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Hypoglycemia: for friends, relatives and co-workers of people with diabetes
What is hypoglycemia?
Hypoglycemia is low (hypo) blood sugar (glycemia). In a person who does not have diabetes, the body regulates the level of insulin and level of blood sugar in the body. A person with diabetes who takes insulin must regulate the amount of insulin s/he injects, and balance it with the amount and type of food consumed and the amount of exercise s/he is doing. Sounds like you just have to follow a formula, right?
ISN'T THERE A PERFECT FORMULA? No - there are formulas, but they don't always work. People who take insulin aim to balance their food, insulin and exercise. While they try to to keep the amount of sugar (glucose) in their blood in a healthy range, sometimes their blood sugar levels will get too low. This could be due to eating slightly less, delayed eating, more exercise than usual, more insulin than usual, or factors like illness, stress and hormones. Even if a person with diabetes eats the same thing every day, and exercises the same amount, his or her blood sugars may vary. People who take oral agents can also get low blood sugar.
BELOW 60-80 mg/dL. When blood sugar drops below approximately 60-80 mg/dL, the body usually releases a hormone called epinephrine. The epinephrine causes early symptoms of hypoglycemia. (Some of the symptoms are listed below.) If hypoglycemia goes untreated (the person doesn't eat or drink something with glucose), the blood sugar can become dangerously low. Severe hypoglycemia is a dangerous and potentially life-threatening condition. Severe hypoglycemia can cause disorientation, loss of consciousness, seizures and, if left untreated, even death. It is important to understand what it is, how to recognize it, how it can occur, and what to do about it if it does.
EVEN A MAJOR DROP CAN CAUSE SYMPTOMS. Although symptoms of low blood sugar most often occur when blood glucose levels drop below about 60-80 mg/dl, a person who has been running quite high blood sugars may experience these symptoms when there is a major drop in blood sugar levels. This can be frightening for them. 
SYMPTOMS VARY EVEN WITHIN THE SAME PERSON. The symptoms of hypoglycemia will vary from person to person, and even from day to day for the same person. Some people with diabetes do not notice their symptoms. Is that because they haven't been trained properly, or because they don't want to notice them? It's hard to say! I have been able to help people identify and become more aware of their own symptoms of hypoglycemia. People who have had diabetes for many years and/or have experienced a lot of hypoglycemia may develop a condition called "Hypglycemia Unawareness." They can get quite low without realizing that they are low. They need to test their blood sugar frequently, and need to be extra careful in general. As a friend, with experience and knowledge, you may be able to tell if your friend with diabetes has low blood sugar, even if your friend cannot.
Symptoms of Hypoglycemia
Each person may experience different hypoglycemia symptoms and may experience different symptoms on different occasions. Some individuals or friends notice symptoms that are not on any medical list.
Here are the most common symptoms:
- Feeling shaky, nervous or anxious
- Feeling sweaty, and either hot or cold.
- Having a fast pulse or a pounding heart, trembling.
- Having tingling in the feet or hands.
- Feeling lightheaded, faint or dizzy.
- Having trouble concentrating
- Being very tired or weak
- Blurred vision
- Headache
- Pale
- Lack of coordination
- Hunger
- Nausea
- Muscle cramps
- Not able to wake up
Some of the symptoms can be recognized by others
- Irritability
- Impatience
- Extreme emotional responses -- anger or crying over small problems
- Confusion or person hard to follow in conversation
- Lack of coordination -- sometimes even walking as if drunk
These symptoms are due to the brain not having enough glucose (sugar) to function properly. Glucose is the basic fuel for the body and when there is not enough it in the bloodstream, the brain and nervous system will not work properly. That is why it can be helpful for friends and co-workers to be able to recognize the symptoms and, if necessary, intervene.
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