Signs of Hypoglycemia (Low Blood Sugar)

© Stephanie Hicks 2011

Do you have hypoglycemia?

You might have heard of the term, or perhaps not. Yet, the medical community is increasingly recognizing that hypoglycemia (more commonly known as low blood sugar) can impact behavior, mood and even lead to symptoms resembling mental illness! Generally speaking, hypoglycemia exists when your blood sugar falls below 70 mg/dL. A normal blood sugar level is considered to be between 80-120 mg/dL.

Avoiding or treating hypoglycemia is not just a matter of eating more consistently, although that may come into play. A diagnosis can require adjustments in sleep, stress reduction, carbohydrate ingestion and much more.

I am a Type 1 diabetic, so I often experience hypoglycemia as a result of over-medication. In other words, if I take too much insulin or don't eat enough, I'll become disoriented and confused. In fact, I have a card in my wallet that states, "I am a diabetic. I am not intoxicated." The symptoms of hypoglycemia present in a similar manner to a person who has had too much alcohol. Speech can get slurred, balance thrown off, and some people even have difficulty forming words. This is because your vital organs (heart and lungs) are taken care of first in the case of low blood sugar. As your brain loses energy, things start to shut down, including judgment and other cognitive functions.

Hypoglycemia occurs when glucose (the sugar that is converted from carbohydrates you ingest) is depleted. Sometimes this can result when glucose is not released into your bloodstream fast enough. This can happen when you eat a meal high in fat because fatty substances slow the absorption of glucose. For example, pizza, fries or burgers are all difficult meals for people with hypoglycemia and/or diabetes. The condition also results when too much insulin is present in the body.

Insulin has been described by my doctor as the "key" that unlocks cells to allow sugar in. We all need sugar to provide energy which is why people with undiagnosed diabetes feel sluggish and tired. They are not getting the benefits of energy from food they eat, due to a deficiency of insulin. As blood sugar levels build up in the body, the natural response is to flush out the excess as waste. This is why diabetics feel thirsty all the time and have to go to the bathroom frequently.

If you are being treated for diabetes with medications other than, or in addition to insulin, you may be at risk for hypoglycemia. The primary reason is that the intended effect of these medications is to lower high blood sugar which is usually indicative of the disease of diabetes. At times, dosage may be too high, causing hypoglycemia as a result.

Any person that is being treated for diabetes may experience low blood sugar as a result of: (1) not enough carbohydrates, (2) too much insulin or other medications, or (3) too much exercise.

Hypoglycemia can also result from liver disease, a hormonal imbalance, or even a tumor in the pancreas. Alcoholics sometimes suffer from hypoglycemia because the liver plays a role in regulating blood sugar levels (releasing stored glucose to provide energy when you are not eating). When the liver is "distracted" by the task of detoxifying excess alcohol, it cannot properly help keep blood sugar levels consistent.

If blood tests reveal low blood sugar, your doctor will likely run additional tests to pinpoint the cause. You may be restricted from driving or performing physical exercise until the reason for the hypoglycemia is determined to reduce the risk of potential injury.

Proper treatment of hypoglycemia depends on its cause. For patients with diagnosed diabetes, the reason is usually too much medication/insulin. As soon as you feel symptoms, treat the low blood sugar first, and then test. If you are wrong in guessing that you are hypoglycemic, you can then dose with extra insulin or medicine.

Most people require about 15 grams of fast-absorbing carbohydrates, ideally glucose tablets to treat hypoglycemia. Do not ingest protein-based foods, or those high in fat because they will slow the absorption of the critically needed sugar. Good sources include: 2-3 glucose tablets, 4-6 ounces of orange juice or regular soda, at least 4 hard candies, or - my personal favorite - a handful of Skittles.

You should start to feel better about 10-15 minutes after treatment. I like to sit quietly and listen to music or look at a magazine before getting up and resuming activity, if possible.

Overnight low blood sugar episodes are different. You don't usually feel them coming on because you are asleep. Each person may react differently, as well. For me, my heart races and I wake up unable to fall back asleep. I usually have really strange, complicated dreams too. A cousin of mine with diabetes has had a number of seizures resulting from hypoglycemia. His family has had to call the paramedics on several occasions. You can try to prevent this from occurring by avoiding alcohol, eating a bedtime snack, and even setting your alarm to test your blood sugar in the middle of the night so that treatment is possible beforehand.

Its can be a fine line for Type 1 diabetics, in particular. On one hand, you want to take enough insulin to push blood sugar levels into the normal range, but since the pancreas does not create any insulin on its own, dosage has to account for minute changes in daily activities and conditions including illness and exercise.

The answer to this question is: it depends. On its own, low blood sugar can lead to medical complications, or even death in severe cases. Extreme hypoglycemia can result in convulsions or a coma. Left untreated, a patient may die as the body literally shuts down. If you have a hypoglycemic loved one, be alert to subtle changes in mood and behavior. You might spot the symptoms of hypoglycemia before they do. When a person is conscious, you can encourage them to drink juice or soda to help treat the low blood sugar. If they have fainted, however, you should immediately call 9-1-1 for medical assistance. Rubbing glucose gel on the inside of their mouth may help, but not if the patient is convulsing.

Hypoglycemia is scary - both for the person experiencing it and anyone around them. I constantly worry about experiencing low blood sugar when driving or running. I could end up in a serious car accident as a result of hypoglycemia if I become confused while driving. When I'm running, I am concerned about being far away from medical assistance without any means of treating the low blood sugar episode. To help in these instances, I always wear a medical identification bracelet and carry a cell phone with me at all times.

Be sure to seek professional medical assistance for diagnosis and treatment of hypoglycemia.  Your doctor will probably suggest revisions to your diet, reduction of stress and potentially an adjustment of sleep habits.  A healthier lifestyle can often reduce the severity of the condition and extend the life of the patient.

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