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hypoglycemiaLow blood sugar or hypoglycemia is one of the most common acute complications of Diabetes especially in individuals on insulin therapy or medications. Symptoms include shakiness, sweating, palpitations, anxiety, and hunger. Some people describe it as “parang nauupos na kandila” and may experience “blacking out” or “feeling like I’m gonna collapse or pass out.” When the blood sugar drops further, it might lead to confusion and disorientation, slurred or rambling speech, irrational or unusual behaviors, extreme fatigue, and lethargy (sleepiness), seizures and unconsciousness which could become fatal for some individuals with other comorbidities. Thus, awareness of the early signs of hypoglycemia would trigger early intervention with emergency foods or drinks and prevention of dangerous low blood sugar levels.

What are the common causes of Hypoglycemia?

1. Medication Errors
● Inadvertent or deliberate errors in medication (generally insulin) dosages
● Excessive insulin or oral secretagogue dosages (example: sulfonylurea and glinide medications)
● Reversal of morning and evening insulin dosages
● Improper timing of insulin in relation to food intake

2. Improper Nutrition or Exercise
● Omitted or inadequate food intake
● Timing errors; delayed meals or snacks
● Unplanned or increased physical activities or exercise
● Prolonged duration or increased intensity of exercise

3. Alcohol and Drugs
● Alcohol intake without food
● Impaired mentation associated with alcohol, marijuana, or other illicit drugs

How can you treat hypoglycemia?

1. Immediate treatment with carbohydrates is essential.If the blood glucose level reading in the glucometer is below 70 mg/dL, treat with 15 g of easily digestible carbohydrates which is equivalent to:

● 15 g carbohydrate from glucose tablets or 1-2 Tbsp of table sugar dissolved in water
● 4-6 ounces of fruit juice or regular soft drinks (do not use the sugar free or zero sugar version since they won’t be able to increase blood sugar)
● ½ can of regular soda pop (not sugar-free)
● 1 cup of any sports drink (not sugar-free)
● 1 Tbsp of sugar, syrup or honey

2. Retest capillary blood sugar levels using a glucometer in approximately 10 - 15 minutes.If the blood glucose level reading in the glucometer remains < 70 mg/dl, treat with an additional 15 g or carbohydrates.

3. Repeat testing and treatment until the blood sugar level returns to within normal range.

4. If it is more than 1 hour to the next meal, test again 60 minutes after treatment as additional carbohydrate may be needed.

While treating yourself or your relative with Diabetes, observe for progression to dangerous symptoms such as difficulty in breathing, blurring of vision and altered mental state and immediately prepare to go to the emergency room or medical treatment. Patients using insulin are more prone to developing hypoglycemia when the timing of their meal and insulin shot is not ideal or if their last meal is inadequate. Watch out for hypoglycemia symptoms in the middle of the night such as cold sweats, palpitations, tremors, and extreme hunger in the middle of the night especially for elderly patients. Always have an easy access carbohydrate source such as table sugar, fruit juice or sports drinks to quickly treat hypoglycemia. If hypoglycemia is recurrent, consult your doctor so your medications can be adjusted and consult a Registered Nutritionist Dietitian for a personalized nutrition program that is fit for you!


/AET

References:

• Jameson, J. L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., & Loscalzo, J. (2018). Harrison's principles of internal medicine, 20th ed. United States of America: McGraw-Hill Education.

• Jamorabo-Ruiz, A., Serraon-Claudio, V., Exevea-de Castro, E. (2011). Medical Nutrition Therapy for Filipinos, 6th ed. Manila: Merriam Webster Bookstore.

• Raymond, J. L., & Morrow, K. (2020). Krause and Mahan’s Food and the Nutrition Care Process E-Book. Elsevier Health Sciences.

• Nelms, L., Sucher, K.P., Lacey, K. (2016). Nutrition Therapy and Pathophysiology, 3rd ed. United States of America: Cengage Learning.

• Gropper, S.S., Smith, J.L., Carr, T.P. (2021). Advanced nutrition and human metabolism, 8th ed. Cengage Learning.