Important to recognize
Low Blood Sugar or Hypoglycemia
Common cause:
- too much insulin or too high a dose of diabetic medication (that stimulate insulin release)
- ate less than usual, missed/delayed a meal
- excess activity or exercise
- alcohol excess can induce a low blood sugar
- medical illness like infections
Symptoms:
- Symptoms vary from no symptoms (Hypoglycemia unawareness) to any of the following
sweaty, shaky, hungry, weak, confused, Irritable, lightheaded, drowsy, occasionally blurred vision, palpitations, or racing heart
Recognize it:
It is an emergency that should be recognized and treated immediately. Others around you should also be able to identify the symptoms of low blood sugar and help.
Treatment of hypoglycemia
What to do?
Take 15 gm of carbohydrates (e.g., half a glass of fruit juice or soft drink). Recheck the blood sugar in 15-minutes and repeat the 15 gm carbohydrates if the blood sugars are still low. The aim is to try to keep the blood sugars around 80 to 120: higher targets, i.e., 140-180s for some people with diabetes who are brittle. (your doctor must determine this target).
If you get a low blood sugar episode without a good reason, talk to your doctor to see if lowering the dose of insulin or diabetic medication is appropriate. If you are an insulin-dependent diabetic and have frequent low blood sugars, Glucagon should be available. If you pass out from severe low blood sugar, someone who lives or works with you can give an intramuscular glucagon injection, or now it is available as intranasal (Baqsimi). Glucagon is only used if you are unable to take any carbohydrates by mouth.
How to use the glucagon kit, where it is kept, must be discussed with friends and family preemptively.
Keep a supply of snacks or glucose tablets or gel in different places such as: in your car, workplace.
Glucagon is injected into the muscle either in the upper arm or front of the thigh. After the glucagon injection, you should be placed on your side to reduce the risk of aspiration from vomit (a side effect of glucagon).
If Glucagon is not available or blood sugars are not improving, someone needs to call the EMTs. Glucose gel or just plain sugar can be placed in the mouth to help the low blood sugar.
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