Low blood sugar can be concern

What goes up must come down--that old statement isn't necessarily true for everything, but people with insulin-dependent diabetes need to keep it especially in mind.

Hypoglycemia--or low blood sugar--is characterized by feelings of weakness, shakiness, an unusual hunger and need to eat something immediately, and a certain level of irritability, said Dr. Carol Rice, Texas Cooperative Extension health specialist.

One kind of low blood sugar, called reactive, can be found in people who don't have diabetes too. This type of low blood sugar, which is not all that common, "happens to some people about four hours after they eat," Rice said. "The general treatment is to eat small meals or snacks about every three hours." That doesn't mean adding calories to the daily diet, she warned. Instead, divide a normal day's intake into small meals and eat more often.

According to the National Institutes of Health, Rice said, "causes of this type of hypoglycemia are open to debate." Some people seem to be more prone to the condition than others, she said, "but the exact cause is not known."

However, she added, people who have undergone gastric bypass surgery seem to be more susceptible to hypoglycemia because "food passes through their system so quickly."

This type of hypoglycemia can be diagnosed by a physician administering a specific type of blood test.

For people with diabetes, a much more common kind of hypoglycemia is caused by insulin and some diabetes pills. This kind of low blood sugar requires prompt action to bring the blood sugar up to a normal level, Rice said. "It happens when the person with diabetes exercises more than usual or eats less than usual or not soon enough after taking medicines for their diabetes."

It can also be caused by alcohol, especially binge drinking, she said, "because alcohol interferes with the liver's ability to raise glucose levels" in the blood. "This is true for both people with and without diabetes," she added.

People with diabetes who want to drink alcohol can do so, but in moderation and only on a full stomach," she said. And before imbibing, talk to a pharmacist about alcohol's affect on any diabetes medication you may be taking, she added.

Hypoglycemia can also be triggered by some medical conditions other than diabetes, and starvation. "People should not go on a fasting diet to lose weight," she said. "It's not healthy.

"Those of us who don't have diabetes take for granted how the body works," and blood sugar regulation is something that occurs automatically, she said. "A person with diabetes has to recognize the symptoms (of hypoglycemia)--and recognize his or her symptoms--and quickly take action."

Ideally, the first step would be to test blood sugar. "If your blood sugar levels are 70 (or less), take something quickly--something with active sugar," Rice said. "Chocolate is not a good resource because it has so much fat."

Instead, she said, keep other sources of quick-acting glucose handy, such as glucose tablets that can be purchased at pharmacies, half of a can of sugar-containing soft drink, five to seven hard candies (such as Lifesavers), six jelly beans, 10 gum drops, two teaspoons of sugar, two teaspoons of honey or an eight-ounce glass of 1 percent fat milk.

For people with diabetes who experience episodes of hypoglycemia, "it's important you don't over treat," Rice said. "Don't drink the whole can of sugar-containing soft drink." Instead, drink the half-can--or eat the candy or honey or other source of sugar--then check blood sugar level. If necessary, repeat the process--but only if necessary.

Everyone with diabetes who takes medicines to lower blood sugar needs to be aware of the dangers hypoglycemia can cause if it occurs while driving. "Anybody taking these medicines who is going to drive has to have with them a source of fast-acting glucose, especially when driving," she said. If a driver's blood sugar level falls and no source of fast-acting glucose is immediately available, she said, that person can cause or be in an accident due to impaired abilities from hypoglycemia.

"Anybody who takes insulin or any type of medication that stimulates insulin (production in the body) will be at (higher) risk for hypoglycemia," Rice said. "For a variety of reasons, it can happen at any time. However, most people taking these medicines quickly recognize the symptoms and take quick action to prevent problems.

"A person with diabetes who is not taking medication is not any more at risk than anyone else."

For most people, though, hypoglycemia shouldn't be a problem. If it is a problem for someone who does not have diabetes, taking care of it should be a matter of common sense.

"Everybody is going to get weak and shaky if you go a long time without food," Rice said. "In some people without diabetes, hypoglycemia affects them and we're not exactly sure why.

"The remedy is to eat small meals every three hours--preferably a normal healthy diet not high in sugar."

3/31/08
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Date: 3/24/08

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