Tuesday, October 5, 2010

Those Dreaded Low's: How to Treat Low Blood Sugar

I  think one thing that is common about diabetes is the fear of lows.  I remember when my son was first diagnosed and we were taught about low blood sugar, we went home and I dreaded that first low.  I was afraid of what he would feel like, and the worst, what if he passed out and I had to use the glucagon!  But that first low quickly happened in a day or so, and it wasn't as bad as I feared.  He felt shaky and very hungry, but he quickly ate and felt better.  Most endocrinologists want to avoid the lows in kids, but the tight control we aim for frequently  leads to occasional lows.  So just being prepared and knowing what to do is the key.

Most people consider a low to be either less than 70, or with kids sometimes we choose less than 80.  After someone has run "high", such as in the 300's and up, when they get their blood sugar under better control, when they are at 100 they may have the symptoms of lows.  Checking your blood sugar is a must to see if you are really low.  If it reads normal but you are having symptoms, consider whether you are used to running high and try  and wait it out and let your body adjust, or consider whether your blood sugar is dropping and the meter hasn't "caught up" to the blood sugar.  My endo says if you feel low, then treat, whether the machine says it's 90 or whatever.  He says it's on the way down.

Symptoms of Lows:

Can include, but not limited to:  headache, drowiness, trembling, blurred vision, hunger, feeling dizzy or faint, confusion, dazy look, fast beating of the heart, trouble speaking.

If you have any symptoms, or notice changes in your child with diabetes, check your blood sugar immediately. 


Rule of 15:  If blood sugar less than 70 mg/dl (or whatever your healthcare professional has recommended), eat or drink 15 gms of carbs that are FAST ACTING.  Fast acting carbs are a simple sugar which will raise your blood sugar fast.  Examples include:  3-4 glucose tabs, 1/2 cup regular soda, small baggies of candy such as skittles, an airhead, lifesavors, etc.  (I like to buy holiday candy in the fun packs to keep on hand for this)  Don't choose something chocolate or something with a high fat content, as that will slow down the rise in the blood sugar.

Wait 15 minutes and recheck.  If blood sugar has not come up to normal, treat with another 15 grams carbs and repeat process.

If your blood sugar is less than 50 mg/dl, then treat  with 30 grams carbs and follow above process.

If you are not eating within an hour, then follow the simple carb with a snack that contains some protein and carbs, such as peanut butter and crackers.

Always keep Glucagon on hand in case of unconsciousness.  Always keep snacks on hand, in the car, bags, in your child's pocket if he/she is off playing in the neighborhood, etc.  Being prepared is very important for lows.  Don't get caught in the middle of nowhere with no simple carbs on hand.

After any lows, evaluate the reason for low so you can prevent them as best as possible.  Was there too much insulin on board, too much insulin to cover a meal,  was the meal not finished, did exercise affect your blood sugars, etc.  Try and correct the reason to avoid the lows, but know that they are not totally preventable, because life happens!

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