Reversing Hypoglycemia Unawareness Is Possible For Many
While it isnt remarkably common, it is an issue for some people with diabetes. There are a few things someone with clear hypoglycemia unawareness can do to keep themselves safe.
First, use a continuous glucose monitor . CGMs are ideal for people who dont experience normal symptoms of low blood sugar because they can alert you to oncoming lows, helping you prevent them from occurring or from dropping as severely. CGMs allow you to set low alerts to levels like 90 mg/dL or 110 mg/dL wherever you feel safest.
Secondly, aim for a higher target range. If you know you have hypoglycemia unawareness, its critical that you raise your target blood sugar range at least slightly. Instead of aiming for 90 mg/dL when dosing insulin for meals and correcting highs, talk to your diabetes healthcare team about aiming for 100 mg/dL or 110 mg/dL, etc. This will reduce the risk of low blood sugars by keeping your blood sugar slightly above that thin line between normal and low.
Hypoglycemia Tests And Diagnosis
To diagnose nondiabetic hypoglycemia, your doctor will do a physical exam and ask questions about any medicines you take. Theyâll want to know all about your health and any history of diseases or stomach surgery.
Theyâll check your blood glucose level, especially when you are having symptoms. Theyâll also check to see if you feel better when your sugar goes back to a normal level.
If your doctor suspects hypoglycemia, you may have to fast until you start to have symptoms. Theyâll test your blood glucose level at different times throughout the fast.
To check for reactive hypoglycemia, you may have to take a test called a mixed-meal tolerance test . For this, you take a special drink that raises your blood glucose. The doctor will check your blood glucose levels over the next few hours.
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.
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No Symptoms Be Alarmed
Surprisingly, the most dangerous episodes of hypoglycemia occur with little or no warning. When low blood glucose occurs on a regular basis, the body can become used to the warning signs and the person may stop noticing symptoms. This is a particularly dangerous condition known as hypoglycemic unawareness. People with this condition might not realize they have low blood glucose until its dangerously low seizures and coma are sometimes the first indication of a problem. The good news is that this condition can often be reversed allowing people to once again notice the signs of low blood glucose if hypoglycemia is avoided for a few weeks through careful monitoring of blood glucose.
Choosing The Right Low Blood Sugar Foods For You
Treating low blood sugars with the right foods comes down to creating good habits. Whether you choose foods on this list or not, what matters most is that youre taking a moment to think about what food youre going to consume. Impulsively gorging yourself on the first food that catches your eye will probably lead to roller coaster blood sugars, weight gain, guilt, and a great deal of frustration.
Instead, try choosing specific foods that you will keep in certain places that you will think of as medicine. It also helps to use foods that are easy to measure so you are able to consume exactly the amount of carbohydrates you need, such as 4 gummy Lifesavers or 15 raisins or 3 dried apricots.
And then, sit on your hands, take a deep breath and wait at least 15 minutes before considering consuming any more food. Once your glucose has returned to a normal level, eating a high-protein and low-carb snack can help to maintain your glucose level, such as a handful of nuts or a piece of string cheese.
If youre concerned about your blood sugar, let someone nearby know or call a friend. If you are not confident that you can successfully treat the low or are having trouble thinking, call 911 or ask someone else to call 911 for you.
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Examples Of Easily Digestible Carbohydrates
- 1/2 cup of juice or regular soda
- 1 tablespoon of honey
- 4 or 5 saltine crackers
- 3 or 4 pieces of hard candy or glucose tablets
- 1 tablespoon of sugar
Very low blood sugar is a medical emergency. If you or someone else with diabetes is experiencing severe symptoms, such as unconsciousness, its important to administer a medication called glucagon and contact emergency services immediately.
If youre at risk for low blood sugar, its important to talk with your doctor about getting a prescription for glucagon.
You should never give an unconscious person anything by mouth, as it could cause them to choke. If you have diabetes, make sure your family and friends know not to do this if you lose consciousness.
Low blood sugar can occur for a number of reasons. Its usually a side effect of diabetes treatment.
Signs Of High Blood Sugar
Someone who has been diagnosed with diabetes will be familiar with how it feels to have hyperglycemia. But for the millions of people who have diabetes or prediabetes and are unaware of it, knowing the signs of high blood sugar could prompt them to seek care and get a diagnosis as soon as possible.
While type 1 diabetes symptoms can come on suddenly and severely, its important to note that type 2 diabetes symptoms can creep up gradually and be so mild that theyre not noticeable, the NIDDK explains. And most people with prediabetes actually have no symptoms, per the NIDDK. So its extremely important to get screened if you have risk factors, like having a family history, being overweight, or being over age 45, the NIDDK says.
Still, there are many potential signs of high blood sugar in the short and long term that it doesnt hurt to be conscious of, especially if you are at elevated risk.
Early on, hyperglycemia can make you feel off in a variety of ways:
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High Blood Sugar Causes
You may be thinking that hyperglycemia can happen just from eating a super-sugary food, but its not really as simple as that. Sure, eating a lot of sugar or carbs can elevate your blood sugar level, but thats typically when your pancreas kicks into gear and creates insulin to move that glucose into cells throughout the body.
But when someone has diabetes, this finely tuned system gets thrown out of whack. In type 2 diabeteswhich accounts for 90% to 95% of diabetes in adults, according to the CDCthe body either cant make enough insulin or cant utilize insulin well, according to the NIDDK. If someone has prediabetes, their blood glucose will be higher than normal but not quite in the type 2 diabetes range yet, per the NIDDK. And in type 1 diabetes, the body does not make insulin or makes very little.
In any case, the result is extra sugar hanging around the bloodstream, making you feel like total crap in the short term and putting your health at risk in the long term.
Severe Low Blood Sugar
As your low blood sugar gets worse, you may experience more serious symptoms, including:
- Having difficulty walking or seeing clearly.
- Acting strange or feeling confused.
- Having seizures.
Severe low blood sugar is below 54 mg/dL. Blood sugar this low may make you faint . Often, youll need someone to help you treat severe low blood sugar.
People with diabetes may experience low blood sugar as often as once or twice a week, even when managing their blood sugar closely. Knowing how to identify and treat it is important for your health. Learn how to treat low blood sugar.
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What Extreme Conditions Can Occur If Hypoglycemia Is Left Untreated
Although severe episodes which can trigger potentially life-threatening comas are rare, they require immediate emergency room care, so its best to make sure you are tracking your blood sugar so that you never have to worry about getting to that point. A drop in blood sugar means less fuel for your brain, so its critical for your body to receive enough glucose. Hypoglycemia that leads to extended, reduced brain function is the biggest concern, as this can lead to seizures and loss of basic bodily functions controlled by the brain, which can ultimately lead to death, explains Dr. Dyer.
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How To Treat Someone Whos Unconscious Or Very Sleepy
Follow these steps:
They may need to go to hospital if theyâre being sick , or their blood sugar level drops again.
Tell your diabetes care team if you ever have a severe hypo that caused you to lose consciousness.
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How Are Low Blood Sugar Levels Treated
Your diabetes health care team will give you guidelines for treating low blood sugar levels, depending on your symptoms. If you can, try to test your blood sugar levels to make sure that your symptoms are because of hypoglycemia. If you can’t test blood sugar immediately, don’t delay in treating your symptoms you can always check your blood sugar after you’ve taken steps to get your blood sugar back up into the normal range.
When blood sugar levels are low, the goal is to get them back up quickly. To do that, you should take in sugar or sugary foods, which raise the blood sugar level quickly. Your health care team might suggest that you:
- Eat, drink, or take something that contains sugar that can get into the blood quickly. Your doctor may tell you to have really sugary foods or drinks or might give you glucose tablets or gel to take all of these can help to raise your blood sugar level fast, which is what you need to do when it’s low.
- Wait about 10 minutes to let the sugar work.
- Recheck your blood sugar level with a glucose meter to see if blood sugar levels are back to normal.
- Get a glucagon shot , if your symptoms are severe or get worse after you eat, drink, or take glucose.
Sometimes, blood sugar levels can get so low that you may not be awake enough to eat or drink something to get them back up. When this happens, you may need a glucagon shot.
A Low Blood Sugar Level And Driving
You may still be allowed to drive if you have diabetes or you’re at risk of a low blood sugar level for another reason, but you’ll need to do things to reduce the chance of this happening while you’re driving.
You also need to tell the Driver and Vehicle Licensing Agency and your car insurance company about your condition.
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What Is Hypoglycemia And Low Blood Sugar
Hypoglycemia is the state of having a blood glucose level that is too low to effectively fuel the body’s cells.
Glucose, which comes from carbohydrates found in foods, is a main source of energy for all of the cells of the body and, especially, the brain. While the body is quite good at extracting glucose from the foods we eat, it relies on a hormone called insulin to actually get the glucose inside the cells of specific organs: the liver, fat, and muscle.
We can think of insulin as holding the key to a cell without insulin, the glucose just remains in the blood, where its also known as blood sugar. During an episode of hypoglycemia, theres not enough glucose in the blood. The normal range is approximately 70 to 150 mg/dl .
Hypoglycemia is most common in newborns. In older children, its most often seen as a complication of insulin therapy for diabetes but can sometimes have other causes as well.
In the majority of cases, hypoglycemia is temporary, easily treated, and usually does not have serious consequences. There are several rare disorders in which hypoglycemia is recurrent and potentially life-threatening. However, with timely diagnosis and appropriate treatment, these can be effectively managed.
How Can I Stop My Blood Sugar From Crashing
Here are a few ways to avoid hypoglycemic episodes:
Get in the habit of self-monitoring your blood glucose. Keeping track of when your blood sugar drops can help you recognize aspects of your routine that may be contributing to your hypoglycemia. Dr. Klonoff recommends a continuous glucose monitor. Its the best tool for automatically checking your blood glucose levels around the clock, he says.
Change your meal plan. When, what, how much, and how often you eat all play a big part in your blood glucose levels. A dietitian can teach you about healthy, well-balanced food choices that will make it easier for you to maintain an acceptable blood sugar range.
Keep a stash of glucose tablets on hand. With your doctor’s recommendation, make sure you always have glucose tablets with you. You can stick them in your briefcase, purse, car, desk, school locker, etc. You may also want to keep snacks nearbyfor example, cheese or peanut butter crackers, although doctors suggest over-the-counter glucose tablets for more accurate dosage. Do not eat a healthy sugar-free candy bar during hypoglycemia, warns Dr. Klonoff. Its lack of sugar means that it will not raise your blood glucose level sufficiently when you want it to.
Certain drinks can help get your blood sugar up as well. Try 8 oz. of fruit juice, a soft drink , or a cup of milk.
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Preventing Low Blood Sugar
Preventing low blood sugar is better than having to treat it. Always have a source of fast-acting sugar with you.
- When you exercise, check your blood sugar levels. Make sure you have snacks with you.
- Talk to your provider about reducing insulin doses on days that you exercise.
- Ask your provider if you need a bedtime snack to prevent low blood sugar overnight. Protein snacks may be best.
Do not drink alcohol without eating food. Women should limit alcohol to 1 drink a day and men should limit alcohol to 2 drinks a day. Family and friends should know how to help. They should know:
- The symptoms of low blood sugar and how to tell if you have them.
- How much and what kind of food they should give you.
- When to call for emergency help.
- How to inject glucagon, a hormone that increases your blood sugar. Your provider will tell you when to use this medicine.
If you have diabetes, always wear a medical alert bracelet or necklace. This helps emergency medical workers know you have diabetes.
Signs And Symptoms Of Low Blood Glucose
Each persons reaction to low blood glucose is different. Learn your own signs and symptoms of when your blood glucose is low. Taking time to write these symptoms down may help you learn your own symptoms of when your blood glucose is low. From milder, more common indicators to most severe, signs and symptoms of low blood glucose include:
- Tingling or numbness in the lips, tongue, or cheeks
- Nightmares or crying out during sleep
The only sure way to know whether you are experiencing low blood glucose is to check your blood glucose levels, if possible. If you are experiencing symptoms and you are unable to check your blood glucose for any reason, treat the hypoglycemia.
A low blood glucose level triggers the release of epinephrine , the fight-or-flight hormone. Epinephrine is what can cause the symptoms of hypoglycemia such as thumping heart, sweating, tingling, and anxiety.
If the blood sugar glucose continues to drop, the brain does not get enough glucose and stops functioning as it should. This can lead to blurred vision, difficulty concentrating, confused thinking, slurred speech, numbness, and drowsiness. If blood glucose stays low for too long, starving the brain of glucose, it may lead to seizures, coma, and very rarely death.
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Where Can I Find Support For My Hypoglycemia
The Hypoglycemia Support Foundation, established nearly 40 years ago, is a national group that offers many resources, including advocacy. They offer salons so that you can personally connect with people like you who are also dealing with bouts of low blood sugar.
Occasionally blood sugar crashes are so extreme they require emergency room care for an immediate dextrose IV treatment. If you have diabetes, wear a medical bracelet so that emergency personnel or bystanders who call for help are aware of this information. Its also a good idea to have a circle of people who serve as close contacts and are aware of your condition and how to help.