Diabetes and Hypoglycemia: All You Need to Know

The body uses glucose as a primary source of energy. Hypoglycemia is a state of having blood sugar (glucose) levels that are below normal.

Diabetes treatment frequently involves managing hypoglycemia. However, individuals without diabetes can experience low blood sugar due to various medications and a wide range of ailments, many of which are unusual.

Studies say diabetes patients may have hypoglycemia if their bodies produce excessive insulin. If you have diabetes and use too much insulin, you may also experience hypoglycemia. 

Studies note that a fasting blood sugar of 70 mg/dL, or 3.9 mmol/L, or less, should be a warning sign for hypoglycemia. Hence, treatment must start immediately to curb the adverse effects of hypoglycemia. 

Nowadays, devices like continuous glucose monitors can help you prevent hypoglycemia. It lets you know whenever your blood glucose levels go too low or too high.

HealthifyPro 2.0 by the digital health platform, HealthifyMe helps you measure your blood glucose levels. The BIOS continuously tracks your blood glucose levels. The data will get sent to you, and your coaches will provide you with the necessary advice and tips to improve your health.

Who is More Likely to Experience Low Blood Glucose Levels?

Low blood glucose is more likely to occur if you

• Have type 1 diabetes
• Take insulin or some other diabetes medicines
• Age over 65 
• A history of low blood glucose 
• Have other health problems (kidney disease, heart disease, or cognitive impairment).

Signs and Symptoms

Each individual responds differently to changes in their blood sugar levels. If someone has hypoglycemia, they might experience:

• Dizziness
• Inability to concentrate
• Extreme hunger
• Headache
• Confusion
• Sweating
• Seizures
• Nausea
• Feeling pukish
• Shaking
• Pale skin
• Blurred vision
• Personality changes
• Numbness in the lips, cheeks, or tongue

Studies also say that the following symptoms can appear when hypoglycemia worsens (chronic):

• Confusion, unusual behaviour or both, such as the inability to complete routine tasks
• Loss of coordination
• Slurred speech
• Blurry vision or tunnel vision
• Nightmares, if asleep
• Unresponsiveness (loss of consciousness)
• Seizures 

The HealthifyMe Note:

Suppose you have diabetes and experience frequent hypoglycemic episodes. In that case, your body may stop exhibiting symptoms, making it harder for your brain to detect hypoglycemia. Dangerously low blood sugar levels can result in a coma or possibly death. Consult your healthcare physician as soon as possible if you experience frequent hypoglycemic episodes so you can get it under control.

Causes of Hypoglycemia 

Whether you have type 1 diabetes, type 2 diabetes, or you don’t have diabetes, there are several different causes of hypoglycemia.

Diabetic Hypoglycemia

Type 1 Diabetes

With type 1 diabetes, hypoglycemia is typical. Studies note that it often occurs when you consume more insulin than your body requires to metabolise your diet, but other factors, such as

• Failing to schedule your insulin shots during meals
• Drinking alcohol or exercising without carefully monitoring your blood sugar
• Temperature and humidity
• Schedule alterations, such as those resulting from travel
• Being at a high altitude
• Puberty
• Menstrual periods

Type 2 Diabetes 

Compared to type 1, type 2 diabetes has a lower prevalence of hypoglycemia. It frequently results from:

• Medications- using insulin and other medications excessively
• Food- consuming insufficient carbohydrates concerning your insulin
• Physical activity- exercise reduces the requirement for insulin.

Non-Diabetic Hypoglycemia

Serious Illnesses

Hypoglycemia can cause severe infections, kidney disease, advanced heart disease, and liver diseases such as severe cirrhosis or hepatitis. Additionally, kidney problems can prevent your body from adequately eliminating drugs. An accumulation of medications that lower blood sugar levels may impact glucose levels.

Too Much Alcohol

Drinking excessive alcohol without eating can prevent the liver from releasing glucose from its glycogen stores into the bloodstream. Studies point out that this may cause hypoglycemia.

Medications

Accidentally ingesting someone else’s oral diabetic medicine can result in hypoglycemia. Other drugs can potentially cause hypoglycemia, particularly in young patients or those with kidney disease, for example- malaria drug quinine (qualaquin). Low blood sugar in people without diabetes can be brought on by

• Diabetes medicines, including insulin
• Beta-blockers
• Sulfamethoxazole and trimethoprim (Bactrim)
• Haloperidol
• Pentamidine
• Monoamine oxidase inhibitors (MAOIs)
• Quinidine
• Sulfonylureas

Chronic malnutrition and Long-term Starvation

Malnutrition and starvation can cause hypoglycemia because when you don’t eat enough food, your body uses up the glycogen stores required to produce glucose. That results in hypoglycemia. 

A Surplus of Insulin

One can develop hypoglycemia if your pancreas produces too much insulin due to a rare pancreatic tumour called an insulinoma. A surplus of insulin-like molecules can also be due to other cancers. The pancreas’ peculiar cells can cause excessive insulin release, which leads to hypoglycemia.

Hormonal Imbalances

Specific diseases of the pituitary and adrenal glands may cause insufficient levels of certain hormones that control glucose synthesis or metabolism. For example, if a child has too little growth hormone, they may have hypoglycemia.

Types of Non-Diabetic Hypoglycemia 

Hypoglycemia without diabetes (non-diabetic hypoglycemia) can be of two categories:

Fasting Hypoglycemia

It happens when you don’t eat for an extended period. Any of the following factors can cause fasting hypoglycemia:

• Medications (most common cause):
• Nonselective beta-blockers (such as propranolol)
• ACE inhibitors (such as captopril)
• Certain antibiotics (such as ciprofloxacin and levofloxacin)
• Alcohol
• Exercise
• Diseases like liver disease, hypothyroidism, pancreatic tumour, malnutrition, stomach surgery, eating disorders, sepsis, hemodialysis, and insulinomas can cause sudden episodes of hypoglycemia.

Reactive Hypoglycemia

It occurs within a few hours of eating a meal. The cause of reactive hypoglycemia can be:

• Hyperinsulinism (excessive production of insulin)
• Refined carbohydrates (such as white bread)
• Surgeries of the digestive system
• Prediabetes (a condition wherein blood sugar level is high but not enough to be termed diabetes) 

Hypoglycemia Diagnosis 

How does hypoglycemia result from skipping meals?

A missed meal might change how food intake and insulin production interact, which may eventually result in a decline in blood sugar levels. Skipping meals might be riskier for diabetics who depend on insulin or other blood sugar-lowering medications because it can result in low blood sugar

To diagnose hypoglycemia (low blood sugar), a person must have the following symptoms:

• Low blood sugar levels bring on the symptoms.
• A blood test measures blood glucose level (often less than 60 mg/dL)
• The individual feels better after consuming anything that returns blood sugar levels to normal.

You can identify the cause of hypoglycemia by performing the following tests:

• Blood tests
• a CT scan (computerised tomography)
• MRI (magnetic resonance imaging) scan
• Ultrasound

Prevention

With Diabetes

Managing your diabetes and your risk of low blood sugar can get affected if you start taking new  drugs, alter your eating or medication schedules, or start doing more activity. Learn the warningsigns and symptoms of low blood sugar before your blood sugar levels drop too low; this can assist you in recognising and treating hypoglycemia. In addition, you can detect when your blood sugar is getting low by regularly monitoring it.

A continuous glucose monitor (CGM) is a good alternative for certain people. A CGM can transmit blood glucose levels to a receiver through a small wire implanted under the skin. Some CGM devices will alert if blood sugar levels go too low. Also, to help prevent hypoglycemia, specific insulin pumps now have CGM integration. As a result, they can stop delivering insulin when blood sugar levels are falling too quickly. Always keep a fast-acting carbohydrate on your hands, such as glucose drinks, juices, or glucose pills. It can address a dropping blood sugar level before it reaches dangerously low levels.

Without Diabetes

Several small meals throughout the day are a temporary solution for treating hypoglycemia that frequently occurs to keep blood sugar levels from falling too low. However, it would help if you had a more specialised intervention for it to be a good long-term plan. So instead, work with your health coach and nutritionist to determine and address the cause of hypoglycemia.

When to See a Doctor?

Immediately seek medical attention if,

• You have signs of hypoglycemia, but you don’t have diabetes.
• You have diabetes, and nothing seems to work despite trying to manage your hypoglycemia by drinking juice or regular (not diet) soft drinks, eating candy, or taking glucose tablets.
• Suppose you have diabetes or a history of hypoglycemia, experience severe hypoglycemic symptoms, or become unconscious. In that case, you should seek emergency medical attention.

Treatment

For treatment, follow these steps if you experience signs of hypoglycemia:

Fast Acting Carbohydrates

Eat or drink 15–20 grams of quick-acting carbs. These are high-sugar, low-protein, and low-fat foods and drinks that the body may quickly turn into sugar. Try honey, glucose pills or gel, fruit juice or fruit.

Recheck Blood Sugar Levels

After 15 minutes of treatment:

1. Recheck blood sugar levels.
2. Eat or drink another 15 to 20 grams of fast-acting carbohydrates, and then check your blood sugar levels in 15 minutes if they are still under 70 mg/dL (3.9 mmol/L).
3. Continue doing these actions until the blood sugar exceeds 70 mg/dL (3.9 mmol/L).

Snack or Meal

Eat a meal or a snack. Eating a nutritious snack or meal once your blood sugar has returned to normal will help avoid further blood sugar drops. Also, it will restock your body’s glycogen reserves.

Foods to Eat For Treatment of Hypoglycemia

Treatment for hypoglycemia (low blood sugar) includes:

• Consuming quick sources of sugar 
• Glucose tablets or gel
• Honey
• Fruit juice
• Glucose drinks 

The HealthifyMe Note:

Hypoglycemia occurs when there are low glucose levels in the blood. Consuming foods that contain a good amount of carbohydrates or sugars can help treat and prevent the adverse effects of low blood glucose levels. Consuming glucose-rich or sugary beverages can assist in curbing the symptoms instantly. Moreover, you can also use alternative medicines. Fruits and fruit juices are a healthy alternative that boosts energy and immunity and is a good source of sugar. Immediate treatment involves eating or drinking 15-20 grams of fast-acting carbohydrates. However, it is essential to consult a health expert to understand the underlying causes of hypoglycemia.

Summary

Blood sugar levels fluctuate throughout the day for various reasons, including when and what you consume and your physical activity and stress levels. But if you frequently have hypoglycemia or perennially feeling the symptoms, you need to take action. Although a diabetes diagnosis can be problematic, the earlier you manage your glucose and resume your favourite activities, the better. 

In people with diabetes, hypoglycemia (low blood sugar) is usual. Suppose you have had diabetes before, and you continue to experience hypoglycemic symptoms. In that case, your doctor may need to modify your treatment strategy or assess you to rule out any other underlying conditions. You should still be examined if you have never been diagnosed with diabetes but exhibit hypoglycemic symptoms.