Hypoglycemia (Severe): What to Do in a Low Blood Sugar Emergency

Hypoglycemia, or low blood sugar, is a condition that occurs when the level of glucose in your blood drops too low. It’s especially common in people with diabetes, particularly those who take insulin or certain oral medications to manage their blood sugar levels. While mild hypoglycemia can often be managed with a quick snack, severe hypoglycemia is a medical emergency that requires immediate attention. This article will guide you through what severe hypoglycemia is, how to recognize it, and most importantly, what steps to take in a low blood sugar emergency.

What is Severe Hypoglycemia?

Severe hypoglycemia occurs when your blood sugar drops to a dangerously low level, making you unable to treat it yourself. This usually means you are confused, disoriented, unconscious, or having seizures, and require assistance from someone else. It is distinct from mild hypoglycemia, where you may experience symptoms like shakiness or sweating, but are still able to take corrective actions like eating a carbohydrate-rich snack.

Key Indicators:

• Blood glucose level below 70 mg/dL (though specific target ranges vary)
• Inability to think clearly or follow instructions
• Loss of consciousness
• Seizures

Recognizing the Signs and Symptoms

Identifying the signs of hypoglycemia, especially severe hypoglycemia, is crucial for quick intervention. Symptoms can vary from person to person and may develop rapidly. Early recognition can prevent a situation from escalating into a severe episode.

Symptoms Leading Up to Severe Hypoglycemia:

• Shakiness: A trembling sensation that can affect your hands, legs, or entire body.
• Sweating: Excessive sweating, even when not physically active or in a warm environment.
• Dizziness: Feeling lightheaded or unsteady.
• Confusion: Difficulty concentrating, remembering things, or making decisions.
• Irritability: Feeling anxious, nervous, or easily agitated.
• Rapid Heartbeat: A noticeable increase in heart rate.
• Blurred Vision: Changes in eyesight.
• Headache: A persistent or throbbing headache.
• Weakness: Feeling unusually tired or lacking energy.

As hypoglycemia worsens and becomes severe, the symptoms can progress to:

• Loss of Coordination: Difficulty walking or moving limbs smoothly.
• Slurred Speech: Inability to speak clearly.
• Seizures: Uncontrolled electrical disturbances in the brain.
• Unconsciousness: Loss of awareness and inability to respond to stimuli.

What Causes Severe Hypoglycemia?

Understanding the causes of severe hypoglycemia is essential for preventing future episodes. Several factors can contribute to dangerously low blood sugar levels: What Is A Normal Blood Sugar Level A Complete Chart For Your A1C

Common Causes:

• Excessive Insulin: Taking too much insulin, either as a single dose or over time, can lower blood sugar levels too quickly.
• Skipping or Delaying Meals: Not eating enough food, especially after taking insulin or oral diabetes medications.
• Intense Exercise: Physical activity without adjusting insulin doses or increasing carbohydrate intake.
• Alcohol Consumption: Alcohol can interfere with the liver’s ability to release glucose into the bloodstream, especially when consumed without food.
• Certain Medications: Some medications, like sulfonylureas (a class of diabetes drugs), can increase the risk of hypoglycemia.
• Kidney or Liver Problems: These conditions can affect how your body processes insulin and other medications.
• Hormonal Imbalances: Conditions like adrenal insufficiency can disrupt blood sugar regulation.

Steps to Take in a Low Blood Sugar Emergency

When someone is experiencing severe hypoglycemia and is unable to treat themselves, the following steps should be taken immediately: Recognizing Low Blood Sugar Symptoms And What To Do Immediately

1. Call for Help: Dial emergency services (911 in the US) or your local emergency number right away. Explain that the person is experiencing a severe hypoglycemic episode and is unconscious or having seizures.
2. Administer Glucagon: If the person has a glucagon emergency kit and you know how to use it, administer glucagon immediately. Glucagon is a hormone that stimulates the release of glucose from the liver.
   • Glucagon Injection: Follow the instructions provided with the glucagon kit. Typically, this involves mixing the glucagon powder with the diluent and injecting it into the thigh, arm, or buttock.
   • Glucagon Nasal Spray: Some glucagon kits are available as a nasal spray. Follow the instructions provided to administer the spray into one nostril.
3. Position the Person Safely: If the person is unconscious, turn them onto their side (recovery position) to prevent choking should they vomit.
4. Do Not Give Food or Drink: Do not attempt to give an unconscious person anything by mouth, as this could cause choking.
5. Stay with the Person: Remain with the person until emergency services arrive. Monitor their breathing and pulse, and be prepared to provide information to the medical personnel.
6. Inform Emergency Responders: Tell the emergency responders about the person’s diabetes, any medications they are taking, and the steps you have already taken.

What is Glucagon and How Does It Work?

Glucagon is a hormone produced by the pancreas that raises blood sugar levels. It works by stimulating the liver to release stored glucose into the bloodstream. Glucagon is available as an emergency medication for treating severe hypoglycemia in people with diabetes. Hypoglycemia And Hyperglycemia Understanding The Difference

How to Administer Glucagon:

1. Check the Expiration Date: Ensure the glucagon kit is not expired.
2. Prepare the Injection: Follow the instructions provided with the glucagon kit to mix the glucagon powder with the diluent (if required).
3. Administer the Injection: Inject the glucagon into the thigh, arm, or buttock.
4. Nasal Spray: Some newer glucagon treatments are administered through the nose. Follow included instructions.
5. Call for Help: Even after administering glucagon, it's crucial to call emergency services. The person needs further medical evaluation.
6. Monitor the Person: Stay with the person and monitor their condition until medical help arrives. It may take 10-15 minutes for the glucagon to raise blood sugar levels.

Preventing Severe Hypoglycemia

Prevention is the best approach when it comes to severe hypoglycemia. There are several strategies to help avoid these emergencies:

Prevention Strategies:

• Regular Blood Sugar Monitoring: Check your blood sugar levels regularly, especially before meals, after exercise, and before bedtime.
• Consistent Meal Schedule: Eat meals and snacks at regular times to maintain stable blood sugar levels.
• Medication Management: Work closely with your healthcare provider to adjust insulin or other diabetes medication dosages as needed.
• Carbohydrate Counting: Learn how to count carbohydrates and adjust your insulin doses accordingly.
• Exercise Planning: Plan your exercise routines and adjust your insulin doses or carbohydrate intake as needed to prevent hypoglycemia.
• Alcohol Awareness: Be aware of the effects of alcohol on blood sugar levels and consume alcohol in moderation, with food.
• Education: Educate family members, friends, and coworkers about the signs and symptoms of hypoglycemia and how to administer glucagon.
• Wear Medical Identification: Wear a medical ID bracelet or necklace indicating that you have diabetes and any other relevant medical information.
• Keep a Log: Maintain a log of your blood sugar levels, medication dosages, and any hypoglycemic episodes to help identify patterns and adjust your treatment plan.
• Emergency Kit: Always carry a glucagon emergency kit and ensure it is readily accessible. Make sure your family members and caregivers know where it is and how to use it.

Living with Diabetes: Resources and Support

Living with diabetes requires ongoing management and support. There are many resources available to help you navigate the challenges of managing your blood sugar levels and preventing hypoglycemia.

Conclusion

Severe hypoglycemia is a serious and potentially life-threatening condition that requires prompt recognition and treatment. By understanding the causes, symptoms, and steps to take in a low blood sugar emergency, you can be prepared to respond effectively and prevent serious complications. Consistent blood sugar monitoring, proper medication management, and a healthy lifestyle are key to preventing severe hypoglycemia. Always consult with your healthcare provider for personalized advice and support in managing your diabetes. With the right knowledge and resources, you can live a healthy and fulfilling life with diabetes. Remember, preparedness and education are your best defenses against severe hypoglycemic events.