Management of Hypoglycemia

Hypoglycemia is the clinical syndrome that results from low blood sugar. This low blood sugar reaction can come on fast. Generally a level below about 60mg/dl is called low blood sugar. It may occur once or twice a weak if you have Type 1 diabetes. It is less common with Type 11 diabetes and may occur some times with people who are pre diabetic or suffering from insulin resistance and their meal time is delayed or they try to do some fasting. Some diabetic patients frequently go in to hypoglycemic or low sugar during the night between 10 pm. and 8 am.

What Causes Hypoglycemia

  • Delaying or skipping meals
  • Eating too little food at a meal
  • Getting more exercise than usual
  • Taking too much diabetes medicines, especially insulin
  • Drinking alcohol

Why is low blood sugar bad?

Of all the organs in the body, the brain depends on sugar (glucose) almost exclusively. The brain cannot make its own glucose and is 100% dependent on the rest of the body for its supply. If for some reason the glucose level in the blood falls or if the brains requirements increase and demands are not met, then there can be effects on the function of the brain.

Symptoms of hypoglycemia

  • Nervousness
  • Sweating
  • Intense hunger
  • Trembling or shakiness
  • Weakness
  • Palpitations
  • Trouble in speaking

If the blood sugar levels drop below 50mg/dl then the symptoms progress to

  • Confusion
  • Drowsiness
  • Changes in behavior - crying, shouting
  • Coma and seizure (convulsions)

The first set of symptoms are a warning or a signal for the patient to do something and help the brain. If food is eaten immediately there is still a chance for the brain to access the circulating blood glucose.

The patient should know this and so should family members or other close friends and associates. This can save and resolve the situation. If the condition is not treated soon enough then the second set of symptoms can occur and be dangerous.

How to treat Hypoglycemia

The treatment is to give about 15gms of carbohydrate which is easily and quickly available. This would be to-

  • Eat a fruit like a small banana or an apple or orange.
  • Drink half a glass of fruit juice
  • Eat 2-3 teaspoons of sugar or honey
  • Eat 2 pieces of hard candy
  • Drink 1 cup of milk

If after 15 minutes you are still feeling the hypoglycemia then take another 15gm of carbohydrate. If the next meal is an hour away then try to eat a snack which has both carbohydrate plus protein. The protein will prevent the blood sugar from falling again before the next meal. The ideal snack would be to have a

  • Glass of milk with a slice of bread
  • Glass of milk with 2 light biscuits like Marie or cracker
  • Glass of milk with half cup of cereal
  • One idli with sambar
  • One slice bread sandwich with egg
  • Curd or buttermilk (half cup or one glass)

The important thing is not to eat a large quantity of food and also to make sure that the food is not high in fat content. This will make the blood sugar shoot up high and then the food will get converted to fat in the body and weight gain will occur. Many diabetic patients look forward to this time of hypoglycemia and at that time indulge in eating chocolates, pastries or Indian sweets. This is very harmful to your diabetes and the fat prevents the blood sugar levels from coming back to normal fast.

The American Diabetic Association states that milk is one of the best choices in this condition. Milk contains lactose (a sugar) and protein which helps to keep the sugar level steady over time.

Those who cannot take milk can take curd or buttermilk.

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