To a non-diabetic, a low blood sugar seems like a enjoyable excuse to eat sweet. For these of us with diabetes, low blood sugars are the precise reverse of enjoyable.
Low blood sugars (often known as hypoglycemia) can interrupt enterprise conferences, put you at risk whereas driving, flip a visit to the playground together with your youngsters right into a nightmare, and go away you feeling like a panicky, sweating mess.
On this article, we’ll have a look at the telltale signs of low blood sugar, the causes of low blood sugar, tips on how to deal with and handle lows, and tips on how to stop them from occurring as incessantly.
What’s low blood sugar?
In a non-diabetic physique, blood sugar ranges not often dip beneath 70 mg/dL. Any decrease and the physique will start to battle to carry out even probably the most primary duties.
Your mind depends on a second-by-second supply of glucose out of your bloodstream to be able to perform — bodily and mentally. With out sufficient glucose (a type of sugar) in your bloodstream, your mind and whole physique will battle to perform.
Left untreated, low blood sugars can result in seizures and loss of life.
What are the signs of low blood sugar?
There are a number of telltale indicators that your blood sugar has dropped beneath a protected degree. The American Diabetes Affiliation (ADA) lists the next as signs of low blood sugar:
- Feeling shaky
- Being nervous or anxious
- Sweating, chills, and clamminess
- Irritability or impatience
- Quick heartbeat
- Feeling lightheaded or dizzy
- Coloration draining from the pores and skin (pallor)
- Feeling Sleepy
- Feeling weak or having no vitality
- Blurred/impaired imaginative and prescient
- Tingling or numbness within the lips, tongue, or cheeks
- Coordination issues, clumsiness
- Nightmares or crying out throughout sleep
It’s possible you’ll expertise different signs past this listing. For instance, in my physique, if I’m strolling on a treadmill and my blood sugar is low, my thighs begin to really feel numb and tingly.
Everybody has their very own basic signs of low blood sugar — work out which signs you are feeling the soonest so you may catch lows before later!
For some folks, particularly those that have lived with diabetes for a lot of a long time, “hypoglycemia unawareness” can change into an issue.
Which means your blood sugar may very well be low however your physique not experiences the widespread signs of a low, placing you in better hazard of experiencing a seizure.
The ADA says it’s doable to regain signs of low blood sugar, nevertheless it takes time and purposeful adjustments in the way you method diabetes administration.
“It’s doable to get your early warning signs again by avoiding any, even delicate, hypoglycemia for a number of weeks,” explains the ADA. “This helps your physique re-learn tips on how to react to low blood glucose ranges. This will likely imply growing your goal blood glucose degree (a brand new goal that must be labored out together with your diabetes care group). It could even lead to the next A1C degree, however regaining the flexibility to really feel signs of lows is well worth the momentary rise in blood glucose ranges.”
Reversing “hypoglycemia unawareness” is feasible for a lot of
Whereas it isn’t remarkably widespread, it is a matter for some folks with diabetes. There are some things somebody with clear “hypoglycemia unawareness” can do to maintain themselves protected.
First, use a steady glucose monitor (CGM). CGMs are perfect for individuals who don’t expertise regular signs of low blood sugar as a result of they’ll warn you to oncoming lows, serving to you stop them from occurring or from dropping as severely. CGMs permit you to set “low alerts” to ranges like 90 mg/dL or 110 mg/dL — wherever you are feeling most secure.
Secondly, intention for the next goal vary. If you realize you have got “hypoglycemia unawareness,” it’s vital that you simply elevate your goal blood sugar vary at the very least barely. As an alternative of aiming for 90 mg/dL when dosing insulin for meals and correcting highs, speak to your diabetes healthcare group about aiming for 100 mg/dL or 110 mg/dL, and so on. This may cut back the danger of low blood sugars by preserving your blood sugar barely above that skinny line between “regular” and “low.”
Signs of low blood sugar whenever you aren’t really low…
For folks with diabetes whose blood sugar ranges have been constantly excessive for an prolonged time period, together with these with A1cs above 8 % and people battling diabulimia, it’s doable on your physique to acclimate to excessive blood sugar ranges.
Which means when your blood sugar does come down, your physique would possibly present signs of being low even when it’s simply in a more healthy vary.
Reversing this difficulty is feasible.
First, in case you are at the moment battling diabulimia, please attain out to WeAreDiabetes or your healthcare group for help and steering on working in the direction of restoration.
Secondly, clarify to your CDE what’s occurring — that you simply’re experiencing signs a low whenever you’re not low — and that you simply’re absolutely dedicated to bettering your blood sugar ranges so you may really feel good at more healthy blood sugar ranges.
However this implies your physique wants time to acclimate, too. You’d work together with your CDE on aiming for a goal blood sugar that’s decrease than the upper vary you’ve been sitting at, however not as little as “regular” blood sugar targets.
This offers your physique an opportunity to regularly — over the course of weeks or months — reacclimate to more healthy blood sugar ranges with out triggering false signs of low blood sugar.
What causes low blood sugar?
In folks with kind 1 and sort 2 diabetes, low blood sugars are usually attributable to an imbalance of meals, exercise, and insulin — or different diabetes drugs that decrease blood sugar.
Exercising with out adjusting insulin doses and carbs
Going for a stroll after lunch, for instance, may cause a extreme low blood sugar for those who took your full dose of insulin on your lunch. The addition of the stroll will increase the speed at which your physique is burning up the glucose from the meal you ate, inflicting a low blood sugar.
TIP: Be taught, study, study, and examine, examine, examine how the physique reacts to several types of train in Christel Oerum’s “Match with Diabetes” information, or Sheri Colberg’s “Diabetic Athlete’s Handbook.”
Dosing insulin for difficult carbohydrate estimates
Taking 3 models of insulin for a medium-sized apple when you’ll have solely wanted 2 is one other instance of the best approach folks with diabetes can expertise low blood sugars whereas doing our greatest to handle our blood sugars.
TIP: Use CalorieKing.com to doublecheck your carb-counts, and hold a bit pocket book of the insulin doses you used for meals you eat usually!
Weight-loss growing sensitivity to insulin
Dropping 5 kilos may end up in the physique finally needing much less insulin, however an individual with diabetes solely is aware of it’s time to scale back their insulin doses once they begin to expertise frequent low blood sugars.
TIP: Chances are high, your physique wants a discount of at the very least 1 to three models in your total background insulin wants or extra for these shedding bigger quantities of physique fats. Speak to your CDE about performing some basal testing and carb-ratio testing to make sure your present insulin doses are correct! (Or learn Gary Scheiner’s Suppose Like a Pancreas!)
Insulin wants altering resulting from different elements
Your insulin wants can change all through your whole life resulting from adjustments in stress, exercise degree, physique weight, development spurts, and so on. When you by no means fine-tune and modify your insulin doses, you’re sure to expertise extra excessive or low blood sugars.
Tight blood sugar targets
Aiming for wholesome non-diabetic blood sugar ranges means its way more seemingly you’ll expertise low blood sugars as a result of the road between “regular” and “low” blood sugars is a really skinny line. Simply the slightest bit an excessive amount of insulin or exercise, and your blood sugar is out of the blue too low.
TIP: When aiming to enhance your A1c, the primary precedence is to stop and keep away from recurring low blood sugars. When you’re always going low, it’s time to take a more in-depth have a look at the doses you’re utilizing for meals and corrections. If taking 2 models of insulin when your blood sugar is 200 mg/dL always sends you right down to 50 mg/dL, that’s a really clear signal that you simply want far much less insulin on your correction doses. Take good notes and pinpoint areas the place you can also make changes.
Particularly for those who’re taking insulin — and for those who take non-insulin drugs that decrease blood sugar — low blood sugars are one thing you’ll be always working to keep away from, deal with, and endure.
Learn extra about adjusting insulin doses, weight-loss, and train:
Ideas for treating low blood sugars
Whereas we’re usually instructed that each one low blood sugars ought to be handled with the “rule of 15” (eat 15 grams of carbohydrates and examine once more after quarter-hour), actual life with diabetes isn’t this easy. Let’s take a more in-depth have a look at tips on how to deal with low blood sugars.
Be sure to have a glucagon package
For the very worst lows — whenever you’re unconscious or whenever you’re sick and you’ll’t hold meals down — a glucagon package can save your life. When you don’t have one, or the one you have got is expired, ask your physician for a brand new prescription. Preserve it in someplace in your home or at work or in your health club bag, and ensure others know the place it’s and tips on how to use it!
Use fast-acting carbohydrates
When you deal with your lows with a chocolate sweet bar, the fats and protein within the bar are going to decelerate the digestion of the carbohydrates. This implies it’ll take longer on your blood sugar to come back again up! As an alternative, select fast-acting carbohydrates like glucose tabs, gummy sweet, juice, dried fruit, jelly beans, Pixie Stix, honey, syrup, and so on.
Deal with with 5 to fifteen grams of carbs and be affected person
Some lows solely require 5 grams of carbohydrates to convey you again as much as a protected degree. When you’re sitting steadily at 65 mg/dL, you seemingly don’t want a full 15 grams of carbs, as a result of which may convey you again nicely above your goal blood sugar vary.
Then again, for those who’re at 55 mg/dL and persevering with to drop, it’s possible you’ll want 15 grams of carbohydrate…and then extra relying on the quantity of insulin you have got onboard and why you’re low.
Then, right here’s the toughest half: sit in your arms and wait earlier than consuming the rest. If you’re nonetheless low then you definately would deal with with extra carbs. (Do examine together with your meter as a result of signs can final even when your blood sugar has come again up).
All the time hold fast-acting carbs close by…all over the place!
In your nightstand, in your purse, in your baby’s diaper bag, in your automobile’s glove compartment, within the jacket you put on to stroll the canine, in your workplace desk, in your associate’s automobile. In all places!
Bear in mind to decide on fast-acting carbs. And in the event that they’re going to be in a location that may get actually chilly or actually sizzling, you have to take into consideration whether or not that kind of meals will rot or soften or freeze. Fruit snacks and Gummy Life Savers and conventional glucose tabs are nice for warm or chilly areas.
Remind your self: I’m answerable for how a lot meals I eat to deal with my lows.
Binge-eating throughout low blood sugars is quite common, however it may be a really damaging behavior. The binge results in an excellent spike in your blood sugar, which ends up in guilt and disgrace and a “rage bolus” of insulin to convey it again down. After which that may result in one other low!
Is that this a typical difficulty for you? Ask your self: is the best way I deal with my low blood sugars wholesome or dangerous to my total well-being?
Right here’s a easy have a look at the binge-eating cycle round low blood sugars from my e-book, Emotional Consuming with Diabetes:
Low blood sugars are an actual ache. For these of us taking insulin and different meds that decrease blood sugar ranges (like Metformin), they’re additionally an inevitable a part of diabetes administration.
One of the best we will do is pinpoint areas to make changes to stop them, and all the time, all the time, all the time have fast-acting carbohydrates close by to deal with lows once they occur.