Causes For Hypoglycemia
Nothing is in order if your blood sugar falls repeatedly. However, too low blood sugar is not to be feared in vain.
- It is normal for blood sugar to fall momentarily below this limit: for most diabetics, this happens every day. The goal of treating diabetes is as normal blood sugar as possible, so especially type 1 diabetic with a well-balanced treatment may develop mild hypoglycemias on a weekly basis.
In most cases, hypoglycemia is harmless.
- Hypoglycemia is considered serious only when the diabetic needs another person's help to cope with it, ie someone must, for example, give him or her something to eat or drink.
Read Can you be cured of diabetes
Whenever a diabetic needs help from others due to hypoglycemia, they should tell their diabetes nurse or doctor. Then the cause of low blood sugar can be traced and treatment can be corrected as needed. However, if the hypoglycemia passes quickly, you do not need to call your doctor right away, especially at night.
- Usually, a discussion on the next working day or in the coming weeks will suffice. Prompt contact is required when hypoglycemia persists or is associated with something special. If the condition leads to unconsciousness, the help of ambulance staff is most often needed.
Read Tips to treat Hypoglycemia in type 2 diabetes
The body reports a drop in blood sugar
Until the first hypoglycemia, it is not possible to know how low the blood sugar should be before your own ability to function is reduced.
- The variation is great and individual. For some, the ability to function goes when your blood sugar drops to around 2 mmol / l, but for most, it only happens when your blood sugar drops to 1.5 or less. Someone else may need help when their blood sugar level is 2.5 mmol / l.
A blood glucose meter provides reliable information, but most recognize a drop in blood sugar on their own. Prior to severe impairment, hypoglycemia causes symptoms, also called insulin sensations.
- There are three types of symptoms. This is partly due to the fact that the body secretes adrenaline, cortisol, and other hormones in response to a drop in blood sugar. Adrenaline causes tremors, palpitations, cold sweats, and pallor. The limbs can also become colder than usual.
Blurred and double vision are some of the major issues when you are scared of sugar in nerves and nerve cells. The speech maybe porridge.
- Hypoglycaemia may also feel like a tingling sensation around the mouth and lips. It is a symptom that quite a few recognize as due to too-low blood sugar.
The more common symptoms of low blood sugar, called feeling hungry and irritable, are caused by a disruption of brain function when the brain is no longer getting enough sugar. It can also lead to headaches, fatigue, and difficulty concentrating.
- So-called cognitive skills such as thinking, remembering, and understanding are worse than usual, for example, headaches can be difficult. Under normal circumstances, a calm person may even become aggressive. A change in behavior is sometimes first identified by a person with diabetes.
Symptoms change over the years
Most clearly, a type 1 diabetic knows the symptoms of hypoglycemia in the early stages of the disease and a type 2 diabetic when he or she has recently started insulin therapy.
- Then a drop in blood sugar causes tremors, palpitations, and cold sweats. They are very clear at first, so it is easy to avoid too low blood sugar. Later, when there are already many years of illness, the symptoms turn more into difficulty concentrating, visual disturbances, and tingling in the mouth.
A long history of diabetes and aging make it difficult for many to identify the symptoms of low blood sugar, but some symptoms usually persist.
- Just no one loses consciousness completely without the symptoms of hypoglycemia.
The balance of treatment affects the symptoms as the body gets used to both high and low blood sugar levels.
If your blood sugar is high for a long time, your body may react completely to your normal blood sugar level as if it were too low and produce symptoms of hypoglycemia. The situation cannot be remedied in one fell swoop, but the balance of care is gradually improved. Gradually, the body gets used to lowering blood sugar levels and symptoms only appear when the blood sugar is really too low.
On the other hand, if the sugar balance is constantly too tight, the body gets used to low blood sugar levels and can no longer produce symptoms of hypoglycemia. When blood sugar levels are raised symptoms may bounce back.
- In an Italian study, blood sugar was not allowed to fall below 6 mmol / l, and after about a month the symptoms of hypoglycemia returned. The body began to recognize again when there is too little sugar in the blood.
Read How to reduce hypoglycemia
Eventually, consciousness disappears
When Insulin sensations appear, a carbohydrate-rich food or drink is needed to raise blood sugar. If the diabetic himself does not notice refueling, others may suggest that he barked something. The helper should make sure the snack is taken.
- For the treatment of a slight decrease in blood sugar, for example, a sandwich and a glass of milk are good choices. They raise blood sugar in 15 to 20 minutes. If your blood sugar is falling sharply, you need a faster-absorbing carbohydrate, such as glucose tablets or gel. Their absorption into the blood begins as early as the mouth. However, in addition to fast-absorbing carbohydrates, you should also enjoy something that is absorbed a little slower.
A conscious but incapacitated diabetic may be asked if he or she is taking glucose preparations. Sugar, honey, or sweet juice also work quickly.
If the body does not get sugar and the blood sugar level continues to fall, the level of consciousness decreases rapidly, and eventually, the diabetic loses consciousness completely. The condition is called insulin shock.
- In shock, a diabetic may cramp-like an epileptic. When seizures occur, the blood sugar level is usually around one.
The unconscious should not be given anything to eat or drink. First aid may include glucagon injection, if available. An ambulance must be called to the scene if consciousness does not return in 5 to 10 minutes.
Hypoglycemia in type 1 and type 2 diabetics is basically similar.
- The main difference is that only insulin is used to treat type 1 diabetes, and the blood sugar lowering effect of insulin ends within a certain time. Therefore, unconsciousness lasts for up to a few hours if left untreated.
- If, on the other hand, a person with type 2 diabetes uses tablet medicines that predispose to hypoglycemia, such as a sulphonylurea, especially with insulin therapy, the loss of consciousness may last longer than with insulin alone. In sulphonylurea-associated hypoglycemia, unconsciousness may recur some time after regaining consciousness, so further treatment is particularly important.
Damage is rarely followed
The idea of losing consciousness seems scary to many.
- Short-term unconsciousness is usually not dangerous. Studies show that no damage results from hypoglycemias with a blood sugar level close to two. There will also be no permanent damage, even if the value goes short around one.
- If a diabetic has frequent unconsciousness for several hours, then the so-called higher mental functions may be impaired. However, permanent damage that does not recover only occurs if the blood sugar level is well below 1 mmol / l for a very long time. But it’s really rare, and it doesn’t happen in normal care, he adds.
Sometimes hypoglycemia can scare the diabetic or his loved ones so much that he keeps his blood sugar constantly too high. - Over the years, its consequences may be more serious than the occasional mild hypo warns.
The liver sends sugar to help
A diabetic who has lost consciousness due to hypoglycemia is not just dependent on the help of other people. He also gets help from his own body.
- A person has a store of sugar in the liver. When blood sugar drops too much, the counter-hormones in hypoglycemia cause the liver to release sugar into the blood, and thus consciousness gradually returns. The effect of an overdose of insulin will disappear over time as its concentration in the body decreases and consciousness begins to return spontaneously.
- In type 1 diabetics, pump therapy can reduce severe hypoglycemia, which is worth remembering if they or their fear are a big problem. In type 2 diabetics treated with tablets, the amount of hypoglycemia is reduced after the use of sulphonylureas is reduced. There are now several drugs for type 2 diabetes, such as metformin and gliptins, which have virtually no risk of hypoglycemia.
For people with severe hypoglycaemic problems, help can be found in the glucose sensor, which alerts you to risk situations. In Finland, hypo dogs are also trained to identify low blood sugar.
- In the prevention of hypoglycemia, it is important that the treatment center seeks to identify each hypothalamic's predisposing factors for hypoglycemia. According to it, insulin treatment is modified individually.
Alcohol poses a danger
Hypoglycemia is life-threatening only very rarely. The risk can be caused by a massive high overdose of insulin, drunkenness, and heart failure.
- When a diabetic drinks alcohol, he must be aware that alcohol prevents the release of sugar from the liver into the blood. Then the body's own mechanism for correcting hypoglycemia will not work. If after a party night you take a normal dose of evening insulin but do not eat anything before going to bed, there will definitely be hypoglycemia at night.
- Never drink so much that you forget the basic principles of treatment: before going to bed you still need to eat a slowly absorbed carbohydrate and make sure your blood sugar is above ten. The usual evening insulin dose can also be slightly reduced.
If you have symptoms of a hangover the next morning, your blood sugar levels should be closely monitored and refueled if necessary, as even after a normal breakfast and a normal dose of insulin, your blood sugar may still fall unexpectedly.
For a heart patient, too low blood sugar can cause severe arrhythmias.
- One study compared diabetics with high levels of hypoglycemia to those with low blood sugar levels at all. A long-term recording of a heart film was made for everyone. Those with high blood sugar levels were clearly more likely to have severe arrhythmias. Severe arrhythmias can occur when the blood sugar level is around two, meaning that hypoglycemia does not have to lead to unconsciousness.
Because of the arrhythmias, researchers are not entirely sure.
- They may be due to the counter-hormones of hypoglycemia, because, for example, the body's adrenaline levels may become very high,
This is how you help the unconscious
- The unconscious should be approached with caution. Even the unconscious responds to touch, so he can swing a helper.
- If glucagon is available as first aid, it is easy to inject into the thigh muscle as instructed.
- The liquid should not be given to the unconscious as it may enter the trachea and cause pneumonia.
- For example, honey can be squeezed onto the oral mucosa with a wooden spoon or spatula. Fingers or metal should not be placed in the unconscious mouth as he or she may bite the jaws while assisting, which could damage the patient's teeth or the finger's fingers.
- An ambulance should be called if consciousness does not return in 5 to 10 minutes.
Hypoglycemia can be prevented
- Regular blood sugar measurement
- learning to estimate carbohydrate intake and finding out the right relationship between carbohydrates and medication
- Taking into account that exercise lowers blood sugar - in long-term exercise also long afterward
- Remembering that alcohol shuts down the liver’s sugar production
- Always keep glucose tablets or other food or drink that raises your blood sugar quickly
- Make sure your blood sugar isn’t too low the night before bed
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