Diabetes: The Dreaded “H” Word

What to do when a hypo happens.

Let’s just put it out there, hypoglycemia happens. And if you’re reading this, then it’s probably happened to you or perhaps a loved one with diabetes. It’s horrible, but a fact of life.[1] It can happen at any time, when you least expect it – while sleeping or in the middle of driving – and when it does occur it can be frightening, especially if you’re alone.

Hypoglycemia, or a blood glucose generally defined as a BG level at or below 70mg/dl (3.9 mmol/L), can occur at any time to many patients with diabetes. This is especially true for patients treated with insulin or oral sulfonylureas, such as glyburide and glipizide.   With the proper education and support, you can be prepared and stay safe.  Your own healthcare team will set a value at which they feel you should treat a low blood sugar.

The symptoms of a low blood sugar include shakiness, sweating, loss of mental acuity, dizziness, and confusion.  Many people can feel this coming on, but others may have hypoglycemia unawareness, which means they don’t know they have low blood sugar.  That is why testing at key times is so important, such as before driving a car or participating in sports.

Not all lows are the same, but what should you do when a hypo happens?

Depending on the severity, you may need to call 911 and a glucagon injection or sugar administered through an intravenous might be needed to save someone’s life.[2] Always err on the side of caution and contact medical help immediately if you are not sure. If you are using the Dario Blood Glucose Monitoring System, then be sure to set the app with emergency contacts.

Dario allows you to enter up to 4 contacts and in the event of a hypo, the app automatically prepares a message that can be sent to them with your blood glucose level plus a link to where you are using your smartphone’s GPS coordinates. This is extremely important and one of the many reasons that puts Dario in a league of its own.

You should use this safety feature, especially if you or your loved one has had hypo issues in the past. When activated, people who need to be notified will be alerted and from there proper medical attention can be determined.

For symptomatic hypoglycemia, many experts in the medical profession recommend the 15/15 rule. This is a simple procedure that dictates that the diabetic should consume 15 grams of carbohydrates, such as a half a cup of fruit juice or three glucose tablets. After this, wait 15 minutes to check again.[3]

However, not all carbs are created equally, and sugars combined with fats and protein will not be absorbed quickly enough to raise your blood sugar as fast as you need it to to treat a low BG. You may be tempted to eat a candy bar, but go for the glucose tablets or gel first.  Once you are in a safe zone and you see your blood sugar is starting to rise, it is often recommended to consume a complex carb with a protein, such as a half of a turkey sandwich.  This can prevent another sudden dip in BG.  Check with your own HealthCare team for more exact direction.

Always wear your medical ID so that if you experience a more serious low blood sugar and lose consciousness, others can properly assist you.  Glucagon, which is an injection to raise blood sugars quickly in case of an emergency, should be on hand if you use insulin, and are Type 1.  Some Type 2 patients on insulin have glucagon as well, depending on provider recommendation.  The key point with glucagon is that you will not be giving it to yourself, so you need to educate any appropriate caregivers or family of how and when to use it.