Diabetes: how to prevent hypoglycemia?

Type 1 diabetes  results from the destruction of insulin-producing cells in the pancreas. It usually affects young people who start insulin therapy immediately, before the age of 40.  Type 2 diabetes affects  older people whose insulin sensitivity is out of control . This is a paradox: In this disease, which is characterized by an excess of sugar (glucose) in the blood, hypoglycemia (lack of sugar in the blood) is common. 

Aid to Young Diabetics (AJD) (Source 1) “Hypoglycemia is having a very low (less than 70 mg/dl (less than 3.8 mmol/l)) blood sugar or interstitial glucose level ”, “When you have hypoglycemia, There may be hypoglycemic discomfort. Discomfort is one or two symptoms at a time, often the same in a person”.    

“An important point is to differentiate the types of diabetes , ” warns Professor Jean-François Gautier, head of the endocrinology department and diabetologist at Saint-Louis Hospital (Paris) .  

• In type 1 diabetes treated with insulin therapy  , hypoglycemia is common. Insulin delivered causes cells  to consume sugar”. Patients learn to manage it;
• The situation is more complicated when people with type 2 diabetes receive antidiabetic therapy with sulfonamides or glinides, which are also hypoglycemic  . These drugs stimulate the production of insulin by the pancreas, but have a longer duration of action.  

The more demanding we are on our treatment goals, the harder we try to keep glycated hemoglobin below 7% and the more at risk of hypoglycemia the person is. This is the other side.

Diabetes causes an increase in blood sugar (blood sugar) called hyperglycemia , which results in symptoms such as fatigue, frequent urination, severe thirst, dry mouth… These are the first warning signs of diabetes. Even when diabetes is in balance in a diabetic person, certain conditions can cause blood sugar levels to rise.      

In the case of hypoglycemia, certain symptoms may appear: 

• sweating;
• shake;
• shake;
• palpitation;
• headache ;
• visual disturbances, including blurred vision;
• burnout ;
• sleepiness;
• feeling weak;
• anxiety ;
• mood disorders (sadness, aggression, or euphoria).

The perception threshold varies from person to person, it is important to learn to perceive these signs that require sugar intake.

Note : The symptoms of hypoglycemia are similar regardless of diabetes  . Signs that require attention so you don’t injure yourself, sit or stop if you’re driving.  

According to the French Diabetes Federation (FFD), there are three levels of severity in an episode of hypoglycemia (Source 2).  

• Symptoms caused by adrenaline production;
• The person can self-medicate.

moderate hypoglycemia

• Symptoms caused by a lack of adrenaline production and glucose in the brain;
• The person can self-medicate.

severe hypoglycemia

• Blood sugar is usually below 2.8 mmol/L ;  
• The person needs help to treat hypoglycemia;
• The person may lose consciousness, fall into a hypoglycemic coma, experience convulsions  , inability to swallow…

Teach your loved ones to react

• If you are being escorted and are unable to resuscitate yourself , “teach loved ones what to do in the following situations,” says FFD;
• If you have type 1 diabetes and have profound or severe hypoglycemia , warn your loved ones that you should not eat anything if you are “unconscious (risk of choking). services: 15 or 112″. 

As soon as the first signs of hypoglycemia appear, you should immediately consume quickly assimilated sugars :   

• 1 to 2 cookies;
• 1 mini can of soda;
• 1 juice;
• 2 to 3 cubes of sugar (10 to 15 g);
• 1 to 2 tbsp. C. to break down

“You need to take sugar and only then measure your blood sugar, which takes 15 to 20 minutes before it rises,” says Professor Jean-François Gautier  . 

In case of signs of hypoglycemia, the AJD recommends measuring your blood sugar level as this allows you to:

• Confirm hypoglycemia  (even if done immediately after taking sugar);
• Learn to recognize the signs of hypoglycemia, as not all symptoms are necessarily caused by hypoglycemia ;
• Allow progress to be tracked in the coming hours.

It’s important to take steps to prevent hypoglycemia, because “confusion or fainting can cause a fall or accident in the short term, and recurrent hypoglycemia can have serious health consequences in the long term ,” recalls Diabetes Quebec. (Source 3).  

Whole wheat bread, rice, pasta , banana… These carbohydrates, which are absorbed slowly, stabilize blood sugar. It should be eaten at every meal.    

As muscle cells consume glucose, physical activity  can cause hypoglycemia.

Physical endurance activities: swimming, cycling, running, walking or cross-country skiing are the most hypoglycemic, states the diabetologist. Gardening or DIY are long-term endeavors that put you at risk for hypoglycemia.

The solution to avoiding episodes of hypoglycemia? Eat more starch at the previous meal or adjust your medication dose if possible .     

Thus, to control hypoglycemia, the insulin dose is reduced when the proportion of starch in meal menus is low .   

  When very frequent hypoglycemia occurs in a patient taking sulfonamides or glinides , Professor Gautier recommends reviewing the treatment with his doctor : “Severe hypoglycemia that requires third-party intervention for sugar intake constitutes an indicator of frailty.”  

  ” It would be wise to reduce or change the dosage of these molecules and tolerate glycated hemoglobin levels around 7.5 to 8% “.