Hypoglycemia or more commonly known as low blood sugar, is a common and dangerous problems faced by diabetics. The good news is that the symptoms revert back to normal once the blood sugar level is normalized.
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A few facts
· A blood glucose level which falls below 65-70 mg/dl is considered as low blood sugar or hypoglycemia.
· 10 gm of glucose will raise the blood glucose level of an adult by 35 mg/dl and in children 1.5 gm glucose/10Kg body weight will approximately raise the blood glucose level by 35mg /dl.
· Glucose raises the blood glucose level within 15 minutes and the sugar level continues to rise for another 45-60 minutes.
· A tablet of glucose is generally of 3 gm glucose and far more effective than any other form of sugar or carbohydrate taken to raise the level of glucose in blood.
· Glucose cannot be absorbed from mouth or stomach, and glucose given rectally as suppository will not raise the blood sugar level of either an adult or a child.
Steps to cope with hypoglycemia
· If you feel sensations that you may have a low blood glucose level, test your blood sugar. If your condition is not such that you can measure blood sugar, then try eating some carbohydrate or glucose so that initial hypoglycemia may not worsen.
· If your blood glucose level is below 65-70mg /dl, eat something sweet, preferably glucose tablets. Take a low dose of glucose and wait for 15-20 minutes, if you don't feel better after the lapse of this time, and then take a repeat dose. Do not take any fluids or food containing fats such as chocolates, biscuits, milk or chocolates as it will decrease the absorption of glucose and hence a slower rise in blood glucose will take place.
· If the level of sugar is below 65-80mg/dl, then a glass of juice or a piece of fruit will be helpful. Postpone exercise, eat carbohydrate and change your insulin dose after consultation with the diabetician.
· If the person is conscious, but cannot swallow, then give him glucose gel or honey. They are also helpful in toddlers and infants.
· A person, who is unconscious or is experiencing convulsions, should be given glucagon injection. Do not give him anything to eat or drink.
· Do not involve yourself in exercise until the symptoms of hypoglycemia have subsided. Do not do anything else that requires your full attention such as driving, handling heavy machinery or appear for an exam till at least 15 minutes of taking glucose and subsiding of symptoms.
· If there is no improvement even after 30 minutes, then it could be due to gastric delaying of glucose into the intestine. In these cases try drinking a carbonated beverage such as lemonade.
· Underlying conditions such as gastroenteritis may also delay the improvement in blood sugar level. In this case a glucagon injection is very important.
· Consult your doctor, and get the insulin dose lowered the very next day.
Management of hypoglycemia in relation to meals
It is very important to focus on the time interval between the meal and the hypoglycemic episode, for a better management of hypoglycemia.
· If hypoglycemia occurs just before meals, take glucose; wait for 15-20 minutes before eating meals. Food will delay the absorption of glucose.
· If low blood sugar appears 45-90 minutes before your meals, then again take glucose and eat your regular meals. You may be required to eat a fruit or something light to avoid reversal of hypoglycemia.
· If hypoglycemia occurs 1-2 hours before meal, take glucose and wait for 15-20 minutes before eating anything else. Try taking something with longer acting carbohydrates this tie since there is time before your next meal. A glass of milk or a sandwich is helpful in this case.
Sweets and hypoglycemia
Sweets containing pure sugar such as pure caramel or boiled sweets can raise the blood sugar more quickly. Sweets containing chocolate and chocolate bars raise the blood sugar very slowly and are not effective in the immediate treatment of hypoglycemia.
Glucose tablets are better than any other form of sweet as they give a measured dose of glucose.
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