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Perhaps the most common image connected with diabetes is that of friends and family relying on a stash of orange juice or candy bars to revive a diabetic if his blood sugar dips far below normal, causing hypoglycemia. In actuality, hypoglycemia is now quite rare, except as a side effect of some combinations of medications.

Nonetheless, people with type 1 diabetes and their families do still need to know about the signs and risks of low blood sugar, because a severe case of hypoglycemia can lead to coma and death.

Diabetes: Low Blood Sugar Symptoms

“Typically what most people will feel is a somewhat sudden onset of shakiness, dizziness, sweatiness, weakness, feeling of anxiety, nervousness, and irritability,” says Suzanne Ghiloni, RN, BSN, a diabetes educator at Joslin Diabetes Center at Harvard University in Boston.

And, as people with diabetes age, the symptoms of low blood sugar become more subtle, says Ghiloni, making it harder to feel when your blood sugar is too low. This is known as hypoglycemia unawareness.
But fainting from hypoglycemia unawareness doesn’t happen to everyone. Hypoglycemia unawareness is more likely to occur in those who:
Have nerve damage, also called neuropathy

Are on strict glucose control

Take certain kinds of high blood pressure or heart medicines.

Many people rely on family and friends to help them identify when hypoglycemia is coming on.

“Sometimes when people have lost the more overt symptoms, significant others and family members may be alerted by the look of the person. They may seem not as sharp, have a glazed look, very pale, or seem slowed, or their gait is a little different,” Ghiloni explains.

Diabetes: How to Handle Low Blood Sugar
If you test and find your blood sugar is low or you feel the symptoms of low blood sugar, you need about 15 grams of carbohydrates to counter the hypoglycemia, says Ghiloni. This works out to about one-half cup of orange juice, a tablespoon of honey, or 10 jelly beans. Then wait 15 minutes and test your blood sugar again to see if it is going back up.

“I particularly favor glucose tablets because they are premeasured, there’s no guesswork, they’re portable, they last for a very long time, no one is going to ask to borrow them from you, and they don’t taste so wonderful that you would want more,” says Ghiloni. It is important not to overtreat, so it helps to have an exact dose available, she adds.

If you take the correct amount of tablets or food and your blood sugar does not come up, you can take another dose and test again in 15 minutes.

Diabetes: Preparing for Unconscious Hypoglycemia

Despite your best efforts, there may come a time when you pass out from low blood sugar.
There are two ways for people to respond to a diabetic’s unconscious hypoglycemia. Someone can either call your Doctor for help or give you a glucagon shot if you have one available. It will take anywhere between 5 and 20 minutes for an unconscious diabetic to come around.

Both solutions require that the people around you know what to do while you are unconscious, as you won’t be able to help yourself. Also make sure that loved ones know what not to do:
They must not give you an insulin shot.
They must not give you anything to eat or drink.
They must not put a hand in your mouth.

Because it’s not always possible to be with people you know, you should wear some form of identification, like a medical bracelet or necklace that makes people aware that you have diabetes in case of unconsciousness. “If you are in a strange place and your behavior is odd, people may think [it’s due to] other things, such as drunkenness — so treatment is delayed or misdiagnosed,” warns Ghiloni.

With good preparation, tracking your blood sugar regularly, and knowing the symptoms of low blood sugar, you should be able to handle any episodes of hypoglycemia that you experience.

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