Blood Sugar Control

Treatment

If you think your blood glucose is too low, use a blood glucose meter to check your level. If it is 70 mg/dL or below, have one of these "quick fix" foods right away to raise your blood glucose:

• 2 or 3 glucose tablets
• 1/2 cup (4 ounces) of any fruit juice
• 1/2 cup (4 ounces) of a regular (not diet) soft drink
• 1 cup (8 ounces) of milk
• 5 or 6 pieces of hard candy
• 1 or 2 teaspoons of sugar or honey

After 15 minutes, check your blood glucose again to make sure that it is no longer too low. If it is still too low, have another serving. Repeat these steps until your blood glucose is at least 70. Then, if it will be an hour or more before your next meal, have a snack.

If you take insulin or a diabetes medication that can cause hypoglycemia, always carry one of the quick-fix foods with you. Wearing a medical identification bracelet or necklace is also a good idea.

Exercise can also cause hypoglycemia. Check your blood glucose before you exercise.

Severe hypoglycemia can cause you to lose consciousness. In these extreme cases when you lose consciousness and cannot eat, glucagon can be injected to quickly raise your blood glucose level. Ask your health care provider if having a glucagon kit at home and at work is appropriate for you. This is particularly important if you have type 1 diabetes. Your family, friends, and co-workers will need to be taught how to give you a glucagon injection in an emergency.

Prevention of hypoglycemia while you are driving a vehicle is especially important. Checking blood glucose frequently and snacking as needed to keep your blood glucose above 70 mg/dL will help prevent accidents.

Hypoglycemia and Diabetes: Doing Your Part Signs and symptoms of hypoglycemia can vary from person to person. Get to know your own signs and describe them to your friends and family so they will be able to help you. If your child has diabetes, tell school staff about hypoglycemia and how to treat it. If you experience hypoglycemia several times a week, call your health care provider. You may need a change in your treatment plan: less medication or a different medication, a new schedule for your insulin shots or medication, a different meal plan, or a new exercise plan.

Hypoglycemia in People Who Do Not Have Diabetes

Two types of hypoglycemia can occur in people who do not have diabetes: reactive (postprandial, or after meals) and fasting (postabsorptive). Reactive hypoglycemia is not usually related to any underlying disease; fasting hypoglycemia often is.

Symptoms

Symptoms of both types resemble the symptoms that people with diabetes and hypoglycemia experience: hunger, nervousness, perspiration, shakiness, dizziness, light-headedness, sleepiness, confusion, difficulty speaking, and feeling anxious or weak.

If you are diagnosed with hypoglycemia, your doctor will try to find the cause by using laboratory tests to measure blood glucose, insulin, and other chemicals that play a part in the body's use of energy.

Reactive Hypoglycemia

In reactive hypoglycemia, symptoms appear within 4 hours after you eat a meal.

Diagnosis
To diagnose reactive hypoglycemia, your doctor may

• ask you about signs and symptoms
• test your blood glucose while you are having symptoms (The doctor will take a blood sample from your arm and send it to a laboratory for analysis. A personal blood glucose monitor cannot be used to diagnose reactive hypoglycemia.)
• check to see whether your symptoms ease after your blood glucose returns to 70 or above (after eating or drinking)

A blood glucose level of less than 70 mg/dL at the time of symptoms and relief after eating will confirm the diagnosis.

The oral glucose tolerance test is no longer used to diagnose hypoglycemia; experts now know that the test can actually trigger hypoglycemic symptoms.

Causes and Treatment
The causes of most cases of reactive hypoglycemia are still open to debate. Some researchers suggest that certain people may be more sensitive to the body's normal release of the hormone epinephrine, which causes many of the symptoms of hypoglycemia. Others believe that deficiencies in glucagon secretion might lead to hypoglycemia.

A few causes of reactive hypoglycemia are certain, but they are uncommon. Gastric (stomach) surgery, for instance, can cause hypoglycemia because of the rapid passage of food into the small intestine. Also, rare enzyme deficiencies diagnosed early in life, such as hereditary fructose intolerance, may cause reactive hypoglycemia.

To relieve reactive hypoglycemia, some health professionals recommend taking the following steps:

• eat small meals and snacks about every 3 hours
• exercise regularly
• eat a variety of foods, including meat, poultry, fish, or nonmeat sources of protein; starchy foods such as whole-grain bread, rice, and potatoes; fruits; vegetables; and dairy products
• choose high-fiber foods
• avoid or limit foods high in sugar, especially on an empty stomach

Your doctor can refer you to a registered dietitian for personalized meal planning advice. Although some health professionals recommend a diet high in protein and low in carbohydrates, studies have not proven the effectiveness of this kind of diet for reactive hypoglycemia.

Fasting Hypoglycemia