As noted in the American Diabetes Association (ADA) scientific sessions in June 2010, severe hypoglycemia is associated with an increased risk of macrovascular (cardiac) events and death. This was documented in the large trial studies called ACCORD and ADVANCE.

What is Hypoglycemia?

Hypoglycemia is also known as low blood sugar. Any blood sugar under 70 mg/dl when testing with a meter is considered low blood sugar. Remember not to use alternate site testing if you think you are experiencing a low sugar since it may not be as accurate. Utilize the sides of your finger tips. Blood sugar that is too low can lead to coma or death and is considered a medical emergency.

What Are Reasons For Hypoglycemia?

  • Too much diabetes medication. The types of medications that mostly can cause low blood sugar are all types of insulin and sulfonylureas such as Amaryl, Glucatrol, Glucatrol XL, Diabeta, Glynase, or Micronase. These medications work by pushing out more insulin from the pancreas. Taking medications such as Starlix or Prandin, which are more short acting than the sulfonylureas, can cause hypoglycemia if not followed with a meal within 15 minutes.
  • Skipping or delaying meals.
  • Eating too few carbohydrates.
  • Too much exercise or too strenuous exercise.
  • Drinking alcohol without eating food at the same time.

What Are The Symptoms of Hypoglycemia?

  • Sweating
  • Hunger
  • Shaking
  • Blurry vision
  • Irritability
  • Confusion
  • Nervousness
  • Dizziness
  • Lack of concentration
  • Weakness
  • Headache
  • Cold and clammy skin
  • Nausea
  • Fast heartbeat

When blood sugar drops below 40mg/dl the symptoms become more pronounced:

  • Slurred speech
  • Drowsiness
  • Drunken-like behavior

Potentially fatal symptoms of hypoglycemia are:

  • Convulsions
  • Coma

How to Treat Hypoglycemia

You should treat low blood sugar AS SOON AS you suspect you have it. The best way to raise your blood sugar above 70 mg/dl is to use glucose tablets. Glucose tablets are made from dextrose, a simple sugar. Glucose tablets are easy to carry and are the quickest to be absorbed. Milk contains lactose and fruit contains fructose, both of which can take longer to metabolize.

Remember “The Rule of 15”

  • Use 15 grams of glucose when treating low blood sugar. Each glucose tablet typically contains 4-5 grams of carbohydrate per tablet.
  • Wait 15 minutes since it takes the brain that long to recognize that you had sugar.
  • Retest blood sugar.
    • If level is still below 70 mg/dl, then repeat with 3 five gram tablets, or 4 four gram tablets.
    • If between 70-80mg/dl, eat a snack of protein and carbohydrate if you have more than one hour to your next meal.
  • Each 5 gram glucose tablet supplies 20 calories and the 3 tablets should raise the blood sugar about 40-50 points.

Why Choose Glucose Tablets Over Regular Soda, Juice or Chocolate Bars

People experiencing hypoglycemia tend to over eat due to anxiety and panic. This causes too much of an increase in blood sugar and too many calories which leads to weight gain. Also, soda and juice are not always available. Glucose tablets can be easily carried in your purse or pocket. Chocolate is mostly made of fat and takes too long to get into your system.

What Else You Should Know About Hypoglycemia

  • If you have Type 1 diabetes or take insulin, talk to your physician about a glucagon shot. You will need a prescription. You will also need to teach someone else to give you the shot since it is used when you are no longer alert to treat yourself.
  • Wear an I.D. to notify people that you have diabetes. An I.D. bracelet is essential if you are not able to communicate.
  • Be aware of “hypoglycemic unawareness.” Some people no longer get symptoms when low blood sugar occurs. Be prepared to test more frequently. This will reduce risk of hypoglycemic-related complications.

Remember, hypoglycemia can be very easily treated if it is recognized and you are prepared.


NOTE: Consult your doctor first to make sure my recommendations fit your special health needs.

Roberta Kleinman

Roberta Kleinman

Roberta Kleinman, RN, M. Ed., CDE, is a registered nurse and certified diabetes educator. She grew up in Long Island, NY. Her nursing training was done at the University of Vermont where she received a B.S. R.N. Robbie obtained her Master of Education degree, with a specialty in exercise physiology, from Georgia State University in Atlanta, Georgia.

She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.

She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.
Roberta Kleinman

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