Diabetes can have wide swings in blood sugar. Diabetes does not always mean only a high blood sugar.it can go down causing Low Blood Sugar or Hypoglycemia It means that the body has lost the amazing and near accurate function of regulation of blood sugars. Blood sugars in our body like many thing else is maintained within a narrow range. This range is from 80-140 gms/dl depending upon the time of checking the blood sugars. Sugars are needed as the source of energy by practically every tissue and organ of our body. Some organs like the brain can utilize only sugars for energy. Many organs can utilize fats also as energy source.
Many hormones and pathways coordinate in a near perfect manner to keep blood sugars within the normal range and INSULIN is one important such hormone. Lack of insulin leads to loss of regulation of blood sugars causing Low blood sugar . This can lead to wide fluctuations in blood sugars. Sugars may go up above 180 mg/dl or low below 60 mg / dl. Less than 60 mg/dl is defined as hypoglycemia or Low Blood Sugars. Many patients however may get hypoglycemia symptoms at 90-110 mg/dl blood sugars (if their sugars have been consistently poorly controlled and above 180-200 most of the time).Some people may not get symptoms at 50 mg/dl also.
WHAT ARE THE SYMPTOMS?
At around less than 70-80 mg/dl person may get hunger pangs and weakness and fatigue and irritable mental feeling.
Below 70 mg/dl in addition to above, sweating may occur, mild mental clouding and improper thought process occur.
Less than 40-50 mg /dl drowsiness sets in, in addition to severe sweating
Less than 30-40 mg/dl person becomes unconscious and may lapse in to coma.
Persistent low blood sugar (< than 40) for a prolonged period, person may get permanent brain damage and may lead to death.
COMMON CAUSES OF HYPOGLYCEMIA.
Body can store only around 70-gms of sugar mainly in the liver. Most of the other organs cannot store blood sugars. In times of food shortage this stored sugar i.e. glycogen is broken down and glucose is released in to the blood, and blood glucose is maintained within normal range.
So if a diabetic
1) Misses a meal
2) Does fasting
3) Mistakenly takes his/her diabetic medication twice
4) Mistakenly takes higher dose of insulin
5) Develops infection or illness and looses appetite
6) Gradually develops a kidney failure
And such similar situations, it may cause blood sugar to go down resulting in hypoglycemia.
Hypoglycemic state indicates that the body reserves of glucose in the form of glycogen are also totally depleted.
WHAT SHOULD YOU DO?
It is important that the diabetic is aware of the symptoms and causes of low blood sugar. Hence he/she can take measures to prevent such a situation.
Also as soon as the patient gets any such symptoms, ideally he should check his own blood sugar with the help of a portable glucometer and immediately eat something either sugar, sweets, fruit or biscuits, bread or any other edible food which has adequate simple sugars
Once blood sugar has gone down it can repeatedly decrease over next 24 to 48 hours, hence person should ensure that his oral intake is adequate over next 2 days. And should frequently check his own blood sugars. Subsequently he should visit his DIabetologist for ruling out any infection or other cause of low blood sugar and to modify his therapy. And to take adequate corrective measures to prevent future hypoglycemic episodes.