Hypoglycemia: How Low Can You Go?
Some people with diabetes develop "hypoglycemic unawareness." Here's what you need to know.
Frequently, it's another person who is familiar with diabetes who spots hypoglycemia. They may notice that a spouse or coworker is confused and urge that individual to check his or her blood sugar. But the person with diabetes may shrug off the suggestion. "Often, some resistance to the idea that blood sugar is low is part of hypoglycemic unawareness," explains Buse.
Experienced spouses or co-workers know to press and offer a glass of orange juice or soda to a person who appears hypoglycemic, Buse says. Indeed, the recommended treatment is to eat 15 grams of sugar or carbohydrates, such as half a cup of a sugary drink like regular soda (not diet) or juice, a piece of hard candy, three glucose tablets, or glucose gels. Repeat until the blood sugar level returns to normal.
In the event a person is unconscious, do not put anything in his or her mouth. Call 911, and inject glucagon (a hormone that causes stored sugars to be released into the bloodstream) if it's available -- but only if you or a friend or family member are trained in its use, Buse says.
To prevent hypoglycemia, the ADA recommends increasing the number of times you check blood sugar levels (particularly before driving), educating family and friends about the condition and how to help you, wearing an ID bracelet that identifies you as a person with diabetes, and filling a prescription for glucagon and making sure those around you know how to use it.
Most important, work with your doctor, who may recommend a continuous glucose sensor that measures blood sugar every few minutes. "The idea is to do away with low blood sugar for a period of weeks or months," says Buse, which will "sort of [reset] your body so you'll recognize the signs of hypoglycemia" if it happens again.