What is hypoglycemia (low blood sugar)?
For patients with diabetes, a decrease in blood sugar below 50 mg/dl is generally considered hypoglycemia. However, in many patients, complaints and symptoms begin before blood sugar drops below 50 mg/dl. For this reason, many organizations dealing with diabetes accept the low blood sugar limit as 70 mg/dl.
What are the symptoms of hypoglycemia?
or How do patients know that they are experiencing hypoglycemia?
The severity of hypoglycemia can be mild, moderate or severe. Clinical findings may vary depending on the severity of hypoglycemia.
Signs of mild hypoglycemia;
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Feeling of hunger,
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trembling in hands,
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cold sweat,
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tingling in lips and tongue,
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pallor,
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nausea ,
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difficulty in concentration
Moderate hypoglycemia symptoms;
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Headache,
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dizziness,
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blurred vision,
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drowsiness,
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difficulty in speaking,
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tachycardia (increased heart rate),
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restlessness,
Severe hypoglycemia symptoms;
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loss of consciousness,
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convulsions.
Diabetic What causes hypoglycemia in patients?
The most common cause of hypoglycemia in patients with diabetes is using excessive or inappropriate blood sugar-lowering medication or insulin. Another most common mistake is skipping a main or snack meal. Consuming a lower amount of carbohydrates at a meal than necessary also causes hypoglycemia. Excessive exercise and not controlling blood sugar before exercise can also be considered reasons. Apart from this, alcohol consumption in diabetic patients, not using medications on time, staying in extreme cold or suddenly moving from a cold environment to an extremely hot environment (sauna, bath, etc.), making insulin injections in inappropriate places, stomach problems, etc. Factors such as prolonged ejaculation time may also lead to hypoglycemia.
Is hypoglycemia dangerous, what are its harms to the patient?
Severe hypoglycemia is accompanied by life-threatening symptoms such as seizures and coma. It is known that frequently recurring hypoglycemia, especially in children and the elderly, negatively affects cognitive functions. Particularly severe hypoglycemia in adults can trigger life-threatening events such as infarction or stroke. In addition, patients experiencing symptoms of hypoglycemia disrupt their treatment or reduce the dose of medication in order to prevent the event from recurring, which causes the course of diabetes to worsen in the long term.
Night. Why is hypoglycemia (nocturnal hypoglycemia) important?
Hypoglycemia that occurs during sleep at night often goes unnoticed. Patients with diabetes notice that they experience hypoglycemia at night due to symptoms such as headache, waking up extremely tired, and the pillow being wet with sweat. Patients experiencing nocturnal hypoglycemia experience extreme fatigue and difficulty concentrating the next day. Hypoglycemia may be severe because these patients cannot recognize the signs of hypoglycemia and take precautions. Seizures, loss of consciousness and even death may occur during sleep.
Is hypoglycemia a condition that occurs only in patients with diabetes? In healthy individuals Is hypoglycemia seen in diabetic patients?
Although hypoglycemia is frequently seen in diabetic patients, it can also be seen in other individuals in some cases. The most common cause of this situation is some medications used. Apart from this, hypoglycemia may also occur in kidney, liver and pancreas diseases. Another cause of hypoglycemia is alcohol consumption, especially on an empty stomach. Hypoglycemia may also occur in people who have had stomach surgery.
What are the effects of hypoglycemia on the social life of individuals?
Experiencing the symptoms of hypoglycemia is a very frightening experience for the individual. Particularly severe hypoglycemia can lead to seizures and loss of consciousness. This experience is a psychological trauma in itself. �r. Because of this negative experience and fear of hypoglycemia, the person tries to eat more often and change medication doses. Therefore, he begins to gain weight and lose control of the disease. In addition, frequent hypoglycemic attacks negatively affect cognitive activities, especially in elderly patients, and limit the individual's intellectual capacity.
Can hypoglycemia be prevented?
Preventing hypoglycemia in diabetic patients is one of the most important parts of treatment. This becomes even more important especially in children, elderly patients, and diabetic individuals with heart or brain diseases. The most important issue for the patient here is to recognize the early signs of hypoglycemia and take the necessary precautions before severe hypoglycemia occurs. It is also very important for the patient to comply with his diet and not skip main and snack meals. Exercise is useful to prevent hypoglycemia, but it should be kept in mind that untimely (after long-term fasting, etc.) and excessive exercise can also trigger hypoglycemia. Measuring blood sugar regularly and sharing the results with the diabetes team also reduces the risk of hypoglycemia. It is also important not to consume excessive caffeinated drinks and alcohol.
The duty of the diabetes team in preventing hypoglycemia is to educate and raise awareness of the patient on these issues. In addition, physicians must individually select the diabetes treatment regimen with the lowest risk of hypoglycemia for each patient.
How is hypoglycemia treated?
If mild hypoglycemia occurs 15-30 minutes before the planned main meals or snacks, the planned meal should be eaten without delay.
In hypoglycemia that occurs at an intermediate time, if the patient is conscious and able to swallow, 15-30 minutes before the planned main meal or snack. 20 g of glucose is taken orally (preferably 3-4 glucose tablets/gel, 4-5 sugar cubes or 150-200 ml fruit juice or lemonade). In the meantime, fat-containing products such as chocolate should not be used. The patient should then have a meal containing 15-20 grams of carbohydrate within 1 hour at the latest. Fluid therapy should be administered to unconscious patients. Especially in cases of severe hypoglycemia in patients with type 1 diabetes, 1 mg glucagon administered intramuscularly by the patient's relatives can be life-saving. For this reason, patient relatives should be informed about this issue. It is important to be educated.
10.What do you recommend for diabetic patients who experience frequent hypoglycemic attacks?
The most important duty for the patient is to comply with his diet and not skip meals. In addition, he/she must measure his/her blood sugar regularly and detect the times when hypoglycemia occurs and share these with the healthcare team monitoring him/her. The patient is expected to have reached the level of knowledge required to recognize and prevent hypoglycemia and to have received training on this subject. In addition, relatives of patients at high risk of hypoglycemia should be taught how to inject glucagon.
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