What Are Clinical Trials For Low Blood Glucose
Clinical trialsand other types of clinical studiesare part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of low blood glucose levels in diabetes, such as
- how to diagnose and treat low blood glucose among people with diabetes
- medicines that can treat symptoms of low blood glucose in people with hypoglycemia unawareness
- educational approaches to reduce fear of low blood glucose, which can make it harder for you to control your diabetes
Symptoms Of A Low Blood Sugar Level
A low blood sugar level can affect everyone differently. You’ll learn how it makes you feel, although your symptoms may change over time.
Early signs of a low blood sugar level include:
- a fast or pounding heartbeat
- becoming easily irritated, tearful, anxious or moody
If a low blood sugar level is not treated, you may get other symptoms, such as:
- unusual behaviour, slurred speech or clumsiness
- seizures or fits
- collapsing or passing out
A low blood sugar level, or hypo, can also happen while you’re sleeping. This may cause you to wake up during the night or cause headaches, tiredness or damp sheets in the morning.
Nighttime Low Blood Sugars
You may experience a low blood sugar night. The low blood sugar might wake you up and your symptoms might be similar to those you have during the day. However, the symptoms may be different. You might have nightmares, sleep poorly, perspire, or feel hot and cold. In the morning you may have a headache, feel nauseated, or feel confused. Notify your doctor if this happens. Check your blood sugar at the time you have the symptoms.
Treatment for a low blood sugar that occurs at night is the same as described earlier.
Your doctor may request that you check a 3:00 a.m. blood sugar 1 to 2 times per week in order to detect any low blood sugars during the night.
Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health care professional.
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How Do I Measure Blood Sugar
If you have diabetes, you probably already keep a watchful eye on your blood sugar through the use of a continuous glucose monitor or a blood sugar meter . Blood sugar measurement is also typically included in routine lab work for people without diabetes â your physician will usually order a glycated hemoglobin test, which measures your average blood sugar over the past two to three months.
Say your A1C test comes back with no sign of diabetes â constantly measuring your blood sugar can still be helpful. For instance, some people experiment with using a CGM to see how their body responds to different types of food. However, itâs good to note that this is a fairly cost-intensive way of figuring out your nutrition, and writing down a food diary that includes how you felt after each meal will also help you figure out what to eat.
Check out these blood sugar monitors if youâre looking for recommendations on how to keep track of your levels at home.
What Are The Complications Of Low Blood Glucose
Mild-to-moderate low blood glucose can be easily treated. But severely low blood glucose can cause serious complications, including passing out, coma, or death.
Repeated episodes of low blood glucose can lead to
- high blood glucose levels, if worry or fear of low blood glucose keeps you from taking the medicines you need to manage your diabetes8
- hypoglycemia unawareness, a condition in which you dont notice any symptoms of low blood glucose until your blood glucose level has dropped very low
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Hyperglycemia And Hypoglycemia In Type 2 Diabetes
If someone has diabetes that isnt treated properly, they have too much sugar in their blood . Too little sugar in the bloodstream is usually a side effect of treatment with blood-sugar-lowering medication.
Diabetes is a metabolic disease in which theres a problem with insulin . It can affect your health in many ways. In type 2 diabetes, not enough insulin is released into the bloodstream, or the insulin cant be used properly. In type 1 diabetes, the body only produces very little insulin, or none at all.
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Sleep Helps To Regulate Body Fat
Sleep helps to maintain your body weight in many different ways, including regulating hunger hormones and insulin levels, as discussed earlier.
Research published in the journal âDiabetologiaâ shows that lack of sleep increases levels of free fatty acids in your blood. Those high fatty acid levels lead to a reduction in insulin sensitivity and hamper your bodyâs ability to metabolize fat.
Controlling glucocorticoid levels is another body fat regulator. Glucocorticoids are hormones that control several processes such as metabolism, inflammatory response, and brain function. One of the principal glucocorticoids is cortisol .
Studies show that when weâre sleep-deprived, cortisol levels increase both during that night of disrupted sleep and the following dayâs long period of wakefulness. When cortisol levels increase, it can lead to insulin resistance. This can lead to an increase in blood sugar, weight gain, and potentially Type 2 Diabetes.
So, a lack of sleep negatively impacts your glucose levels in many ways. But what typically happens to your blood sugar levels when you get a good nightâs sleep? Do you know what your normal blood sugar levels should be overnight?
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Questions Caregivers Should Ask
As a family member, friend, or caregiver, you want to do your best to keep your loved one, friend, or patient safe from severe hypoglycemia. But knowing whats best can be overwhelming. Here are some questions to help you get started.
- What are my loved ones/friends/patients chances for severe hypoglycemia?
- How often should my loved one/friend/patient check their blood glucose?
- What should I do if there is no change after giving the glucagon?
- What would be the best food or drink to give my loved one/friend/patient once they wake up?
- Should I talk with a diabetes educator?
- How can I help treat their hypoglycemia?
THE DEVELOPMENT OF THESE RESOURCES WERE MADE FROM THE GENEROUS SUPPORT OF LILLY DIABETES AND XERIS PHARMACEUTICALS, INC.
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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.
If A Person Is Unconscious
If a person loses consciousness because of severe hypoglycaemia, they need to be put into the recovery position and given an injection of the hormone glucagon . The injection will raise their blood glucose level.
The injection should be carried out by a friend or family member who knows what theyre doing, or by a trained healthcare professional.
You should dial 999 to request an ambulance if:
- a glucagon injection kit isnt available
- theres nobody available whos trained to give the injection
- the injection is ineffective after 10 minutes
Never try to put food or drink into the mouth of someone whos unconscious as they could choke.
If youre able to give a glucagon injection and the person regains consciousness, they should eat some longer-acting carbohydrate food, such as a few biscuits, a cereal bar or a sandwich.
You should continue to monitor the person for signs of recurring symptoms in case they need to be treated again.
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Treating Severely Low Blood Sugar
Blood sugar below 55 mg/dL is considered severely low. You wont be able to treat it using the 15-15 rule. You also may not be able to check your own blood sugar or treat it by yourself, depending on your symptoms. Make sure your family members, friends, and caregivers know your signs of low blood sugar so they can help treat it if needed.
Injectable glucagon is the best way to treat severely low blood sugar. A glucagon kit is available by prescription. Speak with your doctor to see if you should have a kit. Be sure to learn how and when to use it. Let family members and others close to you know where you keep the glucagon kit and make sure theyve been trained in how to use it too.
Its important to contact a doctor for emergency medical treatment immediately after receiving a glucagon injection. If a person faints due to severely low blood sugar, theyll usually wake up within 15 minutes after a glucagon injection. If they dont wake up within 15 minutes after the injection, they should receive one more dose. When the person is awake and able to swallow:
- Feed the person a fast-acting source of sugar .
- Then, have them eat a long-acting source of sugar .
Its also important that friends, family, co-workers, teachers, coaches, and other people you may be around often know how to test your blood sugar and treat severely low blood sugar before it happens.
If any of the following happens, your friend, relative, or helper should call 911:
What If It Goes Untreated
Hyperglycemia can be a serious problem if you dont treat it, so its important to treat as soon as you detect it. If you fail to treat hyperglycemia, a condition called ketoacidosis could occur. Ketoacidosis develops when your body doesnt have enough insulin. Without insulin, your body cant use glucose for fuel, so your body breaks down fats to use for energy.
When your body breaks down fats, waste products called ketones are produced. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Unfortunately, the body cannot release all the ketones and they build up in your blood, which can lead to ketoacidosis.
Ketoacidosis is life-threatening and needs immediate treatment. Symptoms include:
- Shortness of breath
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Prevention Of Low Blood Sugar
Do not skip or delay meals. If your diet plan includes snacks, make sure to take these.
Measure insulin dosage carefully and inject it properly. If you cannot see well, a family member or a visiting nurse can prepare your insulin injections for you.
Take only the prescribed amount of insulin or oral medication for diabetes that your doctor has ordered.
Keep exercise consistent from day to day. Eat a snack or reduce your insulin prior to unusual exercise.
If you are taking insulin, notify your doctor if you have low blood sugars four or more times per week or if you have a severe low blood sugar. Severe low blood sugars are those less than 40 mg., those requiring help from another person, or those which cause you to have a convulsion or become unconscious.
If you are taking oral medication for your diabetes notify your doctor or nurse if blood sugars are running less than 80 mg. or if you have a severe low blood sugar.
Check Your Blood Sugar Often
Regularly checking your blood sugar level can help you keep it in your target range. If youve had low blood sugar episodes in the past, you may want to check your blood sugar levels before driving or operating machinery.
Talk with your doctor about when and how often you should check your blood sugar.
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Low Sugar Symptoms & Sleep
Nighttime hypoglycemia is caused by various factors, from exercising too close to bedtime to drinking alcohol in the evening. If untreated, low overnight blood sugar levels can lead to headaches and loss of sleep and in extreme cases, seizures or even death.
You may have these symptoms when your blood sugar has dropped below 70 milligrams per deciliter . When you have had diabetes for many years, you may not always develop symptoms of mild low blood sugar.
Some young children with diabetes cannot recognize symptoms of low blood sugar. Others can, but not every time. To be safe, the parents need to do a home blood sugar test whenever they suspect low blood sugar in a child.
Symptoms may include:
You may wake up with a headache in the morning if your blood sugar was low during the night.
A useful first step towards preventing hypoglycemia is to test your blood glucose levels before bed. For people on two or more insulin injections per day can help prevent hypos overnight keeping blood glucose levels above 6.5 mm before going to bed.
If overnight hypos are suspected, carry out a test at 3 am. Together with a before bed and first thing in the morning test, this can help to understand how your sugar levels are behaving overnight.
If sugar levels are dropping too low overnight, you may need to adjust your insulin doses. Speak to your doctor if you need help with correctly adjusting your insulin.
Hypos can also be prevented by:
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Exercise Food And Alcohol
For people with type 1 diabetes, maintaining the correct blood glucose level involves balancing how much insulin you inject, the amount of food you eat, and how much energy you burn during exercise.
Hypoglycaemia may occur if youve taken your dose of insulin as usual, but your carbohydrate intake is lower than normal or has been used up more quickly. This may happen if you delay or miss a meal or snack, dont eat enough carbohydrate, or exercise more than usual.
People with diabetes whove drunk too much alcohol, or drank alcohol on an empty stomach, can also get hypoglycaemia.
However, its not always possible to identify why a particular episode of hypoglycaemia has occurred, and sometimes it happens for no obvious reason.
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Manage Low Blood Glucose Early
Learn to recognise your early warning signs of having a hypo. Be alert to what these are and test your blood glucose levels if any of these symptoms develop. Also make sure to always carry your emergency treatment with you. Keep it in your bag, at work and at home so you can treat low blood glucose early before it becomes more serious.
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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.
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How Serious Is Hypoglycemia
Hypoglycemic episodes can range from mild to severe.
Mild hypoglycemia can usually be treated by the individual and are to be expected to some degree in people on insulin. Mild hypos are not associated with significant long term health problems unless they are occurring very regularly or for long periods of time.
Severe hypoglycemia, however, will require treatment from someone else and may require an ambulance. Severe hypos can lead to immediate danger if not treated immediately. Whilst rare, severe hypos can potentially lead to coma and death.
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