Recognizing and preparing for symptoms of low blood sugar
Lyndsay Riffe is a certified diabetes educator who also has type 1 diabetes and says, "There are so many variables that affect blood glucose levels, some that are in our control and some that are not. However, knowing the cause of low blood glucose levels and having a deeper understanding of these variables can set one up for less hypoglycemia."
Can you recognize symptoms of low blood sugar?
Testing blood sugar is the most effective way to prevent hypoglycemia. "Hypoglycemia can occur due to medications, which might be prescribed to help control blood sugar levels, or by taking too much insulin," says Susan Weiner, RD MS CDE CDN. "Other reasons for hypoglycemia include: taking insulin and not eating enough carbohydrates or calories, increased or unexpected physical activity, severe liver or kidney disease, gastric bypass surgery or alcoholism. As a CDE, I work closely with my patients and their physician to determine how often blood glucose testing is necessary. When someone if first diagnosed with diabetes, it is very important to test more frequently. I usually suggest testing first thing in the morning (fasting), 2 hours post a meal, and before bed. If morning blood sugars are not within target range, we might suggest occasionally testing at 3 AM."
Symptoms of low blood sugar
Common symptoms include the following:
- Feeling shaky
- Anxious and/or mental confusion
- Fatigue and/or insomnia
- Headaches and/or Heart palpitations
"Sometimes people experience changes in mood such as depression, temper tantrums, and uncontrollable crying or emotional swings. Many of my patients report craving carbs (refined or simple sugars), when they experience low blood sugars. Extreme hypoglycemia can result in fainting, coma or even death," adds Weiner.
Preventing and preparing for the symptoms of low blood sugar
Here are nine ways to work on both preventing and preparing for symptoms, should the occur:
- Test often. Testing regularly can help you stay ahead of possible lows.
- Keep regular appointments with your physician. Keep a list of your medications to discuss with your doctor to determine if your dosage or timing of medications or insulin needs to be adjusted. Provide your doctor with your blood sugar record for evaluation.
- See a certified diabetes educator/registered dietitian. Schedule an appointment with a registered dietitian who is also a certified diabetes educator. Together you can design a meal plan to help avoid fluctuations in blood sugar. Including lean protein and high fiber foods and not skipping meals and snacks will help regulate your blood sugar levels.
- Watch how much you drink. The consumption of alcohol can make you more prone to hypoglycemia (especially several hour after consuming.) If you do choose to have alcohol, make sure to eat food and monitor your blood sugars; be aware you are at risk for lows several hours post consumption.
- Carry fast acting glucose tablets or gels with you at all times. This fast acting source of carbohydrate can help quickly elevate blood sugar levels. Food substitutes include 4 ounces for fruit juice, 1 tbps of honey , 4 tsp of sugar or 5 pieces of hard candy.
- Teach family members how to use glucagon. A family member or significant other should be instructed on how to use a life saving glucagon kit.
- Check your blood sugar before exercising. If it is below 100 mg/dL, have a snack and re-test in 15 minutes. Check your blood sugar again during extended periods of physical activity. Remember hypoglycemia can occur 24 after exercising.
- If you are sick, contact your physician. Proper sick day management (including possible medication adjustment) may be needed to prevent hypoglycemia.
- Wear a medical alert bracelet. The symptoms of hypoglycemia can be confused with being intoxicated.
In short, prevention is the best method (when possible) through dietary and lifestyle modifications, as well as regular testing of your sugars.
Interview with Lyndsay Riffe, CDE
Interview with Susan Weiner, CDE, RD