How does a drop in sugar manifest?
Symptoms develop in two stages. First, a vegetative reaction is triggered: trembling in the hands, cold sticky sweat, palpitations, anxiety, pallor, acute hunger, tingling around the mouth. These are warning signals that give you time to consume carbohydrates. Then, if sugar continues to fall, signs of a lack of glucose in the brain appear: weakness, headache, poor concentration, visual disturbances, slurred speech, unsteadiness of gait, strange or aggressive behavior, which others sometimes mistake for intoxication. The extreme degree is convulsions and coma.
- Trembling, sweating, palpitations
- Sharp feeling of hunger and anxiety
- Paleness and tingling around the lips
- Weakness, dizziness, headache
- Impaired speech, vision, coordination
- Strange behavior, irritability
- Convulsions and loss of consciousness
Why does sugar drop?
In people with diabetes, the most common cause is a discrepancy between the dose of the drug and the amount of food or exercise: a missed meal, too much insulin, unusual physical activity, drinking alcohol, which blocks the production of glucose by the liver. The risk increases with kidney failure and in the elderly. In people without diabetes, hypoglycemia is rare and requires a mandatory search for the cause: it can be a reactive decrease in sugar after eating, prolonged fasting, severe liver and kidney diseases, adrenal insufficiency, a condition after gastric surgery, and in rare cases, insulinoma, a tumor that produces insulin.
- Excessive dose of insulin or sulfonylurea
- Skipping or delaying meals
- Unusual physical activity
- Alcohol, especially on an empty stomach
- Kidney and liver failure
- Adrenal insufficiency
- Reactive hypoglycemia after eating
- Condition after gastric surgery
- Insulinoma is a rare cause
First aid: rule 15
If the person is conscious and can swallow, give him about 15 grams of fast carbohydrates and measure his sugar again after 15 minutes. If it is still low, repeat the technique. After normalization, you need to eat something with slow carbohydrates and protein so that your sugar does not drop again. Chocolate, ice cream and baked goods are not suitable for stopping an attack: fat slows down the absorption of glucose. If the person is unconscious, do not put anything in their mouth - it is a choking hazard. Lay on your side, call 103, and if you have a trained assistant and the drug, administer glucagon.
- 15 g of fast carbohydrates: 3–4 glucose tablets, half a glass of juice, 1 tablespoon of honey
- After 15 minutes - repeat sugar control
- If the numbers remain low, repeat the technique
- Then a snack with slow carbohydrates and protein
- Do not give chocolate or baked goods to relieve an attack
- Unconscious - nothing in mouth, put on side, call 103
- Glucagon is administered by a trained person
Survey
The main rule is to detect low sugar in the laboratory precisely at the moment of symptoms, because complaints of trembling and weakness by themselves do not confirm hypoglycemia. The classic guideline is the combination of symptoms, low glucose and their resolution after eating carbohydrates. In a person without diabetes, at the time of an episode, blood is taken for insulin, C-peptide and cortisol, which makes it possible to distinguish excess of one’s own insulin from that administered externally and to identify adrenal insufficiency. In unclear cases, the examination is carried out in a hospital under observation.
- Measuring glucose at the time of symptoms
- Insulin and C-peptide during an episode
- Cortisol
- Assessment of liver and kidney function
- Revision of doses and regimen of glucose-lowering therapy
- Fasting test in hospital according to indications
How to prevent attacks
For people with diabetes, it is important to coordinate medication doses with diet and exercise, not skip meals, measure sugar regularly, especially before driving and physical activity, and always carry fast carbohydrates with you. Relatives and colleagues should know about the diagnosis and be able to help. Alcohol is dangerous because a decrease in sugar can occur after several hours, including at night, so you should not drink on an empty stomach. If there are frequent nighttime episodes or loss of warning signs of an attack, you need to contact an endocrinologist to review the treatment regimen - this problem cannot be dealt with on your own.
- Don't skip meals
- Coordinate doses with nutrition and exercise
- Always carry fast carbohydrates
- Test your sugar before driving and sports
- Don't drink alcohol on an empty stomach
- Inform loved ones and know how to use glucagon
- Wear a bracelet or diagnosis card
- Consult a doctor for recurring episodes