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Diabetes Care CenterBox 356176

1959 N.E. Pacific St. Seattle, WA 98195

206-598-4882

120458

© University of Washington Medical Center

Diabetes Care Center

Hypoglycemia

Farsi

08/2003

How to cope with low blood sugar

General Facts on Low Blood SugarHypoglycemia (low blood sugar) is not uncommon for peoplewith diabetes. It is estimated that over a 40-year period theaverage patient with Type 1 (insulin-dependent) diabetes willhave approximately 2,000 to 4,000 hypoglycemia episodes.Although hypoglycemia usually occurs in patients who useinsulin, it can also occur in patients who take one of the oralhypoglycemic medicines (e.g. glyburide, glipizide).

CausesThere are several different causes of hypoglycemia: missing ameal, eating a meal that is smaller than usual, or doing heavierthan normal exercise. Hypoglycemia can occur during or up to 36hours after an unusually strenuous period of exercise.

Taking too much insulin or oral hypoglycemic agent or waitingan unusually long time between taking the insulin or the oralagent and eating may also cause hypoglycemia. Finally, drinkingalcoholic beverages may also result in hypoglycemia. This isespecially true if you drink on an "empty stomach."

Recognizing the causes

and symptoms of

hypoglycemia can help

you prepare for and

respond to this condition

when it arises.

Patient EducationDiabetes Care Center

SymptomsThe symptoms of hypoglycemia vary, and may even varyfor the same person over time. Common symptomsinclude:

• shaking

Page 2Diabetes Care CenterHypoglycemia

Feeling funny?It could be a sign you

need to check your

blood glucose level.

• sweating

• nausea

• hunger

• heart pounding

Other symptoms which usually (but not always) occurlater include:

• blurred vision• confusion• tiredness

• anxietySome patients lose the ability to recognize the symptomsand this is called "hypoglycemia unawareness." We knowthat some patients who have had diabetes for more than10 years do not recognize their hypoglycemia due toneuropathy (damage to the nerve fibers). We are nowbeginning to appreciate that hypoglycemia unawarenessis common in many more individuals than previouslythought. It is especially common in individuals who try tokeep their blood glucose levels in near normal ranges.The reason for this is not yet entirely clear. Therefore,should you and your physician decide you want toachieve "tight" blood glucose control, it will be importantfor you to measure your blood glucose levels frequentlyeach day. This will minimize your risk for hypoglycemia.

If you do not feel right, if you are just "feeling funny," itis important to measure your blood sugar. Your "funnyfeeling" might be caused by a dropping blood glucoselevel. If a blood glucose meter is not available, the beststrategy is to treat yourself as if you were having ahypoglycemia episode.

Symptoms, continued

Hypoglycemia is best treated by taking 10 to 15 grams ofsimple carbohydrate, such as two to three glucose tablets,six to ten Life Savers, or about six ounces of fruit juice.Usually, the symptoms of hypoglycemia will improve inabout 10 minutes. However, if symptoms have not beenresolved in 15 minutes, the above treatment should berepeated.

It is also important to provide longer-acting foods afterthe acute treatment just described. If the hypoglycemiaoccurs within an hour before your next meal, simply treatthe hypoglycemia immediately and eat your meal at yourregular time. However, if your hypoglycemia occursmore than one hour before your next meal or if it occursduring the night, you should also eat food with protein,such as a glass of milk or half a sandwich.

Overtreating hypoglycemia can also be a difficultproblem for people with diabetes. Frequently a patientwill expect to feel better immediately after treatment.However, if high fat foods (ice cream, candy, sweetdesserts) are eaten, they can actually slow the absorptionof glucose and slow the rise in blood sugar. High fatfoods are easily eaten in excess and these extra caloriescan cause an increase in weight, which, in turn, can havean adverse effect on overall health and blood glucosecontrol.

If you experience severe hypoglycemia, you will need theassistance of someone else, usually a spouse, parent, orco-worker. Severe hypoglycemia can cause an extremelack of physical and mental alertness, confusion, or evena seizure. This situation is best treated with glucagon, aninjectable medication that raises your blood sugar. Peoplearound you will need to learn how to give this simpleinjection.

Tell others if you know

that you have severe

hypoglycemia; tell

people you trust how

they can help if your

condition requires

treatment. Carry

glucagon with you and

make sure these people

learn how to inject this

medication.

Page 3Diabetes Care Center

Hypoglycemia

Be PreparedAll patients taking medication to lower their blood glucoselevels should have some quick-acting glucose sourceavailable at all times. Glucose tablets or Life Savers can beeasily carried in a pocket or purse. We suggest that all ourpatients wear a medic-alert bracelet stating that they havediabetes. We will also provide you with a card for yourwallet or purse that will identify your physician in case ofan emergency.

My Signs/Symptoms of Hypoglycemia Are:

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Driving

Hypoglycemia can have devastating consequences if itoccurs while you are driving. You should measure yourblood glucose level prior to driving, not drive if glucose islow and have glucose tablets immediately available in yourcar’s glove compartment, your pocket or purse in case earlysigns of hypoglycemia occur.

Page 4Diabetes Care ClinicHypoglycemia

Driving, continued

Special precautions must be taken if you have"hypoglycemic unawareness." Always measure yourglucose level before driving and always have a quicksource of glucose available to you at all times. Neverdrive when your glucose level is low.

It is difficult to give a precise value for "low." Bothindividuals and blood glucose meters can vary.

Personal blood glucose level:_________________________________

What level is too low for me?__________________________________

One good question to ask is, "Is my blood sugar going upor down?" A low blood glucose reading one hour afterlunch will probably go higher while a similar low readinglate in the afternoon several hours after lunch willprobably go still lower. If there is any question aboutyour blood sugar levels and the safety of driving, it isalways better to be cautious.

If you participate in potentially hazardous activities, suchas scuba diving, parachute jumping, or mountainclimbing, ask your health care provider for furtherguidance.

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Hypoglycemia

Notes:

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Questions?

Call (206) 598-4882

Your questions areimportant. Call your doctoror health care provider ifyou have questions orconcerns. The UWMCClinic staff is also availableto help at any time.

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© Copyright University of Washington Medical Center2/2000

Diabetes Care CenterBox 356176

959 NE Pacific St. Seattle, WA 98195

(206) 598-4882