells.

When blood glucose begins to fall, glucagon, another hormone produced by the pancreas, signals the liver to break down glycogen and release glucose, causing blood glucose levels to rise toward a normal level. A person with diabetes, will have an impaired glucagon response to hypoglycemia, making it harder for glucose levels to return to the normal range.

Symptoms of hypoglycemia may range from hunger, nervousness and shakiness, perspiration, dizziness or light-headedness, sleepiness, confusion, difficulty in speaking and feeling anxious or weak.

Hypoglycemia can happen to some persons while they are asleep. As a result of this they may cry out or have nightmares, perspire profusely or feel tired, irritable, or confused on wake up.

A Side Effect

Hypoglycemia can occur in people with diabetes who take certain medications to keep their blood glucose levels in control. Usually hypoglycemia is mild and can easily be treated by eating or drinking something with carbohydrate. But left untreated, hypoglycemia can lead to loss of consciousness. In people taking certain blood-glucose lowering medications, blood glucose may sometimes fall too low due to any of these reasons:

1. increased physical activity or exercise
2. meals or snacks that are too small, delayed, or skipped
3. excessive doses of insulin or some diabetes medications
4. excessive drinking of alcohol

Prevention

If a person with diabetes takes insulin but skips a meal, the insulin lowers the blood glucose, but it will not find the food it is designed to break down. This mismatch might result in hypoglycemia.

Prevention of hypoglycemia, needs to take care of the following:

Medications: As some medications can cause hypoglycemia, it is advisable to always take medications and insulin in the recommended doses and at the recommended times.

Meal plan: it is important to consult a registered dietitian and agree on a meal plan that fits one's preferences and lifestyle. This involves eating regular meals, having adequate food at each meal, and trying not to skip meals or snacks.

Daily activity: talk to your health care team about whether you should have a snack or adjust your medication before sports or exercise. If you know that you will be more active than usual or will be doing something that is not part of your normal routine--shoveling snow, for example--consider having a snack first.

Treatment

If a person with diabetes feels that his/her blood glucose is too low, they need to check their blood glucose level, immediately. If it is noticed to be 70 mg/dL or below, taking any of these foods right away might help to raise the level of blood glucose:

• 2 or 3 glucose tablets
• 1/2 cup (4 ounces) of any fruit juice
• 1/2 cup (4 ounces) of a soft drink
• 1 cup (8 ounces) of milk
• 5 or 6 pieces of hard candy
• 1 or 2 teaspoons of sugar or honey

After 15 minutes, of consuming any of these foods diabetics need to check their blood glucose again to make sure that it is no longer too low. If still found too low, they may have another serving of the foods prescribed, that may even need to be repeated, till the blood glucose is at least 70. In some diabetics exercise can also cause hypoglycemia, a reason why they need to check their blood glucose levels before exercise.

In extreme cases where there is loss of consciousness, and a diabetic cannot eat, glucagon can be injected to quickly raise your blood glucose level. This is particularly important for persons with type 1 diabetes. Besides, the family, friends, and co-workers of such persons will need to be taught how to give you a glucagon injection in an emergency.