Low blood glucose or hypoglycemia is one of the most common problems associated with insulin treatment, but it can also happen to people with diabetes taking oral medications. In general, hypoglycemia is defined as a blood glucose level below 70 mg/dl. It can make you feel weak, sweaty, shaky, and irritable. The most common reasons for hypoglycemia are skipping or delaying a meal or snack, taking too much diabetes medication, and more exercise than usual. A less common, but occasional cause for hypoglycemia, is drinking alcoholic beverages. The key is to identify the symptoms early and to treat it before it gets worse.

Common signs and symptoms of hypoglycemia are:

  • Hunger
  • Cold, clammy skin
  • Rapid heart beat
  • Shakiness
  • Nervousness
  • Light headedness

Hypoglycemia can also happen during sleep. Some signs of hypoglycemia during sleep include:

  • Crying out or having nightmares
  • Finding pajamas or sheets damp from perspiration
  • Feeling tired, irritable, or confused after waking up

The signs may be mild at first. But a low glucose level can quickly drop much lower if you don’t treat it. When your patient’s glucose level is very low, he may get confused, pass out, or have seizures. If he has any signs that the glucose may be low, test, do not guess! If it’s less than 70 mg/dL, you need to treat it right away. Teach your patient the following:

The 15-15 rule

  • Eat 15 grams of carbohydrates, then wait 15 minutes and test the blood sugar again.
  • If the blood sugar is still low, eat 15 more grams of carbohydrates, then wait 15 minutes and do another test.
  • If the results are still low, call the doctor and have someone take him to the hospital

Be careful not to over treat hypoglycemia, or your blood sugar could go too high.

Foods that provide about 15 grams of fast-acting carbohydrates:

  • glucose gel or tablets (as directed)
  • 4 oz. or ½ cup fruit juice
  • 6 oz. or 2/3 cup or ½ can regular (not diet) soft drink
  • 1 tablespoon honey
  • 3-4 teaspoons granulated sugar
  • 2 tablespoons raisins
  • 8 hard candies

The following are foods to avoid during hypoglycemia. It contains fats that slow gastric emptying and absorption of carbohydrates.

  • Ice cream, milk shakes
  • Doughnuts
  • Chocolate bars
  • Pies, cakes
  • Potato chips
  • Nuts
  • Pizza, french fries, cheese

It is also prudent to encourage your patients to tell his family members, close friends, teachers, and people at work about his diabetes. They can greatly help your patients when they experience low blood sugar.