What Causes Low Blood Glucose In People With Diabetes
Low blood glucose levels can be a side effect of insulin or some other medicines that help your pancreas release insulin into your blood. Taking these can lower your blood glucose level.
Two types of diabetes pills can cause low blood glucose
- sulfonylureas, usually taken once or twice per day, which increase insulin over several hours
- meglitinides, taken before meals to promote a short-term increase in insulin
The following may also lower your blood glucose level
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.
Complications From Spells Of Hypoglycemia
Mildly low blood sugar levels are somewhat common for people with diabetes. However, severely low blood sugar levels can be life threatening. They may lead to seizures and nervous system damage if left untreated long enough. Immediate treatment is critical.
Its important to recognize your symptoms and treat them quickly. For people at risk for low blood sugar, having a glucagon kit a medication that raises blood sugar levels is important. Talk with your doctor for more information.
You may also want to talk with friends, family members, exercise partners, and co-workers about how to care for you if your blood sugar drops too low.
Its important for them to recognize low blood sugar symptoms and to know how to use the glucagon kit, as well as understand the importance of calling 911 if you lose consciousness.
Wearing a medical identification bracelet is a good idea. It can help emergency responders care for you properly if you need urgent medical attention.
Treat low blood sugar as soon as possible. Avoid driving if you are experiencing low blood sugar, as it can increase your risk for having an accident.
There are several ways you can prevent low blood sugar. Well look at each of these prevention methods in more detail below.
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What Is Low Blood Glucose
Low blood glucose, also called low blood sugar or hypoglycemia, occurs when the level of glucose in your blood drops below what is healthy for you. For many people with diabetes, this means a blood glucose reading lower than 70 milligrams per deciliter .1 Your number might be different, so check with your doctor or health care team to find out what blood glucose level is low for you.
What Causes Hypoglycemia In A Child
Hypoglycemia can be a condition by itself. Or it can be a complication of diabetes or other disorder. Its most often a problem in someone with diabetes. It occurs when theres too much insulin. This is also called an insulin reaction.
Causes in children with diabetes may include:
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Too much insulin or oral diabetes medicine
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The wrong kind of insulin
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Incorrect blood-glucose readings
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Tingling feelings around the mouth
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Nightmares and confusion on awakening
The symptoms of hypoglycemia can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
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How To Recognize Hypoglycemia
The first signs of hypoglycemia include feeling sweaty, shaky, and hungry. However, not everyone has these symptoms or notices them in time to prevent low blood sugar from getting worse. Its also important to know that your symptoms of hypoglycemia will change the longer you have T1D.
As hypoglycemia gets worse, symptoms can include:
- Feeling weak
- Having difficulty walking or seeing clearly
- Acting strange or getting disoriented
- Having seizures
Severe hypoglycemia may make you faint or pass out. This is dangerous if you are driving, climbing stairs, or doing other activities where you need to stay aware of things around you.
Hypoglycemia can happen at night. If it does, you are likely to wake up, but its important not to rely on your body to wake you up. A continuous glucose monitor, or CGM, can alert you and those around you with an alarm to let you know if your blood sugar starts getting low while you are sleeping.
Its a good idea to check your blood sugar often when lows are likely, such as in hot weather or when you travel. Your CGM can also let you know when your blood sugar is getting lower.
Watch out for hypoglycemia unawareness.
You might not have early warning signs of low blood sugar. This is called hypoglycemia unawareness, and it raises the risk of having severe lows. It is more likely if:
- You have had diabetes longer than 5 or 10 years
- You have frequent episodes of hypoglycemia
- You take certain medicines, such as beta blockers for high blood pressure
Digestive Endocrine And Circulatory Systems
After you eat, your digestive system breaks down carbohydrates and turns them into glucose. Essentially, glucose is your bodys fuel source.
As your sugar levels rise, your pancreas releases a hormone called insulin, which helps glucose get taken up and used by cells throughout your body. If you have insulin-dependent diabetes, you must take the right about of insulin to get the job done.
Any excess glucose goes to your liver for storage.
When you go a few hours without eating, blood sugar levels go down. If you have a healthy pancreas, it releases a hormone called glucagon to make up for the absence of food. This hormone tells your liver to process the stored sugars and release them into your bloodstream.
If everything works as it should, your blood sugar levels should remain in the normal range until your next meal.
Insufficient blood sugar levels can cause a rapid heartbeat and heart palpitations. However, even if you have diabetes, you may not always have obvious symptoms of low blood sugar. This is a potentially dangerous condition called hypoglycemia unawareness. It happens when you experience low blood sugar so often that it changes your bodys response to it.
Normally, low blood sugar causes your body to release stress hormones, such as epinephrine. Epinephrine is responsible for those early warning signs, like hunger and shakiness.
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What Should I Do If This Happens
People and their partners or roommates should learn to recognize the signs of nighttime hypoglycemia. Be prepared! Ask your doctor for an emergency glucagon kit. This kit contains a fast-acting medication that can be injected if the person cant be woken up. Store the kit in a bedside drawer for easy access.
DO NOT PUT ANYTHING INTO A PERSON’S MOUTH IF THEY ARE ASLEEP OR CANNOT SIT UP.
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If the person cannot be woken: If there is no emergency glucagon kit, call 911. If the person has a glucagon kit, the partner or roommate should follow the instructions to fill the syringe and inject the medicine. Once fully awake, he/she should eat a meal and check their blood glucose every few hours using a home test kit. After giving the injection, the persons doctor should be notified.
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If the person can be woken up and sit without support: They should be given a fast-acting glucose source. Good options include hard candy, fruit juice or glucose paste or tablets, which can be purchased at most pharmacies. Once the person is fully awake, they should eat a meal and check their blood glucose every few hours using a home test kit.
How Can I Help My Child Live With Hypoglycemia
Children with type 1 diabetes or other conditions that may cause hypoglycemia need to follow their care plan. Its important to test blood glucose often, recognize symptoms, and treat the condition quickly. Its also important to take medicines and eat meals on a regular schedule.
Work with your childs healthcare provider to create a plan that fits your childs schedule and activities. Teach your child about diabetes. Encourage them to write down questions they have about diabetes and bring them to healthcare provider appointments. Give them time to ask the provider the questions. Check that the answers are given in a way your child can understand. Work closely with school nurses, teachers, and psychologists to develop a plan thats right for your child.
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Nighttime Low Blood Sugar
While low blood sugar can happen at any time during the day, some people may experience low blood sugar while they sleep. Reasons this may happen include:
- Having an active day.
- Being physically active close to bedtime.
- Taking too much insulin.
- Drinking alcohol at night.
Eating regular meals and not skipping them can help you avoid nighttime low blood sugar. Eating when you drink alcohol can also help. If you think youre at risk for low blood sugar overnight, have a snack before bed.
You may wake up when you have low blood sugar, but you shouldnt rely on that. A continuous glucose monitor can alert you with an alarm if your blood sugar gets low while youre sleeping.
General Information About Low Blood Sugar
Low blood sugar, clinical name hypoglycemia, is a condition in which blood sugar levels in the body fall too low. Generally, a blood sugar level between 80 and 110 milligrams per deciliter is considered to be in normal range. When this level falls below 80, individuals may develop symptoms of low blood sugar. This condition often occurs in people with diabetes, when they try to control high glucose levels and the level falls too low. However, low blood sugar can occur from other causes, such as going for long periods without eating, from certain medications and from specific medical conditions.
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What Should My Blood Sugar Level Be When I Wake Up
These are goal levels, according to The Joslin Diabetes Center:
- Under 100 mg/dl if you do not have diabetes.
- 70 to 130 mg/dl if you have diabetes.
The dawn effect can often lead to a high morning measurement in diabetes. This is your bodys tendency to get ready for the day by raising blood sugar by increasing levels of counter-regulatory hormones the ones that counteract insulin as in normal blood sugar. For people with diabetes, you do not have the capacity to counterbalance this rise in blood sugar, so levels can be dangerously high.
Ways to lower your morning blood sugar value include:
- Eating dinner earlier
- Checking your medications making sure you are taking them properly and asking your doctor if they are correct
- Going for a walk after dinner
How Is Hypoglycemia Diagnosed In A Child
The healthcare provider will ask about your childs symptoms and health history. He or she may also ask about your familys health history. He or she will give your child a physical exam. Your child may also have blood tests to check blood sugar levels.
When a child with diabetes has symptoms of hypoglycemia, the cause is most often an insulin reaction.
For children with symptoms of hypoglycemia who dont have diabetes, the healthcare provider may:
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Measure levels of blood sugar and different hormones while the child has symptoms
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See if symptoms are relieved when the child eats food or sugar
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Do tests to measure insulin action
Your child may need to do a supervised fasting study in the hospital. This lets healthcare providers test for hypoglycemia safely.
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Low Blood Glucose During Sleep
Your blood glucose level can drop while you sleep and stay low for several hours, causing serious problems.7 Symptoms of low blood glucose while you sleep can include
- crying out or having nightmares
- sweating enough to make your pajamas or sheets damp
- feeling tired, irritable, or confused after waking up
Although you may not wake up or notice any symptoms, low blood glucose can interfere with your sleep, which may affect your quality of life, mood, and ability to work. Having low blood glucose during sleep can also make you less likely to notice and respond to symptoms of low blood glucose during the day.
Hypoglycemia: What Should You Do If Your Child Has Low Blood Sugar
What your child eats, their energy, stress, illness, or even a sunburn all of these can cause changes in your childs blood sugar. Its normal for their blood sugar levels to go up and down throughout the day and night, and if it stays in a healthy range, it may not even be noticeable.
When your childs blood sugar is too low , you need to take action to get their blood sugar levels back to a safe range. Without treatment, your child may be at risk for dangerous symptoms, such as fainting, seizures, or a coma.
Fortunately, you can easily treat your childs blood sugar during the day or at night. Heres what you should know about keeping your childs blood sugar levels in a healthy range.
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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
Possible Causes Without Diabetes
Even if you dont have diabetes, you may experience low blood sugar. However, hypoglycemia is much less common in people without diabetes.
Some possible causes of low blood sugar in people who dont have diabetes are:
- certain medications, such as quinine
- some medical conditions, such as hepatitis and kidney disorders
- a tumor that produces excess insulin
- endocrine disorders, such as adrenal gland deficiency
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How To Help Others Help You
Knowing the signs of low blood sugar, having an action plan, and being prepared with your glucose meter and glucose tablets are vital, but sometimes you might need to rely on other people to help when youre blood sugar drops too low. Take these additional steps so youre prepared and they are, too:
Teach your loved ones. If youre unable to help yourself, friends, family, or colleagues may need to treat you with an injection of glucagon, a hormone that tells your liver to release stored glucose, the American Diabetes Association says. For this reason, its a good idea to teach those close to you what to do. If they dont know how to give you the injection or if glucagon isnt available, they must call 911 and get you the help you need, Evans says. Low blood sugar thats sustained for a prolonged time can lead to irreversible brain damage, according to the University of Maryland Medical Center.
Wear an ID bracelet. Evan suggests that everyone with diabetes should get a tattoo or wear a medical ID bracelet. The bracelet should say diabetes and whether youre on insulin or take other medications, the Joslin Diabetes Center in Boston recommends.
Talk to your doctor about your low blood sugar risk. If you have frequent bouts of hypoglycemia, be sure to talk with your doctor. The solution may be as simple as changing how much or the kind of diabetes medicine you take. However, never make any changes to your medication regimen without your doctors approval.
Always Follow Up With The Doctor
It is very important to call your doctor as soon as possible after experiencing nocturnal hypoglycemia. The patient and doctor should try to figure out what caused the episode and how to prevent it from happening again.Often the doctor will suggest:
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Changing the dose or timing of insulin or other medications
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Setting an alarm for the early morning so that the patient can test their blood glucose levels and determine how often the episodes occur
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Having the person wear a continuous glucose monitor that checks blood glucose every five minutes with an alarm that wakes the patient from sleep if levels start to drop too low. This option is usually reserved for patients who experience frequent or severe nocturnal hypoglycemia
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What Is A Continuous Glucose Monitor
Besides a glucometer, you can also monitor your blood sugar with a continuous glucose monitor. These monitors are devices connected to the body all day, allowing quick access to information anytime you need it. These monitors help prevent surprise highs or lows in blood sugar and address them quickly.
There are other things you can do to avoid blood sugar crash if you have diabetes, including:
- Eating a balanced diet
- Avoiding sugary foods and drinks outside of mealtimes
- Eating small portions
- Avoiding restricting or cutting out full food groups
- Planning ahead