Managing type 2 diabetic hypoglycemia.

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Hypoglycemia survival skills are of vital importance for type 2 diabetics.

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Hypoglycemia occurs when a blood sugar testing result goes below the normal range.

Occasionally we all miss meals, snacks, and medications when busy or having fun, but before a person notices it, incorrect timing of food and insulin dosing, sulfonylureas, and meglitinides can lead to low blood sugar.

Unplanned physical activity or drinking alcohol and (even if planned) without adequate food intake can also place a person at hypoglycemia risk.

Symptomatic hypoglycemia is glucose levels that are less than 70mg/dL.

An individual can still address symptomatic hypoglycemia themselves but may need help from others. Symptoms may include feeling shaky, weak, tired, and irritated.

To quickly bring low blood glucose back to normal, a person should eat 15 grams of carbohydrate-rich foods. Then wait 15 minutes to see the effect on blood sugar. If readings are still low, eat another 15 grams.

Each of the following is an example of approximately 15 grams.

  • Hard candy (8 to 10 pieces).
  • One medium-size fruit.
  • Can of regular soda (4 to 6 oz.).
  • Container of orange juice (4 to 6 oz.).
  • One tablespoon of sugar, honey, and syrup.
  • Three to five packets of sugar.
  • 1/4 cup of dried fruit (raisins, apricots, bananas).

(American Association of Diabetes Educators et al., 2019b)

Survival carbohydrate foods should be readily available at the bedside, in the car, at work, and at school to bring glucose levels up as soon as possible.

Avoid foods that contain fat and protein because they will bring the blood sugar levels up at a slower rate.

  • Peanut butter and nuts.
  • Cooked chicken, meat, and fish.
  • Eggs.
  • Butter, margarine, or oils.

Significant hypoglycemia is a glucose level of less than 54mg/dL.

Research by (American Association of Diabetes Educators et al., 2019b), a person experiencing significant hypoglycemia will likely have confusion and slurred speech leading to seizures and a coma, and consequently not alert enough to swallow food and liquids safely. The individual in need may show resistance to others due to panic and uncertainty.

Because the glucagon hormone secreted by the body naturally will not be sufficient to raise glucose to an appropriate level. The person in crisis will require an urgent glucagon injection.

A glucagon emergency kit is available only with a prescription based on a person's diabetic medical history and prescribed by a primary care physician. The Food and Drug Administration (FDA) has also approved a ready-to-use glucagon rescue pen Gvoke HypoPen Emergency Glucagon Pen Now Available | diaTribe and a nasal spray https://beyondtype2.org/nasal-glucagon-baqsimi-approved-by-the-fda/.

Hypoglycemia is a medical situation to take seriously. A primary care physician should always be aware of a diabetic patient's hypoglycemia events.

References:
American Association of Diabetes Educators, Cornell, S., Halstenson, C., & Miller, D. K. (2019). The Art and Science of Diabetes Self-Management Education Desk Reference (4th ed.). American Association of Diabetes Educators.

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I am a Registered Dietitian and Certified Diabetes Care and Education Specialist with a culinary arts degree. My comprehensive blend of cooking and nutrition expertise provides reliable “back to the basics” practical information.

Buckeye, AZ
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