Hypoglycemia Explained: What to Do During a Severe Low Blood Sugar Event

Understanding hypoglycemia, or low blood sugar, is crucial, especially for individuals with diabetes. A severe hypoglycemic event can be frightening and even life-threatening. This article explains what hypoglycemia is, how to recognize the signs, and, most importantly, what to do during a severe episode.

What is Hypoglycemia?

Hypoglycemia occurs when the glucose (sugar) level in your blood drops too low. Glucose is the primary source of energy for your body, and when levels fall below a certain point, your body can't function properly. For most people with diabetes, hypoglycemia is defined as a blood sugar level below 70 mg/dL (3.9 mmol/L).

It's essential to understand that the symptoms and severity of hypoglycemia can vary significantly from person to person. Factors that can influence blood sugar levels and the likelihood of experiencing hypoglycemia include:

Insulin Dosage: Incorrect dosage or timing of insulin.
Meal Timing and Content: Skipping meals, delayed meals, or insufficient carbohydrate intake.
Physical Activity: Increased physical activity without adequate adjustment in food intake or medication.
Alcohol Consumption: Alcohol can interfere with the liver's ability to release glucose.
Certain Medications: Some medications, besides diabetes medications, can affect blood sugar levels.
Kidney and Liver Issues: Impaired kidney or liver function can affect glucose metabolism.

Recognizing the Signs and Symptoms of Hypoglycemia

Recognizing the symptoms of hypoglycemia is the first step in managing it effectively. Symptoms can develop quickly and may include:

Shakiness
Sweating
Dizziness or Lightheadedness
Hunger
Irritability or Anxiety
Confusion
Rapid Heartbeat
Blurred Vision
Headache
Weakness

In severe cases, hypoglycemia can lead to:

Loss of Consciousness
Seizures
Coma

It's crucial to note that some people, particularly those who have had diabetes for a long time, may experience hypoglycemia unawareness, where they don't feel the early warning signs. This can make them more vulnerable to severe episodes. Exploring Blood Sugar Support Supplements What Does The Science Say

What To Do During a Severe Low Blood Sugar Event

A severe low blood sugar event requires immediate action. If someone is experiencing a severe hypoglycemic episode and is unable to treat themselves (e.g., they are unconscious or having a seizure), follow these steps:

Do NOT Try to Give Them Food or Drink: If the person is unconscious or unable to swallow, attempting to give them food or liquid can cause choking.
Administer Glucagon (If Available): Glucagon is a hormone that raises blood sugar levels. It's often prescribed to individuals at risk of severe hypoglycemia. If glucagon is available and you know how to administer it, follow the instructions on the packaging. Glucagon is typically given as an injection into the muscle (arm, thigh, or buttock).
Call Emergency Services (911 in the US): Even if you administer glucagon and the person regains consciousness, it's crucial to call emergency services. They can provide further medical attention and ensure the person's condition is stable. Explain to the dispatcher that the person is experiencing a severe hypoglycemic event and has been given glucagon.
Turn the Person on Their Side: If the person is unconscious or unresponsive, turn them onto their side in the recovery position to prevent choking in case they vomit.
Stay With the Person Until Help Arrives: Monitor the person's breathing and responsiveness until emergency medical personnel arrive.

After a Severe Hypoglycemic Event

Once the person regains consciousness and is able to eat and drink, give them fast-acting carbohydrates such as:

Glucose Tablets or Gel: These are the most reliable and fastest-acting options. Follow the instructions on the product label.
Juice or Regular Soda (Not Diet): Offer 4 ounces (120 ml) of juice or regular soda.
Hard Candies: Give several hard candies to suck on.

After the initial treatment with fast-acting carbs, follow up with a longer-acting carbohydrate source such as:

Crackers and Peanut Butter
Cheese and Crackers
A Sandwich

This will help stabilize blood sugar levels and prevent a recurrence of hypoglycemia.

It's critical for the person who experienced the severe event to follow up with their healthcare provider to review their diabetes management plan and identify the cause of the hypoglycemia. Adjustments to medication, diet, or exercise may be necessary. Achieving Blood Sugar Balance A Practical How To Guide

Prevention of Hypoglycemia

Preventing hypoglycemia is always better than treating it. Here are some strategies to help prevent low blood sugar:

Monitor Blood Sugar Regularly: Frequent blood sugar monitoring is essential for managing diabetes and preventing hypoglycemia.
Take Medications as Prescribed: Follow your healthcare provider's instructions carefully regarding the dosage and timing of your medications.
Eat Regular Meals and Snacks: Avoid skipping meals or delaying them. Ensure that you are consuming adequate carbohydrates.
Adjust Insulin Dosage for Exercise: Talk to your healthcare provider about how to adjust your insulin dosage when you are more active than usual.
Be Aware of Hypoglycemia Symptoms: Learn to recognize the early warning signs of hypoglycemia so you can treat it promptly.
Educate Family and Friends: Teach your family and friends how to recognize and treat hypoglycemia, including how to administer glucagon.
Wear Medical Identification: Wear a medical ID bracelet or necklace that identifies you as having diabetes and provides emergency contact information.
Check Blood Sugar Before Driving: Always check your blood sugar before driving, and keep a source of fast-acting carbohydrates in your car.

The Role of Glucagon

As mentioned above, glucagon is a critical medication for treating severe hypoglycemia. It works by stimulating the liver to release stored glucose into the bloodstream, quickly raising blood sugar levels. Glucagon is available by prescription and should be part of the emergency kit for anyone at risk of severe hypoglycemia.

It's vital that family members, friends, and caregivers are trained on how to administer glucagon in case of an emergency. Several types of glucagon are now available, including injectable forms and nasal sprays, each with its own specific instructions.

Understanding Blood Sugar Targets

Blood sugar targets can vary depending on individual factors such as age, overall health, and the presence of other medical conditions. However, general guidelines typically recommend:

Before Meals: 80-130 mg/dL (4.4-7.2 mmol/L)
1-2 Hours After Starting a Meal: Less than 180 mg/dL (10.0 mmol/L)

These are general targets, and your healthcare provider may recommend different goals based on your individual needs. It’s crucial to work closely with your medical team to determine the optimal blood sugar targets for you. The Secret To A Lower A1C Daily Habits For Long Term Blood Sugar Balance

Continuous Glucose Monitoring (CGM)

Continuous Glucose Monitoring (CGM) systems are devices that continuously track blood sugar levels throughout the day and night. They provide real-time data, trend arrows, and alerts for high and low blood sugar, helping individuals better manage their diabetes and prevent hypoglycemia.

CGMs can be particularly helpful for individuals with hypoglycemia unawareness or those who experience frequent low blood sugar events. They can also provide valuable insights into how different foods, activities, and medications affect blood sugar levels.

Summary

Severe hypoglycemia can be a serious complication of diabetes. Knowing how to recognize the signs, administer glucagon, and call for emergency help is essential for ensuring the safety and well-being of individuals at risk. By understanding the factors that contribute to hypoglycemia and implementing preventive strategies, you can reduce the risk of severe episodes and live a healthier life. Always work closely with your healthcare provider to develop a personalized diabetes management plan that meets your individual needs.

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