Understanding And Treating Hypoglycemia (Low Blood Sugar) in Type 1 Diabetes

Medical Disclaimer: Nada Sami does not represent Matt Vande Vegte or FTF Warrior LLC in any way. Please consult your medical team and/or doctors before making any changes to your diabetes management, and seek immediate medical attention if you think your life may be in danger. This article is in no way medical advice.

Any diabetic patient will likely experience two conditions during their lifetime: Hypoglycemia and Hyperglycemia. They are mainly related to the amount of glucose in your body which acts as a fuel for the brain, muscles and organs to function properly. Hypoglycemia is a very dangerous situation and if severe hypoglycemia does occur, a quick intervention is needed immediately. If not, it can unfortunately lead to death. Hypoglycemia is when the blood glucose levels are lower than the acceptable levels that lie between (70-180 mg/dl) or (3.9 - 10 mmol). 

Hypoglycemia can be classified into:

1. Mild / level 1 hypoglycemia: blood glucose is less than 70 mg/dl but higher or equal to 54 mg/dl.

2. Moderate / level 2 hypoglycemia: blood glucose is lower than 54 mg/dl. 

3. Severe / level 3 hypoglycemia: blood glucose is below 40 mg/dl. And here the person will likely be unable to function in a normal way. 

But what can cause a person to experience such a condition? 

“Hypos” can happen to non-diabetics in certain situations disturbing the body homeostasis like: 

1. Fasting or decreased food intake.

2. Exercising too much.

3. Drinking too much alcohol on an empty stomach.

But in diabetic patients we can add some other causes like: 

1. Taking too much glucose-lowering drugs: especially too much insulin, medicines called sulphonylureas (such as glibenclamide and gliclazide) or medicines called glinides (such as repaglinide and nateglinide).

2. Skipping or delaying a meal after taking the medications: but not necessarily fasting. 

3. Eating less carbohydrate-containing food than usual, such as bread, cereals, pasta, potato and fruit.

Usually hypoglycemia can be detected by its symptoms that start to appear when glucose levels are 70 mg/dl or lower. And they include: 

1. Hunger: especially a very strong cravings for sugars and carbs.

2. Sweating: this type of sweating is different from the regular sweat experienced normally after exercising or embarrassing situations. This one is cold sweats that usually feels like the energy you have left is being expelled from the body with these small droplets. 

3. Sleepiness: this symptom freaks us all out when we experience hypoglycemia during sleep, so you start to wonder if you're really sleepy or if you are experiencing a hypoglycemia.

4. Fast and Irregular heartbeat: as your body is trying to compensate the insufficient amount of fuel. 

5. Fatigue: overall feeling of tiredness or exhaustion.

6. Unusual behavior, slurred speech or clumsiness: you feel like being drunk (and this leaves some funny memories). This happens mainly due to insufficient supply of glucose to the brain cells. 

When the hypoglycemia becomes severe or there was no immediate treatment, the symptoms develop more into: 

1. Blurred vision

2. Numb Limbs 

3. Pale Skin 

4. Seizures (fits) 

5. Collapsing 

If you, your loved ones or someone you saw experience any of those symptoms, you are to take the following measures: 

1. Measure the blood glucose level to make sure it is a hypoglycemia. 

2. The 15-15 Rule: this implies having 15 grams of carbohydrate and then checking the blood glucose after 15 minutes. If it’s still below 70 mg/dl, have another serving.

Repeat these steps until your blood sugar is at least 70 mg/dl. Once your blood sugar is back to normal, eat a meal or snack to make sure it doesn’t lower again.

Try drinking sugary drinks in order to treat a hypoglycemia, but not the diet-fizzy ones as they do have a low glycemic index and won’t affect the glucose levels.

In case of non-responding conditions, emergency should be called immediately. 

1. Eat your main meal (containing carbohydrate) if you're about to have it or have a carbohydrate-containing snack.

2. If the person is having an extremely severe hypoglycemic episode and started to pass out, a glucagon shot should be administered right away. 

Finally, hypoglycemia is a very dangerous life-threatening situation, but a person can take some steps to prevent it. And that mainly involves keeping blood glucose levels under control.

You can ensure this control by:  

1. Eating meals and snacks on a regular schedule after taking the medications.

2. Checking blood glucose levels and carrying juice or candies, especially during the times you are most likely to have a low value (during exercise, when drinking alcohol, when skipping meals, etc.)

3. Sticking to a suggested exercise plan.

4. Taking medicines for diabetes on time and as directed.

5. Talking to your doctor if you are experiencing frequent episodes of hypoglycemia. 

Nada Sami is a fresh graduate of clinical pharmacy and a type 1 diabetic patient for more than 20 years. She is interested in the field of autoimmunity due to her diabetes, that made her the person she is today. Her career mainly involves educating and counseling patients about their medications and diseases as well.