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September 19, 2016

Hypoglycemia in people with diabetes

Hypoglycemia is a temporary complication that can occur in people with diabetes, particularly those taking insulin or medications to stimulate insulin production by the pancreas. This abnormal glycemic decrease, which can be mild, moderate or severe, affects the well-being and quality of life of the affected people. It can even be dangerous. 

What is hypoglycemia?

Hypoglycemia occurs when blood sugar levels (glucose) is insufficient (less than 4 mmol/L). If left untreated, it can cause a wide range of symptoms such as hunger, trembling, anxiety, drowsiness, confusion and even loss of consciousness.  

Glucose is the main source of energy for the body and the brain and, as such, is considered an essential nutrient for good health. Hypoglycemia is a real, frequent and serious problem. It can cause death in more severe cases. This is why a clear understanding of hypoglycemia, its treatment and its prevention is so important. 

How to prevent hypoglycemia?

Here is what you can do to prevent hypoglycemia:

  • Test your blood glucose as often as recommended by your healthcare professional.
  • Eat at regular times.
  • Consult your healthcare professional before starting a new exercise program.
  • Avoid drinking alcohol in excess.
  • Do not modify your drug therapy without first consulting your healthcare professional.

People who are at risk of becoming hypoglycemic, particularly those taking insulin or medications that may cause hypoglycemic side effects, should always be ready to take action if the need arises. Be prepared – always have these essential items at your disposal: 

  • A blood glucose meter
  • Test strips, lancing device and lancets
  • Snack high in carbohydrates
  • An extra snack, like a granola bar, in case your mealtime gets pushed back
  • A source of fast-acting carbohydrates, like glucose in the form of tablets, gel or liquid, sugar packets, hard candy (ex.: Life Savers®) or a juice box.

Diabetes should never hold you back! You can enjoy an active and fulfilling life, as long as you are well-prepared to manage your diabetes when you are away from home. Be sure to have your medication as well as your essential items with you at all times.

How to treat hypoglycemia

Hypoglycemia is sometimes difficult to detect. If you experience symptoms resembling a hypoglycemic episode or if you find yourself in a situation in which you may be predisposed to one (ex.: skipping a meal, intense physical exercise, excessive alcohol consumption, etc.), start by testing your blood glucose levels. If the reading is under 4 mmol/L, you must act fast. 

As a general rule, taking 15 g of sugar (glucose) will return glucose levels back to normal and will reduce hypoglycemic symptoms. For example, you may immediately eat or drink:

  • 15 g of glucose tablets (note that the number of tablets varies depending on the brand used)
  • 15 g of glucose liquid or gel
  • ¾ cup of juice or regular soft drink 
  • 1 tablespoon (15 ml) of sugar dissolved in water
  • 1 tablespoon (15 ml) of honey, maple syrup or corn syrup 
  • 6 LifeSavers® or any other similar candy

Then, retest your blood glucose level 15 minutes later. If it is still less than 4 mmol/L, you must consume another 15 g of glucose. Continue these steps until your blood glucose levels are above 4 mmol/L.

Once your blood glucose has returned to normal, eat your next regularly-scheduled meal. If you must wait more than 60 minutes before your next meal, eat an additional snack containing 15 g of carbohydrates and a source of protein, such as a piece of bread with peanut butter or 4 to 6 crackers with cheese.

Driving and diabetes

If you have diabetes, you need to take certain precautions before driving a vehicle, especially if you are at risk for hypoglycemia. The following measures should help you minimize the risk of incidents or accidents:  

  • Always measure blood glucose levels before you get behind the wheel or on a motorcycle, and, for long trips, every 4 hours thereafter.
  • Your blood glucose reading should be above 4 mmol/L.  
  • If your blood glucose is less than 4 mmol/L, take 15 g of fast-acting carbohydrates. 
  • About 15 minutes later, measure your blood glucose again (should be above 4 mmol/L). 
  • After treating your hypoglycemia, wait at least 45 minutes before driving. 

Tips from healthcare professionals

  • Never leave home without your blood glucose meter and fast-acting carbohydrate snacks. 
  • If you develop symptoms of hypoglycemia, pull over immediately and test your blood glucose. If the reading is less than 4 mmol/L, treat your hypoglycemia right away. 
  • Drivers who have experienced severe bouts of hypoglycemia or hypoglycemia without prior symptoms should always test their blood glucose before driving, then again every hour. In such cases, a reading above 6 mmol/L is recommended.

Pharmacy services

Your family pharmacists are trained to help you keep a close watch on your blood glucose levels. They can also teach you how to recognize, prevent and treat hypoglycemia. Feel free to consult them any time!

If you have diabetes, it is extremely important to properly control your blood glucose. If you are having difficulty reaching the targets set by your healthcare professional or if you experience bouts of hyperglycemia or hypoglycemia, speak with your family pharmacists. They can give you advice and recommend changes to your drug therapy, if need be.

Many Uniprix-affiliated pharmacies offer a blood glucose testing service and private consultations on diabetes management. Ask about these services. 

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