By Dr Olubiyi Adesina
Consultant Diabetologist
Low blood sugar is called hypoglycaemia. It is the commonest emergency situation encountered in people with diabetes. Very prompt recognition and treatment of this condition is essential as it leads to brain damage and death in severe and prolonged cases. Sugar in the blood is what the brain uses to keep functioning well; therefore there must be a continuous supply and abnormally low levels in the blood due to treatment of diabetes with drugs like insulin, glibenclamide and Chlorpropamide can lead to serious untoward effects. Other causes of hypoglycaemia include inadequate food intake, excessive exercise and overdose of any of the earlier stated drugs. Prompt recognition of the warning
symptoms of hypoglycaemia by people
with diabetes and those that live with
them is essential to avert danger. It should be known that people with
diabetes of long duration who have
had their nerves damaged by diabetes
may have developed the inability to
experience the warning symptoms of
low blood sugar and people will only know there is a problem when they
have lost consciousness. This condition called hypoglycaemia
unawareness may also occur in people
who have frequent episodes of low
blood sugar and the body then just
stops responding to low levels of blood
sugar. What then are these early warnings
symptoms of hypoglycaemia that must
be known by people with diabetes and
those around them? These include
symptoms like palpitations (increased
awareness of one’s heartbeat), hunger pangs, tremors of the hands, sweating,
anxiety and numbness of different parts
of the body. All these are called warning symptoms
of hypoglycaemia as they are indicating
that the individual should go and eat
before it is too late. The late symptoms of hypoglycaemia
include behavioural changes like anger,
confusion, fatigue or weakness,
transient weakness of one side of the
body, restlessness, incoherence,
warmth, headaches, visual changes like blurring of vision, convulsions, loss of
consciousness and if the hypoglycaemia
is prolonged, death. When such late symptoms occur, the
individual is then unable to help himself
in abolishing the episode of
hypoglycaemia and requires help to
prevent demise. When the warning symptoms occur,
such a person should quickly take a
sugary drink or put some sugar inside
the mouth, or take glucose tablets or
some orange juice. This should be followed immediately
by a more solid meal. The cause of the
episode should be identified and
guarded against in the future. When the late symptoms have
supervened and the person is quite
aggressive, having convulsions or has
become comatose, immediate transfer
to a health facility is of utmost
importance. Such people may be given glucagon injection during the process of
transferring to the hospital. The general advice is that people with
diabetes should not let their blood
sugar level be below 4mmol/1 (80mg/
dl) at any time and should get personal
glucose monitors to use to check their
blood sugar levels from time to time. How then can hypoglycaemia be
prevented? One of the important steps
is to be educated about the causes and
symptoms of hypoglycaemia. Each individual on blood sugar
lowering medications should
understand how they work and their
side effects and ensure that proper
dosages are taken. Adequate intake and sometimes more
frequent intake of meals also help to
guard against hypoglycaemia. Meals
should not be missed. Frequent blood sugar monitoring
should be carried out especially in
people who have had several episodes
of hypoglycaemia especially before
tasks like driving and before onset of
vigorous exercise. Alcohol intake should be in moderation
as it may also lead to low and
sometimes high blood sugar levels. Hypoglycaemia is a fact of life for
people with diabetes who wish to keep
their blood sugar levels as close to
normal as possible. Hypoglycaemia must be prevented as
much as possible as it has been linked
with damage to the brain causing
memory problems called dementia.
http://sunnewsonline.com/new/opinion/diabetes-and-low-blood-sugar/