S For Treating A Person With Symptoms Keeping Them From Being Able To Treat Themselves
Dont hesitate to call 911. If someone is unconscious and glucagon is not available or someone does not know how to use it, call 911 immediately.
- Inject insulin
- Provide food or fluids
Learn More About Blood Glucose Management> >
The reason blood glucose tends to spike after eating in many people with diabetes is a simple matter of timing. In a person who doesnt have diabetes, eating foods containing carbohydrate causes two important reactions in the pancreas: the immediate release of insulin into the bloodstream, and the release of a hormone called amylin. The insulin starts working almost immediately and finishes its job in a matter of minutes. The amylin keeps food from reaching the small intestine too quickly . As a result, the moment blood glucose starts to rise, insulin is there to sweep the incoming glucose into the bodys cells. In most cases, the after-meal blood glucose rise is barely noticeable.
However, in people with diabetes, the situation is like that of a batter with very slow reflexes facing a pitcher who throws 98-mph fastballs: The timing is all fouled up. Rapid-acting insulin that is injected at mealtimes takes approximately 15 minutes to start working, 6090 minutes to peak, or reach maximum effectiveness, and four hours or more to finish working. Meanwhile, amylin is either produced in insufficient amounts or not at all, so the movement of food from the stomach to the intestines is not slowed the way it should be. As a result, food digests even faster than usual. This combination of slower insulin and faster food can cause the blood glucose level to rise quite high soon after eating. Once the mealtime insulin finally kicks in, the high is followed by a sharp drop.
Why Do People Get Blood Sugar Spikes After Meals
When people eat a meal, especially when it contains carbohydrates, it is normal for them to have a temporary spike in their sugar level before the insulin their body produces immediately starts working to lower the spike. For someone with type 1 diabetes, who cant produce their own insulin, these spikes can be higher and last longer.
This is because it can take longer for the type of insulin they inject to start working, in comparison to the insulin that is produced naturally by the body of someone who does not have diabetes, to reduce these post-meal spikes.
Furthermore, it is important to know that people living with type 1 diabetes may have alterations in different digestive enzymes which will cause faster digestion of our meals . This can obviously impact on the size of the spike too.
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How Common Is Low Blood Glucose
Low blood glucose is common among people with type 1 diabetes and among people with type 2 diabetes who take insulin or some other diabetes medicines. In a large global study of people with diabetes who take insulin, 4 in 5 people with type 1 diabetes and nearly half of those with type 2 diabetes reported a low blood sugar event at least once over a 4-week period.2
Severely low blood glucose, defined as when your blood glucose level drops so low you cant treat it yourself, is less common. Among U.S. adults with diabetes who take insulin or some diabetes medicines that help the pancreas release insulin into the blood, 2 in 100 may develop severely low blood glucose each year.3
Are There Any Newer Technologies To Prevent Hypoglycemia
We are lucky that in this day and age, we can predict hypoglycemia and prevent it through technology like continuous glucose monitors, explains Dr. Shah. Additionally, he notes that there are newer insulins available to help decrease episodes of hypoglycemia.
One of our roles as your doctor is to educate every patient about the self-management of diabetes and to create a personalized care plan, explains Dr. Shah. By self-managing your condition you will really feel empowered enough to take control of your health.
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What Can Cause Low Blood Sugar Levels
Some things that can make low blood sugar levels more likely are:
- skipping meals and snacks
- not eating enough food during a meal or snack
- exercising longer or harder than usual without eating some extra food
- getting too much insulin
- not timing the insulin doses properly with meals, snacks, and exercise
Also, some things may increase how quickly insulin gets absorbed into the bloodstream and can make hypoglycemia more likely. These include:
- taking a hot shower or bath right after having an insulin injection increases blood flow through the blood vessels in the skin, which can make the insulin be absorbed more quickly than usual
- injecting the shot into a muscle instead of the fatty layer under the skin
- injecting the insulin into a part of the body used a lot in a particular sport .
All of these situations increase the chances that a person may get hypoglycemia.
How To Bring Blood Sugar Down Fast
June 9, 2021 By Toby Smithson
Estimated reading time: 0 minutes
No matter how careful we are there will be times when our blood sugar levels soar. Of course, we want answers. But first, lets get that blood sugar level down. Heres how we can do that quickly.
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Veggies Or Fat Or Protein
I was taught to eat my salad first, then the meal but I read that you advised to break a longer fast with ¼ cup of Macadamia nuts, and an hour later a salad. He talked about the veggies doing their thing in the upper intestine, and the fat and protein in the lower. My question is which should I eat first to receive the best benefit. I eat once a day while fasting at least 24 hours. When 24 hours comes past 8 pm, I wait until the next day around lunch, then move ahead one hour each day and repeat.
I think you should eat the salad first. There is some data to suggest that eating the veggies first reduces insulin.
Dr. Jason Fung
When Combining Keto And : 2 Intermittent Fasting On Fasting Days Do You Still Follow The Macro Guidelines For Keto
On the two days of fasting, should the 500 calories consumed be of the same macro proportions as followed on the normal keto days? Or can you consume 500 calories of any food without going out of ketosis?
I dont generally recommend people to count calories. Fasting means not eating anything at all, so there is no counting macros. Dr. Mosleys 5:2 diet allows 500 calories of whatever you like. But thats his diet, not mine. I advocate intermittent fasting, with no calories.
Dr. Jason Fung
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Taking The Excessive Or Inadequate Amount Of Diabetes Medication Can Cause Blood Sugar To Go Up And Down
I will give you an example. For example, you take 10 units of insulin before every meal and you eat a bagel every morning, not that you should, but this morning you decided to eat something different. He decided to eat 2 eggs, cucumbers, and yogurt because you are in the mood for a healthy breakfast. On the other hand, he still took to 10 units. What you may not have realized is that a bagel has 50 g of carbs versus yogurt and cucumbers probably have less than 20 g of carbs. As you can imagine if your blood sugars remain okay with 10 units of insulin and 50 g of carbs he will more than likely end up having very low sugar after eating only 20 g of carbohydrates and taking the same 10 units of insulin. This case is a good example of taking an excessive amount of medication when you do not need it. You have to be very careful when it comes to short-acting insulins or short-acting medications such as NovoLog, Humalog, Fiasp, Starlix, repaglinide, and sometimes glipizide and glyburide.
How Can I Prevent Low Blood Glucose
Your best bet is to practice good diabetes management and learn to detect hypoglycemia so you can treat it earlybefore it gets worse.
Monitoring blood glucose, with either a meter or a CGM, is the tried and true method for preventing hypoglycemia. Studies consistently show that the more a person checks blood glucose, the lower his or her risk of hypoglycemia. This is because you can see when blood glucose levels are dropping and can treat it before it gets too low.
If you can, check often!
- Check before and after meals.
- Check before and after exercise .
- Check before bed.
- After intense exercise, also check in the middle of the night.
- Check more if things around you change such as, a new insulin routine, a different work schedule, an increase in physical activity, or travel across time zones.
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Choose The Right Medication
Two classes of injectable hormones, GLP-1 agonists , semaglutide ) and amylin mimetics , have powerful effects on post-meal blood sugar. Both GLP-1s and Symlin slow gastric emptying and keep carbohydrates from raising the blood sugar too quickly after meals. Symlin, which is a replacement for the amylin hormone , also helps to diminish appetite and blunt post-meal glucagon secretion. GLP-1s blunt appetite and promote the growth of insulin-producing cells in the pancreas of those with type 2 diabetes. So both can contribute to better post-meal high blood glucose control.
Your choice of oral medication can also impact your after-meal control. Sulfonylureas stimulate the pancreas to secrete a little extra insulin throughout the day, without regard to meal timing. Because these medications fail to concentrate the insulin secretion at times when it is needed most, after-meal blood sugars can run very high. There are alternative medications called meglitinides which also stimulate the pancreas but do so in a much faster and shorter manner. When taken at mealtimes, meglitinides produce better after-meal high blood glucose control than sulfonylureas.
Another class of oral diabetes medications improve after-meal control by partially blocking the transport of sugars across the intestines and into the bloodstream. However, these medications can sometimes cause gas, bloating and stomach upset, so the pros dont always outweigh the cons.
Risk Factors For Brittle Diabetes
The biggest risk factor for brittle diabetes is having type 1 diabetes. Brittle diabetes occurs rarely in people with type 2 diabetes. Some doctors classify it as a complication of diabetes, while others consider it a subtype of type 1 diabetes.
Type 1 diabetes is characterized by blood sugar levels that fluctuate between high and low . This results in a dangerous roller coaster effect. The fluctuation in glucose levels can be rapid and unpredictable, causing dramatic symptoms.
In addition to having type 1 diabetes, your risk of brittle diabetes is higher if you:
- are female
Balancing your blood sugar levels is the primary way to manage this condition. Tools that can help you do this include:
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So What To Do If Blood Sugar Wont Stay Up
If you have low blood sugar, the first course of action is to raise the sugar level back to the normal region of around 100 mg/dl.
So, its important to take sugar-rich foods or glucose immediately. You might want to try one of these following tips,
- One glass of instant glucose
- Four to six pieces of hard candy
- 1/2 cup fruit juice
- 1 cup of milk
- 1/2 cup soft drink
- 1 tablespoon honey
In the case of a person who is unconscious due to low blood sugar, a Glucagon injection has to be given to him immediately.
Aside from this, prescribed medication by a doctor is the best low blood sugar treatment.
Stress And Anxiety Can Cause Blood Sugar Fluctuations
Blood sugars can go up and down due to stress and anxiety
Unfortunately when you are under stress and have anxiety our body produces stress hormones. The most commonly known stress hormones are cortisol and adrenaline. These are the same hormones that can increase blood sugars in the morning known as the dawn phenomenon. However, chronically elevated stress and anxiety can lead to elevated cortisol and adrenaline levels which are hormones that reduce the efficacy of insulin. Pain is another reason that can increase blood sugar levels through the same mechanism. Thinking positively and finding ways to reduce stress and anxiety can definitely improve blood sugar levels.
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Treating Low Blood Sugar
You are at risk of having a low blood sugar reaction if you:
- Skip or delay a meal or snack
- Take too much insulin or eat too few carbohydrates
- Drink alcohol, especially without eating carbohydrates
Check your blood sugar if you have any of these symptoms:
- Weakness and/or fatigue
If your blood sugar is less than 70 milligrams per deciliter :
- Eat 15 to 30 grams of carbohydrate
- Wait 15 minutes and then recheck your blood sugar
- If your blood sugar is still less than 100 mg/dl, take another 15 grams of carbohydrate and retest your blood sugar in another 15 minutes. Repeat if necessary.
Important: If you have frequent low blood sugars speak to your doctor. You may need changes in your medication and/or meal plan.
Causes Of Low Blood Glucose
Low blood glucose is common for people with type 1 diabetes and can occur in people with type 2 diabetes taking insulin or certain medications. The average person with type 1 diabetes may experience up to two episodes of mild low blood glucose each week, and thats only counting episodes with symptoms. If you add in lows without symptoms and the ones that happen overnight, the number would likely be higher.
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Causes And Risk Factors
As your body goes between fed and unfed states throughout the day, your blood sugar levels will naturally fluctuate up and down. In someone without diabetes, blood sugar levels are regulated by insulin and stored glycogen to stay within normal ranges.
If you have diabetes, you are at a higher risk of having a blood sugar spike than people without diabetes. Eating foods high in simple carbohydrates, like desserts, sugar-sweetened beverages, and refined-grain pasta and bread, are the main cause of blood sugar spikes.
However, there are additional causes for high blood sugar levels, such as:
- Eating more than planned
- Over-treating low blood sugar levels
- Dawn phenomenon: This is a natural surge in blood sugar early in the morning. It can be higher in people with diabetes who have insulin resistance.
- Somogyi effect: This is high early morning blood sugar levels caused by a rebound effect from low blood sugar levels in the middle of the night and your body triggering a release of hormones to raise blood sugar levels.
Preventing Low Blood Sugar Levels
Here are some other tips to help you avoid low blood sugar levels:
- Eat all your meals and snacks on time and try not to skip any.
- Take the right amount of insulin.
- If you exercise longer or harder than usual, have an extra snack.
- Don’t take a hot bath or shower right after an insulin shot.
- Stick to your diabetes management plan.
- Check your blood sugar levels regularly, so you can tell if your blood sugars are running too low and your treatment plan needs adjustment.
- Carry something containing sugar with you at all times and take it right away if you have symptoms. Don’t wait to see if the symptoms will go away they may get worse!
Alcohol and drugs can cause major problems with your blood sugar levels, so avoiding them is another way to prevent diabetes problems. Drinking can be particularly dangerous even deadly for people with diabetes because it messes up the body’s ability to keep blood glucose in a normal range. This can cause a very rapid drop in blood glucose in people with diabetes. Drug or alcohol use is also dangerous because it may affect someone’s ability to sense low blood sugar levels.
Learning how to recognize the signs of low blood sugar levels and get them back to normal is an important part of caring for diabetes. Keeping track of your blood sugar levels and recording lows when they occur will help you and your diabetes health care team keep your blood sugar levels in a healthy range.
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Managing Blood Sugar Levels
Many people with diabetes must check their blood sugar levels daily with a glucose meter. This device takes a drop of blood, usually from a finger, and displays the sugar level within a few seconds.
People with type 1 diabetes will need to take insulin as their doctor recommends, usually several times a day.
Those with type 2 diabetes or gestational diabetes may need to change their diet and exercise habits. They may also need to take oral medications or insulin.
A number of strategies can help prevent hyperglycemia.
- check their blood sugar levels as their doctor advises and take the correct amount of insulin, if they have type 1 diabetes
- speak to their healthcare provider or dietitian about which foods to eat or avoid, how much to eat, and how often
- take precautions to avoid infections, for example, through regular hand washing, as illness, such as a cold, can trigger a rise in blood pressure
- plan their food intake and exercise to balance blood sugar levels
- minimize stress, as far as possible, for example, through exercise, getting enough sleep, and stress-reducing activities such as meditation or yoga
Low blood sugar, or hypoglycemia, can happen when a person:
- has certain medical conditions
- does a lot of exercise
- skips meals or eats too little
It can also be a side effect of diabetes medicines. Taking too much insulin can result in low blood sugar levels.
Symptoms of low blood sugar may include:
- visit a doctor regularly