Hypoglycemia & Hyperglycemia

Fasting
Normal for person without diabetes: 70–99 mg/dl (3.9–5.5 mmol/L)
Official ADA recommendation for someone with diabetes: 80–130 mg/dl (4.4–7.2 mmol/L)

2 hours after meals
Normal for person without diabetes: Less than 140 mg/dl (7.8 mmol/L)
Official ADA recommendation for someone with diabetes: Less than 180 mg/dl (10.0 mmol/L)

HbA1c
Normal for person without diabetes: Less than 5.7%
Official ADA recommendation for someone with diabetes: 7.0% or less

Hypoglycemia, or low blood sugar, occurs when blood glucose drops below 70 mg/dL and is a possible side effect of certain diabetes medications.

Symptoms of hypoglycemia include

• Hunger
• Nervousness and shakiness
• Perspiration
• Dizziness or light-headedness
• Sleepiness
• Confusion
• Difficulty speaking
• Feeling anxious or weak

Causes of hypoglycemia include

• Skipping meals or eating meals and snacks that are too small
• Taking too much insulin or diabetes medication
• Overexerting yourself with too much exercise or other activities
• Drinking too much alcohol

Avoiding hypoglycemia
There are several ways that you can avoid hypoglycemia

• Take your medicines as prescribed – at the right times in the right doses. If you have questions about your medicines, ask your doctor, pharmacist or diabetes educator.
• Eat regular meals. A dietician can help you create a meal plan that meets your medical needs and includes the foods you like. Stick with your meal plan, eat the right amount of food and don’t skip meals and snacks.
• Keep healthy snacks handy. If you plan on doing physical activity that you wouldn’t normally do – a night of dancing or some heavy yard work – then consider having a small snack to keep your blood sugar up.
• Use caution with alcohol. Alcohol can cause hypoglycemia, especially when you drink on an empty stomach. Talk to your doctor about the effect alcohol has on your health. If you do drink alcohol, make sure it’s in moderation and with a meal or snack. Remember that alcohol can cause hypoglycemia up to two days later.

Treatment

Fortunately, hypoglycemia can be easily treated by having a quick snack to boost your blood sugar. The rule is 15 grams of simple carbohydrates. Some ideas include:

• 1/2 cup (4 ounces) of any fruit juice
• 1/2 cup (4 ounces) of a regular (not diet) soda
• 1 cup (8 ounces) of fat free milk
• 5 or 6 pieces of hard candy

Wait 15 minutes after your snack and then test your glucose again. If your glucose is still below 70mg/dl, then have another snack and retest 15 minutes later. Repeat these steps until your glucose is above 70mg/dl. Because hypoglycemia can occur at any time, keep glucose tablets or hard candy with you at all times.

Severe hypoglycemia

In severe cases, hypoglycemia can cause you to pass out. Glucagon is a hormone that can be injected, usually in an arm or leg, to help raise your blood sugar. Ask your doctor or diabetes educator if you should have a glucagons emergency kit in your home. You’ll need to teach your friends or family members to inject glucagon for you because you won’t be able to inject it yourself in an emergency.

In people without diabetes, the body uses the hormone insulin to move sugar (glucose) from the bloodstream and into cells. In people with diabetes, the body doesn’t produce enough insulin or respond to insulin properly. The result is that sugar builds up in the blood stream, damaging the body’s organs, blood vessels and nerves. Too much sugar in the bloodstream is called hyperglycemia. The goal of diabetes management is to keep blood sugar in a healthy range to avoid health complications. Over time, hyperglycemia can damage your body’s organs, blood vessels and nerves and put you at risk for complications.