We all knew that High Blood Sugar levels are bad and they cause
lots of Complications like those of Heart ( Heart Attacks, Stroke Paralysis),
Kidneys ( Renal failure), Eyes (Retinopathy, Glaucoma, Cataract), Nervous
System ( Peripheral Neuropathy, Autonomic Neuropathy - Silent Angina,
Gastropathy, Uropathy), Sexual Dysfunction in Males and Females, but we never
paid adequate attention to the Low Blood Sugar levels.
Hypoglycemia is difficult to describe in words, it is an intense
craving for food, an unsatisfiable hunger, may progress to weakness, lethargy,
perspiration, Palpitations- Feeling ones heartbeats further lowering of Blood
Sugar may affect the brain leading to epilepsy like fits or even loss of
consciousness and coma....These are very rare but may happen in a Diabetic.
These symptoms start appearing only when the Blood Sugar levels
drop to less than 60 mg/dl.
The causes of Hypoglycemia in Diabetic patients can be many:
- Skipping meals or fasting while taking Insulin or Glucose lowering medication
- Excessive or inappropriate medication as compared to Sugar levels
- Infections in Diabetics, specially Loose motions, Dehydration
- Complications of Diabetes like Renal / Kidney Failure
- Inadvertent intake of Sugar lowering medicines or Insulin
- Sudden Exercise without decreasing Insulin or Glucose lowering medications
- Hypoglycemia may be caused by some medications for other purposes- they should be avoided.
Hypoglycemias may occur while trying to achieve tight control of
Blood Sugar. Our body has a very intricate mechanism of controlling Blood Sugar
levels, At high blood glucose levels Insulin is secreted from the pancreas
which lowers Blood Glucose, while at lower glucose levels – the so called
counter regulatory hormones like Glucagon, Cortisol, Epinephrine are secreted
which increase the Blood Glucose levels by facilitating release of Glucose from
stores of the body like muscles, fat, liver cells etc. But in Diabetes both
these mechanisms may be derailed, Due to prolonged uncontrolled Diabetes-
mechanisms which increase Blood Glucose- the counter regulatory mechanisms may
get impaired and lead to severe and
prolonged hypoglycemia. This is called Hypoglycemia unawareness, when
despite decreasing Blood Glucose levels the diabetic patient does not feel any
symptoms.
How to avoid Hypoglycemia in Diabetes:
- Hypoglycemia can be avoided with some simple precautions-
- If you have skipped meals or are fasting use may have to change the dosages of some medicines or skip them altogether.
- Insulin dosages should be uptitrated slowly, step by step under the guidance of an expert in prescribing Insulin, don’t lose patience…
- All infections should be proimplty and effectively treated
- Medicines which may cause Hypoglycemia should be avoided.
- Proper dose adjustment of Insulin and medications should be done before starting intense exercise.
Discuss with your doctor if you ever have the above symptoms so
that the dosage of medications may be adjusted accordingly..
Hypoglycemia may be very harmful,
First of all it puts back the patients confidence by years and
makes him or her over cautious, It may be a precipitating factor for Heart
Attacks, Arrythmias and even sudden death. Hypoglycemia may result in falls
which may cause fractures of accidents while driving.
But this does not mean that Blood Sugar need not be controlled, Judicious
use of medications and with good patient education using structured programmes
as is the standard practice in our
centre- Total care Control- Diabetes Care Centre; it is possible to achieve good HbA1C control
even in patients who are taking Insulin 3-4 times a day.
Dr Rajesh Kesari- Diabetologist in Delhi
Dir. & Consultant at Total Care Control
Diabetes Care Centre
B-294, New Ashok Nagar, opp. main gate East End Appts
near New Ashok Nagar Metro Station
Tel:9899764447, 011-22710663, 9871110663
