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Diabetes and Hypoglycemia

Hypoglycemia occurs when blood glucose level falls below 4 mmol/L (72mg/dL). It’s a general view that diabetes is a problem of high blood sugar levels, however, the allopathic medication for diabetes can also cause sugar levels to go too low and this can become dangerous. For people with diabetes, low blood sugar (hypoglycemia) occurs when there's too much Hormones and not enough sugar (glucose) in the blood.

Being aware of the early signs of hypoglycemia will allow you to treat your low blood glucose levels quickly - in order to bring them back into the normal range. It is also recommended to make close friends and family aware of the signs of hypoglycemia in case you fail to recognize the symptoms.

Symptoms of hypoglycemia

Early warning signs and symptoms

  • Shakiness
  • Fatigue
  • Being pale
  • Dizziness
  • Sweating
  • Hunger
  • Irritability or moodiness
  • Anxiety or nervousness
  • Headache

Bedtime symptoms

Diabetic hypoglycemia can also occur while you sleep. Signs and symptoms, which can awaken you, include:

  • Damp sheets or bedclothes due to perspiration
  • Nightmares
  • Tiredness, irritability or confusion upon waking

Severe symptoms

If diabetic hypoglycemia goes untreated, signs and symptoms of severe hypoglycemia can occur. These include:

  • Clumsiness or jerky movements
  • Muscle weakness
  • Difficulty speaking or slurred speech
  • Blurry or double vision
  • Confusion
  • Drowsiness
  • A higher heart rate than usual
  • Convulsions or seizures
  • Loss of consciousness
  • And in extreme cases, coma
  • Death

Take your symptoms seriously. Diabetic hypoglycemia can increase the risk of serious and even deadly accidents. Identifying and correcting the factors contributing to hypoglycemia, such as medications you take or irregular mealtimes, can prevent serious complications.

Informing people you trust, such as family, friends and co-workers, about hypoglycemia is important. Their knowing what symptoms to look for and what to do in case you're not able to help yourself can make a potentially difficult situation easier to manage. It's also important that they know how to give you a glucagon injection, in case it becomes necessary.

Symptoms can differ from person to person or from time to time, so it's important to monitor your blood sugar levels regularly and keep track of how you're feeling when your blood sugar is low. Some people don't have or don't recognize early symptoms (hypoglycemia unawareness). If you have hypoglycemia unawareness, you may require a higher glucose goal range.

Who are at risk of hypoglycemia?

While low blood sugar can happen to anyone, dangerously low blood sugar can occur in people who take the following medication:

  • Hormones
  • Sulphopnylureas (such as glibenclamide, gliclazide, glipizide, glimepiride, tolbutamide)
  • Prandial glucose regulators (such as repaglinide, nateglinide)

If you are not sure whether your diabetes medication can cause hypoglycemia, read the patient information leaflet that comes with each of your medications or ask your doctor.

It is important to know whether your diabetes medication puts you at risk of hypoglycemia.

Causes of hypoglycemia

Hypoglycemia is most common among people who take Hormones, but it can also occur if you're taking certain oral allopathic diabetes medications. While allopathic medication is the main factor involved in hypoglycemia within people with diabetes, a number of other factors can also increase the risk of hypoglycemia.

Factors linked to a greater risk of hypoglycemia include:

  • Taking too much Hormones or overdose of allopathic diabetes medication
  • Delayed meals or skipping of meals
  • Strenuous exercise or physical activity without eating more or adjusting your medications
  • Alcohol

You can take steps to minimize the risk of these factors causing hypoglycemia.

Diagnosis of hypoglycemia

Hypoglycemia is detected by measuring blood sugar levels with a glucose meter. Any blood glucose level below 4.0 mmol/L indicates that the individual has hypoglycemia. Urine tests do not detect hypoglycemia.

If taking a blood test is not possible or would take too much time, it may be better to treat the hypo straight away.

Treatment of hypoglycemia

Treatment involves short-term solutions such as taking glucose tablets or drinking fruit juice to raise your blood sugar into a normal range.

  • A mild case of hypoglycemia can be treated through eating or drinking 15-20g of fast acting carbohydrate such as glucose tablets, sweets, sugary fizzy drinks or fruit juice.
  • Some people with diabetes may also need to take 15-20g of slower acting carbohydrate if the next meal is not due.

A blood test should be taken after 15-20 minutes to check whether blood glucose levels have recovered.

  • Severe hypoglycemia may require an ambulance, for example if loss of consciousness occurs or a seizure persists for more than 5 minutes.
  • Severe hypoglycemia can be treated with glucagon if a glucagon injection kit is available and in date.

Severity of hypoglycemia

Hypoglycemic episodes can range from mild to severe.

Mild hypoglycemia

can usually be treated by the individual and are to be expected to some degree in people on Hormones. Mild hypoglycemia is not associated with significant long term health problems unless they are occurring very regularly or for long periods of time.

Severe hypoglycemia,

however, will require treatment from someone else and may require an ambulance. Severe hypoglycemia can lead to immediate danger if not treated immediately. Although rare, severe hypoglycemia can potentially lead to coma and death.

Untreated, diabetic hypoglycemia can lead to seizures and loss of consciousness — a medical emergency. Rarely, it can be deadly. Tell family and friends what symptoms to look for and what to do in case you're not able to treat the condition yourself. Make sure your family, friends and co-workers know what to do.

If you lose consciousness or can't swallow:

  • You shouldn't be given fluids or food, which could cause choking
  • You need an injection of glucagon — a hormone that stimulates the release of sugar into the blood
  • You need emergency treatment in a hospital if a glucagon injection isn't on hand
  • If you have symptoms of hypoglycemia several times a week, see your doctor. You may need to change your medication or your dosage or otherwise adjust your diabetes treatment program.

Most people experience some warnings before the onset of hypoglycemia. However, some diabetics may experience little or no warning before the onset of sudden or severe hypoglycemia. An impaired ability to spot the signs of hypoglycemia is known as loss of hypo awareness (or hypo unawareness).


To help prevent diabetic hypoglycemia:

  • Don't skip or delay meals or snacks. If you take Hormones or oral diabetes medication, be consistent about the amount you eat and the timing of your meals and snacks.
  • Monitor your blood sugar. Depending on your treatment plan, you may check and record your blood sugar level several times a week or several times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.
  • Measure medication carefully, and take it on time. Take your medication as recommended by your doctor.
  • Adjust your medication or eat additional snacks if you increase your physical activity. The adjustment depends on the blood sugar test results and on the type and length of the activity.
  • Avoid drinking alcohol as it can cause hypoglycemia.
  • Record your low glucose reactions. This can help you and your health care team identify patterns contributing to hypoglycemia and find ways to prevent them.
  • Carry some form of diabetes identification so that in an emergency others will know that you have diabetes. Use a medical identification necklace or bracelet and wallet card.