This content material initially appeared on diaTribe. Republished with permission.
By Amelia Harnish
Feeling shaky, drained, and irritable after a nighttime low? For folks with diabetes, this phenomenon is called a “low hangover.” Right here’s the best way to handle.
Whereas a fortunate few might have solely heard tales about it, many individuals with diabetes have skilled the dreaded “low hangover” firsthand.
Low hangover describes the constellation of signs that may come following an episode of hypoglycemia (low blood sugar). These can embrace headache, nausea, mind fog, and fatigue – all of which make “hangover” a fairly apt descriptor.
“The mind requires glucose as its gas and quickly malfunctions when disadvantaged of it,” defined Dr. Brian Frier, a professor on the College of Edinburgh, Scotland, who makes a speciality of diabetes. “This causes cognitive impairment and generates signs.”
Discussions of low hangover and what to do about it abound in affected person circles and assist boards. But it surely’s not essentially one thing your physician will concentrate on, which can be as a result of it’s not a medical time period or official analysis.
“I’ve heard this time period a couple of times from sufferers. It’s not one thing we usually talk about however possibly we should always talk about it extra,” mentioned Dr. Katherine Kutney, a pediatric endocrinologist at Rainbow Infants and Kids’s Hospital in Cleveland, Ohio.
Contemplating that individuals with diabetes might expertise low blood sugar as usually as a couple of times every week, the danger for a low hangover is fairly excessive. Right here’s what to learn about this little-discussed phenomenon.
Why do ‘low hangovers’ occur?
The “low” in low hangover refers to hypoglycemia.
For most individuals with diabetes who take insulin, that is outlined as a blood sugar below 70 mg/dL. For folks with out diabetes or who aren’t taking insulin, blood sugars all the way down to 60 mg/dL could be regular.
Most frequently for folks with diabetes, hypoglycemia occurs when there’s a mismatch between the insulin dose they’re taking and what their physique wants.
“An excessive amount of insulin makes blood sugar drop. The difficult half is that insulin sensitivity can change for a lot of causes,” Kutney mentioned.
For instance, your insulin dose could also be too excessive, or possibly you didn’t fairly eat sufficient to match the dose. Different causes embrace having a very lively day or not consuming as a lot fats or protein as traditional.
Many individuals with diabetes expertise hypoglycemia at evening whereas they sleep. Analysis finds that roughly 50% of extreme hypoglycemic episodes occur at evening.
These low sugar spells might result in extra signs (particularly fogginess) as hypoglycemia whereas sleeping can have an effect on reminiscence consolidation and cognitive perform. Nocturnal hypoglycemia is commonly attributable to being lively near bedtime or taking an excessive amount of insulin.
“Though blood glucose can rise shortly after hypoglycemia is handled and be restored to a standard degree, the restoration of the mind lags behind. So, cognitive perform can take as much as 30-60 minutes to get better, and temper adjustments can persist for for much longer,” Frier defined.
What does a ‘low hangover’ really feel like?
Signs vary, however much like an alcohol hangover, folks with diabetes recovering from a hypoglycemic episode usually really feel drained and usually unwell following remedy.
“Hypoglycemia has a adverse impact on temper, which is annoying and ugly,” Frier added. “Temper adjustments embrace what’s known as ‘tense-tiredness,’ emotions of unhappiness, irritability, and typically anger and a adverse appraisal of conditions. These temper adjustments are widespread, could be profound, and are continuously ignored by clinicians.”
If you expertise low blood sugar, your physique tries to counteract the low by releasing hormones like epinephrine (often known as adrenaline) and cortisol. These hormones, particularly epinephrine, trigger the shakiness, nervousness, and sweating which are widespread signs of low blood sugar.
“The adrenaline doesn’t essentially shut off straight away as soon as blood sugar is over 70 mg/dL, which may result in this low hangover feeling,” Kutney mentioned. “Cortisol normally makes folks really feel extra energized, however may go away you feeling ‘worn out’ as a result of fluctuations within the ranges.”
The phenomenon of a “low hangover” is normally noticed within the morning after an episode of nocturnal hypoglycemia. How lengthy signs final additionally depend upon the period and severity of hypoglycemia.
How lengthy does it take for signs to go away?
As soon as your blood sugar ranges return to regular, signs can linger for hours however normally go away with out further remedy.
Whereas signs sometimes resolve inside a day, repeated hypoglycemia can start to impression your well being and well-being. Nobody likes to really feel fatigued, foggy, and nauseous. These signs can result in needing a time without work, which if repeated, usually can impression work or faculty schedules.
Some analysis suggests that repeated episodes of hypoglycemia can impression cognitive perform over time. Repeated lows are additionally related to hypoglycemia unawareness, which implies you don’t discover the indicators of low blood sugar; this may be harmful and even lethal.
Are there any methods for treating hypoglycemia at evening?
Sadly, like hangovers from extra alcohol consumption the evening earlier than, there aren’t any confirmed fast fixes for a low hangover.
“Treating it with rapid-acting carbs like glucose tablets, fruit juice, Skittles, or SweetTarts will assist blood sugar get better faster,” mentioned Kutney. “Nevertheless, this received’t essentially keep away from the low hangover feeling.”
One of the simplest ways to keep away from a low hangover is to forestall hypoglycemia. Take into accout that is simpler mentioned than executed as a result of many low episodes are sometimes out of an individual’s management. Nevertheless, applied sciences like steady glucose screens (CGM) are helpful instruments for hypoglycemia prevention and managing blood sugar ranges usually.
“Automated insulin supply techniques (pumps that talk with the CGM to regulate the insulin) can usually forestall a low from occurring,” Kutney added.
One other factor to be careful for is overtreating low blood sugar.
“Most individuals want about 15 grams of rapid-acting carbs to deal with a low, however this could range. If you happen to overdo it, this could trigger excessive blood sugars later which may contribute to a sluggish feeling after lows,” Kutney mentioned.
In any other case, one of the best recommendation for coping with a low hangover is to take it straightforward and relaxation. Frier added that you just must also keep away from doing something that might be probably dangerous on this state, like driving or making vital choices.
“The message for individuals who expertise low blood sugar is to understand that the aftermath of handled hypoglycemia could be extended. Attempt to be affected person and permit time for a full restoration to happen,” he mentioned.