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. 

What is hypoglycemia?

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.

Differentiate with hyperglycemia

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.      

Symptoms: How do you know if you are having an attack of hypoglycemia?

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.  

Coma, discomfort… What are the more serious consequences?

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

mild hypoglycemia

  • 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″. 

What should be done in the face of hypoglycemia attack? How do I calm him down?

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  . 

Measure blood sugar level

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.

How to prevent and prevent a hypoglycemia crisis?

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).  

Consume starch at all meals

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

Anticipate physical effort

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 .     

Adjust insulin doses

Insulin doses to be injected need to be predicted according to the carbohydrates taken.

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

Re-evaluate treatment if necessary

  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% “.

What should be done to avoid cases of hypoglycemia at night?

To prevent nocturnal episodes of hypoglycemia, the AJD recommends:

  • Make sure you have enough dinner  ;
  • If there was physical activity in the afternoon , reduce the insulin dose in the evening;  
  •    Check at the start of the night that capillary or interstitial glycemia is within the target defined by the healthcare team .

To manage and prevent the risk of hypoglycemia, it is important to heed the following recommendations:

  1. Regular nutrition : Create a balanced nutrition plan and take care not to skip meals. Consume a balanced diet of carbohydrates, proteins and fats. Balance your blood sugar with healthy snacks, especially between meals.

  2. Use the drugs in the right dosage : Use your diabetes medications regularly and according to your doctor’s instructions. Keep in touch with your doctor to adjust your medication dosage and consult before making any changes.

  3. Balance your activity pattern : Exercise is important for your overall health, but it can affect your blood sugar. Monitor your blood sugar before and after exercise. Balance your blood sugar level by eating something before the activity if needed.

  4. Monitor your blood sugar levels: If you have diabetes, check your blood sugar levels regularly. You can measure blood glucose at home using a glucometer. Monitoring your blood sugar levels will help you detect and respond to hypoglycemia or hyperglycemia.

  5. Keep in touch with your doctor : If you have diabetes, keep in touch with a diabetes specialist that you are followed regularly. Follow your doctor’s directions, get your blood tests done regularly, and contact him if you have any questions or concerns.

It is important to follow these steps to reduce the risk of hypoglycemia. Monitoring yourself and your health closely will help you minimize the risk of hypoglycemia attacks. However, in case of any symptoms or concerns, always consult a healthcare professional.

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