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What to Do During Severe Hypoglycemia: A Guide for Persons with Diabetes

Hypoglycemia, often referred to as low blood sugar, is a common complication for people with diabetes, particularly those who take insulin or certain oral medications. While mild to moderate hypoglycemia can often be managed with quick-acting carbohydrates, severe hypoglycemia requires immediate and often external intervention. This guide aims to provide clear, step-by-step instructions on what to do when someone experiences severe hypoglycemia, focusing on recognizing the signs, providing immediate treatment, and preventing future episodes.

Understanding Severe Hypoglycemia

Severe hypoglycemia occurs when blood glucose levels drop to a point where the individual is unable to treat themselves. This can manifest as:

• Loss of consciousness
• Seizures
• Extreme confusion or disorientation
• Inability to swallow or cooperate with treatment

Recognizing these signs is crucial for prompt and effective intervention, especially for family members, friends, or caregivers who may need to assist. Understanding what causes hypoglycemia and how individual medications impact blood sugar is the first step in effective management and prevention. Regular monitoring with a blood glucose meter or a continuous glucose monitor (CGM) also plays a critical role. Understanding Your Blood Sugar Range A Guide For Better Health

Immediate Actions During a Severe Hypoglycemic Event

The primary goal during a severe hypoglycemic episode is to raise the person's blood glucose levels as quickly as possible. Here’s what you should do: The Complete Guide To Understanding And Lowering Your A1C Blood Sugar

1. Call for Help: If the person is unconscious or unable to swallow, immediately call emergency services (911 in the US). Provide them with a clear description of the situation. It's important to let the responders know the person has diabetes and is experiencing severe hypoglycemia.
2. Administer Glucagon (if available):
   • What is Glucagon? Glucagon is a hormone that raises blood sugar levels by signaling the liver to release stored glucose. It's often prescribed to individuals at risk for severe hypoglycemia.
   • How to Administer: If a glucagon emergency kit is available and you are trained to use it, administer the glucagon immediately. Glucagon is typically injected into the thigh, arm, or buttock. Follow the specific instructions provided with the glucagon kit. Note: Always check the expiration date on the kit before administering.
   • Post-Injection Care: Even after glucagon administration, monitor the person closely and continue to follow emergency medical professional instructions.
3. If the person is conscious and able to swallow: Do NOT attempt to give them anything by mouth if they are not fully alert. Choking is a risk. If fully conscious, provide a fast-acting source of glucose, such as:
   • Glucose gel or tablets: Follow the instructions on the packaging.
   • Juice or regular (non-diet) soda: Offer about 4 ounces (120 ml).
   • Honey or corn syrup: About a tablespoon, rubbed inside the cheek if swallowing is difficult.
4. Monitor and Wait: After providing glucose, wait approximately 15 minutes and recheck the person’s blood glucose level. If it’s still low (typically below 70 mg/dL or 3.9 mmol/L), administer another dose of fast-acting glucose.
5. Contact a Healthcare Professional: Even if the person recovers, it's crucial to contact their healthcare provider to determine the cause of the severe hypoglycemic episode and adjust their diabetes management plan accordingly.

Important Considerations When Dealing with Hypoglycemia

• CPR: If the person stops breathing, begin CPR immediately, if you are trained to do so, until emergency services arrive.
• Positioning: If the person is unconscious but breathing, place them in the recovery position (lying on their side) to prevent choking if they vomit.
• Never Inject Insulin: Do not administer insulin to someone experiencing hypoglycemia. This will further lower their blood sugar.

Preventing Future Episodes of Severe Hypoglycemia

Prevention is key to minimizing the risk of severe hypoglycemic events. Here are some preventative measures:

• Regular Blood Glucose Monitoring: Check blood sugar levels frequently, especially before meals, bedtime, and exercise.
• Medication Management: Work closely with your healthcare provider to ensure your insulin or diabetes medication dosage is appropriate. Be aware of how different medications interact and affect your blood sugar levels.
• Consistent Meal Timing: Eat meals and snacks at regular intervals to avoid large fluctuations in blood glucose.
• Carbohydrate Counting: Learn how to estimate the carbohydrate content of meals and snacks to match insulin doses accordingly.
• Exercise Precautions: Check your blood sugar before, during, and after exercise. Adjust insulin doses or carbohydrate intake as needed. Always carry a fast-acting source of glucose during physical activity.
• Alcohol Awareness: Be aware of how alcohol can affect blood sugar levels, often causing delayed hypoglycemia. Drink alcohol in moderation and always with food.
• Wear a Medical Alert: Consider wearing a medical alert bracelet or necklace that identifies you as having diabetes and includes emergency contact information.
• Educate Family and Friends: Ensure that family members, friends, and caregivers know how to recognize the signs of severe hypoglycemia and how to administer glucagon, if prescribed.

Hypoglycemia Unawareness

Some individuals with diabetes may develop hypoglycemia unawareness, a condition where they no longer experience the early warning signs of low blood sugar. This significantly increases their risk of severe hypoglycemic episodes.

• Strategies to Address Hypoglycemia Unawareness:
  • Strict Blood Glucose Monitoring: Frequent monitoring can help identify patterns and trends that lead to hypoglycemia.
  • Adjusting Target Blood Sugar Levels: Your healthcare provider may recommend slightly higher target blood sugar levels to reduce the frequency of hypoglycemic episodes.
  • CGM (Continuous Glucose Monitoring): A CGM can provide real-time blood glucose readings and alerts, helping individuals identify and treat hypoglycemia before it becomes severe.

Tools and Resources for Managing Hypoglycemia

• Blood Glucose Meters: Essential for regular blood sugar monitoring.
• Continuous Glucose Monitors (CGMs): Provide continuous blood glucose readings and alerts.
• Glucagon Emergency Kits: Prescription medication to treat severe hypoglycemia.
• Diabetes Education Programs: Offer comprehensive training on diabetes management, including hypoglycemia prevention and treatment.
• Diabetes Apps: Many apps are available to track blood sugar levels, insulin doses, carbohydrate intake, and exercise.
• American Diabetes Association (ADA) and Juvenile Diabetes Research Foundation (JDRF): Reliable sources of information and support for people with diabetes.

Understanding Blood Sugar Level Ranges

It's vital to understand target blood sugar level ranges for individuals with diabetes, which will vary depending on the individual, their medications, and overall health goals. However, the following general guidelines are often followed:

Disclaimer: The above ranges are general guidelines only. Consult with your healthcare provider for individualized target ranges.

Conclusion

Severe hypoglycemia can be a frightening and dangerous complication of diabetes. By understanding the signs, knowing how to respond in an emergency, and implementing preventative measures, individuals with diabetes can significantly reduce their risk of experiencing this life-threatening condition. Remember that communication with your healthcare team is crucial for developing a personalized diabetes management plan that minimizes the risk of hypoglycemia and promotes overall health. Empower yourself and those around you with the knowledge and resources needed to manage diabetes safely and effectively. ``` Top 7 Low Glycemic Index Foods For Persons With Type 2 Diabetes