Hypoglycemia (reactive, nocturnal, neonatal): what it is and causes

A sudden feeling of malaise, tremor and dizziness arise. Sometimes with a headache , sometimes an urgent need to sit down so as not to pass out. You are probably experiencing a hypoglycemic attack.

The term is more common and better known by those who have diabetes or live with someone who has. In these cases, blood glucose drops are more constant and, therefore, the symptoms and measures to resolve them need to be well known.

But even those who have never had an altered blood glucose test can suffer from such malaise. Learn more about hypoglycemia and what you need to do if it occurs!

What is hypoglycemia?

Hypoglycemia is a condition characterized by an irregular drop in blood sugar , which occurs more frequently in patients with diabetes and – more difficultly – in people without any disorder of the pancreas.

It is worth remembering that the drop in blood glucose is not a disease, but a sign or symptom of some other condition, which may be a lack of food, the use of medication, glycemic disorders or dysregulation of the body, for example.

On average, normal blood sugar (blood glucose) rates vary between 70mg / dL and 99mg / dL on an empty stomach, which can reach up to 140mg / dL after meals for patients without diabetes.

This range of values ​​indicates that the body is functioning properly, managing to balance the production of hormones insulin and glucagon – responsible for regulating blood sugar – in a manner appropriate to food intake.

However, when the values ​​fall below 70mg / dL, the symptoms can start with malaise, tremors, hunger, mental confusion and dizziness, which tend to worsen rapidly, as blood glucose tends to fall rapidly if not corrected.

Clinically, hypoglycemia is defined from 3 aspects, called the Whipple triad, in which the patient needs to present:

  • Symptoms and signs characteristic of low blood sugar;
  • Low blood glucose (verified by measuring the glucometer);
  • Improvement after glycemic stabilization.

The condition, especially in patients with diabetes, should be considered urgent as soon as the condition worsens rapidly and can result in severe damage, such as loss of consciousness and seizures . But the good news is that, just as blood glucose drops quickly, after drinking something sweet, it rises in a short time too.

The symptoms may even take a little longer to pass, but gradually the body stabilizes and there is no more risk from hypoglycemia.

In ICD-10, hypoglycemia is listed under the codes:

  • E16.0 – Drug-induced hypoglycemia without coma;
  • E16.1 – Another hypoglycemia;
  • E16.2 – Hypoglycemia, unspecified;
  • T38.3 – Insulin poisoning and oral hypoglycemic drugs (antidiabetics).

Hyperglycemia and hypoglycemia: what is the difference?

Hypoglycemia and hyperglycemia are the opposite, or extremes, of changes in blood sugar levels.

While the first characterizes a sudden drop, usually showing symptoms when the indexes reach below 70mg / dL, the second is characterized by blood glucose levels above 200mg / dL, which can reach values ​​above 600mg / dL, especially in patients with type 2 diabetes. 1.

Hyperglycemia should be treated according to the patient’s condition. For example, in cases of pre-diabetes, often just dietary regulation and the adoption of physical exercise can be sufficient to stabilize rates.

However, in patients with diagnosed diabetes, the lack or delay in using the medication, the excess of carbohydrate or sugar foods or low insulin dosages can cause hyperglycemia.

It is important that patients with diabetes know how to differentiate the conditions and, above all, always use the glucometer to measure blood glucose.

It is also worth mentioning that there may be variation in symptoms. For example, there are patients who feel bad with blood glucose levels close to 250mg / dL, while others may notice changes only when the rate exceeds 350mg / dL.

In general, sleep, hunger, headaches, dizziness, thirst and increased urine are quite common in hyperglycemia. While the symptoms of hypoglycemia begin suddenly, the signs of hyperglycemia can be slow and gradual.

Glucose and organic functioning

Food is essential to provide the body with the necessary nutrients for carrying out and maintaining activities essential to life, with glucose being the body’s main source of energy .

Maybe you are thinking that you don’t even consume that much sugar – or you have even replaced the sweets with sugar-free versions – but in fact a good part of our diet is made up of carbohydrates that, after being digested, turn into glucose.

This is the basis of digestion: that ingested fruit or sandwich is broken several times so that the body can extract its properties from them, transforming each food into nutritional resources.

Some carbohydrates are more complex and therefore more difficult to break down, requiring the body to degrade it more often. It is as if a carbohydrate is a large wall, formed by several blocks that are simpler units of carbohydrates.

In order for carbohydrate to be properly digested, the body needs to separate these units (doing this through the digestive processes that occur mainly in the stomach).

Then, after the stomach juices break down the carbohydrate molecules, the smaller (or simpler) units of sugar reach the intestine and are absorbed, falling into the bloodstream like glucose.

The pancreas produces and secretes a hormone called insulin, which is responsible for sending glucose into cells, causing energy needs to be met.

It is worth remembering that the main function of glucose is to act as a fuel (or energy) for the activities of the organism – ranging from the pumping of blood through the heart to all the movements of a crossfit class .

But usually meals provide more energy than cells are needing – which is good, as the body constantly needs energy sources – so that surplus is sent to the liver, which will do a series of biochemical reactions to store glucose.

When all the stock is depleted, blood glucose starts to drop and the signs and symptoms manifest as an alert: the body needs sugar.

In healthy people, even when glucose stores are low and the body begins to show signs of hypoglycemia, there are mechanisms that prevent it from falling sharply.

In general, they are very similar to the processes that keep blood sugar levels regular for a few hours without eating: the body decreases insulin production and increases the secretion of glucagon, catecholamines, cortisol and GH (growth hormone) – hormones associated with metabolism and glycemic regulation.

Basically, what happens is a lower consumption of glucose by the body and a hepatic production of glucose (almost like an alternative production of energy). The result is that blood sugar levels return to normal.

However, in patients with diabetes, hypoglycemia is a more serious condition due to an essential factor: as the patient usually applies insulin or takes drugs that reduce blood glucose, the body cannot inhibit this action and slow down the reduction of blood sugar.

Along with this, the body is not able to produce the hormone glucagon totally or partially, making glycemic stabilization not possible and hypoglycemia continue to worsen.

Read more: Glucose: what is the normal value after the meal?

Types

Hypoglycemia can be divided into those that occur on an empty stomach and those that occur after eating, called postprandial or reactive.

Fasting hypoglycemia

Patients with diabetes and who have fasted for a long time are more susceptible to hypoglycemia because the body is not able to balance the hormonal release of insulin and glucagon, preventing glycemic rates from falling dramatically.

However, non-diabetic people may also experience malaise related to low glucose during fasting.

In general, there is an association of factors, such as long hours without eating, intense physical activity, alcohol consumption, use of drugs capable of inducing blood sugar reduction, metabolic dysfunctions or diseases other than diabetes itself (such as diabetes). kidney dysfunction).

Postprandial or reactive hypoglycemia

Even shortly after eating, hypoglycemia can occur as a reaction to eating. This type of glycemic drop is also called reactive, as it acts as a body mechanism after a large intake of carbohydrates, especially if they are simple carbohydrates (for example, soft drinks).

Basically, the body produces a lot of insulin to handle the carbohydrates ingested, but that amount can result in insulin spikes followed by blood sugar drops.

Uncommon in healthy people, the condition occurs mainly in patients who have undergone gastric surgery or who have an intestinal absorption disorder.

Hypoglycemia in newborns (neonatal)

The condition has variable severity, according to the frequency, intensity of the blood glucose drop and the child’s age. Symptoms are those that occur in episodes of hypoglycemia, such as tremors, cold sweat and neurological changes, including possible damage to the body.

In general, the most common causes are the excessive production of insulin (hyperinsulinism), deficiency in the production of elements that regulate blood glucose (such as growth hormone, glucagon and corticosteroids), as well as disorders of the body of hereditary origin.

It is possible that cases of transient hyperinsulinism occur in newborns of mothers with diabetes, that is, increased production of the hormone insulin.

In this case, during pregnancy, the baby is exposed to the glycemic dysregulations of the maternal organism and gets used to the higher blood sugar levels. In response, a child’s pancreas produces more insulin than it normally does.

Thus, the less controlled the mother’s blood glucose is, the greater the chances of the baby having difficulty regulating blood sugar levels in the months following delivery.

Newborns who are part of the risk group – having a mother with diabetes, being premature, pregnancy having developed in stressful environments, having a family history of pancreatic diseases – should be evaluated even without symptomatic manifestations.

There are also cases of hypoglycemia caused by persistent hyperinsulinism, which may require surgical treatment to remove part of the pancreas tissue.

Causes

Hypoglycemia occurs due to a drop in blood sugar, when energy stores have already been depleted by the body. There are some factors that can lead to low blood glucose, such as:

Prolonged fasting

Going too long without eating can trigger a sharp drop in blood glucose levels, especially in patients with diabetes.

In these cases, it is the lack of carbohydrate intake that causes hypoglycemia, making the body unable to maintain ideal rates.

Generally, the body of people without diabetes can cope with periods of prolonged fasting, inhibiting the release of insulin and secreting more glucagon (a hormone that has an opposite action to insulin, raising blood glucose). However, it is possible that this mechanism will fail and the symptoms will appear.

Medicines

Antidiabetic drugs are the biggest cause of hypoglycemia.

Even with frequent control of blood glucose levels, several factors can cause blood sugar to drop, especially in patients using injectable insulin, as doses are generally variable according to diet and physical activities, for example .

Usually, patients who use associated antidiabetic drugs (more than one medication) or insulin are at increased risk of induced hypoglycemia due to the high dosage of the medications.

In general, the excess occurs because the quantity is still being adjusted (or needs adjustments) or because there are associated factors, such as:

  • Change of medication (brand or active ingredient);
  • Alteration of the routine, such as changes in meal times;
  • Use of other remedies that increase the medication action;
  • Combination of drugs;
  • Dosage errors;
  • Ingestion or drug application at very close times.

For these cases, the most frequent causative drugs are:

  • Injectable human insulin;
  • Sulphonylureas, such as glibenclamide ;
  • Meglitinide analogues, such as repaglinide and nateglinide ;
  • Inhibitors of the sodium and glucose 2 transporter , such as dapagliflozin and empagliflozin .

Among the drugs not used to treat diabetes and which can cause hypoglycemia are:

  • Antimalarials, such as quinine and sulfadoxine ;
  • Paracetamol ;
  • Acetylsalicylic acid ;
  • Serotonin reuptake inhibitors, such as sertraline ;
  • Antidepressants, such as amitriptyline .

Intense physical activities

Glucose is used as an energy source so that the body can perform its activities – ranging from maintaining vital activities to the practice of intense exercises, such as an aerobic class.

Therefore, as physical activities are carried out, blood glucose is converted into energy.

If you go to the gym, you’ve probably seen or heard someone talking about consuming fast carbohydrates in the middle of training. This is because they help replenish energy sources and prevent tiredness and fatigue from slowing down the body. In addition, they help to avoid hypoglycemia.

Usually associated with a few hours without eating or a low-carb diet, physical activity can cause a sudden drop in blood glucose.

Alcohol consumption

When we drink alcohol, it is up to the liver to metabolize and eliminate the substance. But the problem is that it is not very well liked by the body, which considers it a poison and, therefore, concentrates its activities on cleaning the body to eliminate it.

But the process is not so fast. On average, the liver takes 60 minutes to filter the blood, even if you only drank one beer.

The organ is so concentrated on the metabolism of the drink that it fails to properly perform other functions, such as blood glucose balance.

Gradually, the blood glucose is being consumed and, if the liver is overloaded filtering the alcohol, there is no release of the hormone glucagon (capable of preventing hypoglycemia).

The result is that the blood sugar lowers, reaching the alcoholic coma depending on the amount ingested (that is why when someone overdoes it at parties, they need to take glucose into the vein).

Body changes

Some conditions, in addition to diabetes, can affect the regulation of blood glucose, such as liver, heart or kidney failure. In addition, tumors and changes in the pancreas can trigger exaggerated drops in blood glucose.

Insulinoma

The condition of insulinoma is a rare type of tumor that affects the release of insulin. Most patients diagnosed with insulinomas have a benign type of the disease, with small tumors that are located in pancreatic cells.

However, even benign cases generate excessive insulin production and trigger constant hypoglycemic attacks.

Surgical treatment for tumor removal is, in general, the most indicated measure.

Risk factors

Some conditions pose greater risks for hypoglycemia, such as:

  • Need for prolonged fasting, for example for exams;
  • Intense physical activity;
  • Use of new medications;
  • Changes in doses or forms of diabetes treatment;
  • Food diets;
  • Alcohol use;
  • Liver or kidney disorders.

Symptoms

When blood glucose reaches the 70mg / dL range, symptoms may start to manifest and tend to intensify as this value continues to decrease.

It is worth mentioning that, many times, patients with diabetes may present different physical and psychological manifestations when there are episodes of hypoglycemia, as well as people without diabetes may have less intense forms of the condition.

The most frequent initial symptoms are usually:

  • Dizziness;
  • Malaise;
  • Anxiety;
  • Irritability;
  • Tremors;
  • Palpitations;
  • Tachycardia;
  • Nausea;
  • Cold sweat;
  • Hunger;
  • Difficulty concentrating.

In general, these are usually warning signs, called neurogenic symptoms and that precede neuroglycopenic symptoms (due to a lack of glucose in the brain), which are:

  • Headache;
  • Mental confusion, speech difficulties and concentration;
  • Drowsiness or feeling faint;
  • Fatigue;
  • Difficulty in vision;
  • Lack of motor coordination;
  • Ataxia (inability to control muscles);
  • Behavioral changes.

As blood glucose continues to fall, the risks are greater, as the brain is one of the organs that most needs glucose to maintain its functions. Therefore, it is one of the most affected when inventories are reduced.

Generally, blood glucose levels below 40mg / dL already represent high risks to the central nervous system, and below 27mg / dL the chances of seizure, irreversible brain damage and death are increased.

Hypoglycemia is a very dangerous condition for the body, as the body needs glucose to maintain vital functions. For this reason, all patients – with diabetes or not – must be treated in an emergency during a crisis of glycemic decline.

Asymptomatic hypoglycemia

In general, the drop in blood sugar causes some manifestation, even if subtle, but there are cases in which hypoglycemia can occur asymptomatically or, at least, not noticeable by the patient.

Even when the blood glucose index is quite low, less than 50mg / dL, the symptoms may be absent and, therefore, represent risks to the patient’s health.

In these cases, it is important that there is regular monitoring, with the use of glucometers, as well as the habits and care with food and physical activities are constant.

Night hypoglycemia

Often, patients with diabetes can experience bouts of nocturnal hypoglycemia without being able to wake up. The condition is serious because the state of numbness prevents the drop in blood sugar from being recognized and it is possible to treat it.

Often, nocturnal hypoglycemia is identified only in the morning, when the patient wakes up and, generally, perceives the bed wet due to excessive sweating.

Another important aspect to detect possible hypoglycemic crises at night is hyperglycemia upon waking.

In other words, the patient goes to sleep with normal blood glucose levels, but upon waking up he finds a marked elevation (which can reach more than 250mg / dL).

This is due to the rebound effect, in which the body detects a situation of risk and initiates the release of muscle glycogen and counter-regulating hormones, for example adrenaline and glucagon, as a resource for the lack of glucose.

In such cases, it is necessary to evaluate the dosages of the medications before going to sleep, adjusting the insulin doses slowly or making a habit of eating something before bedtime.

How is the diagnosis made?

The most qualified professionals to diagnose and monitor hypoglycemia and diabetes are the endocrinologist, pediatrician and general practitioner . Clinically, hypoglycemia is diagnosed when the 3 Whipple criteria are met:

Symptoms and signs common to hypoglycemia

The patient or doctor usually suspects hypoglycemia when the first signs and symptoms begin to manifest.

Sweat, mental confusion, malaise and dizziness are conditions that, in people with diabetes, already indicate a warning sign, but that are not always quickly recognized by healthy people.

The condition tends to be more difficult to diagnose in children (as it is more difficult for them to report symptoms properly), patients who have never had a hypoglycemic attack, or in cases where it occurs during sleep.

Low glucose check

With a rapid blood glucose test, done on glucometers, it is possible to see the low blood sugar levels.

Diabetes patients are always recommended to have gauges at home and carry them around during the day. In general, values ​​below 70mg / dL are considered hypoglycemic.

Improvement of symptoms after correction

After checking the low glycemic index, the patient must make the correction and wait for the condition to stabilize. To compose a clinical episode of hypoglycemia, symptoms and signs must be quickly alleviated and resolved.

Although the malaise may persist for some time, in general, the symptoms resolve quickly in a few minutes.

If the signs and symptoms persist after the glycemic correction, without any improvement, it is necessary to investigate the problem.

Glycemic rate values ​​and how to measure it

In healthy patients, blood glucose values ​​do not vary much, even after very sugary meals, as the body is able to perform its functions of keeping the glycemic rate constant and controlled.

There are two ways to check the blood glucose value, which can be through blood tests in the laboratory or tests on glucometers (called capillary blood glucose).

If the person does not have diabetes and no relative or close friend has it, it is unlikely that they will have a blood glucose meter (glucometer) available. In such cases, fees are usually checked if the doctor orders a blood test.

Fasting blood glucose

Fasting glycemia is done through simple blood collection, requiring the patient to fast for 8 hours or more, depending on the laboratory’s recommendations.

The test will check your blood sugar concentration in the morning. Values ​​can indicate:

  • No change : 75 to 99 mg / dL;
  • Pre-diabetes : between 110 mg / dL and 125 mg / dL;
  • Diabetes : equal to or greater than 126 mg / dL;
  • Hypoglycemia : equal to or less than 70 mg / dL.

Glucometer test

Another way to check blood glucose is through the glucometer, a small and portable device that should be part of the routine of every patient with diabetes.

The test checks the blood sugar concentration at the time it is being performed (capillary glycemia) – there are tests capable of making a glycemic average of the last 90 days – and it is essential to assist in the control and treatment of the disease.

It is necessary to obtain a small drop of blood, using lancets, and deposit it on the measuring tape. On average, the device takes between 5 and 10 seconds to display the value.

In patients without diabetes, about 60 minutes after meals, it is normal for blood glucose to reach levels of up to 140mg / dL, but they are gradually reduced in up to 3 hours after a meal.

The ideal for patients with diabetes is to keep blood glucose as close as possible to this range.

Is there a cure?

Yes , considering the episode or occurrence of hypoglycemia, it is resolved by restoring glycemia. But it is necessary to verify which are the causes of this fall.

In patients with diabetes, hypoglycemia is a condition that can be reduced or prevented through treatment adjustments, but which can still occur again.

In general, maintaining a balanced diet and moderating physical activities is able to reduce possible episodes of hypoglycemia.

Treatment: what to do in case of hypoglycemia?

Before taking any action, it is necessary to investigate the causes and origins of hypoglycemia. If there is any triggering agent, such as liver or kidney changes, cancer , metabolic disorders or difficulty in nutritional absorption, it is necessary that the patient undergo specific treatment for the case.

Patients with diabetes and constant hypoglycemic crises need, together with the doctor, to adjust the treatment, aiming above all to better balance the dosage of medications.

But, during an episode of hypoglycemia, treatment consists of eating simple carbohydrates, in adequate amounts to replace blood glucose. That is, your body literally needs sugar.

When the patient is conscious

Prefer drinks over food, as the action is faster. The simpler the type of sugar, the faster the condition will stabilize, so avoid drinks with a lot of fat or protein, as digestion will be slower.

The ideal is to consume a soft drink or a glass of water with sugar.

In cases of up to 50mg / dL of blood glucose, it is necessary to consume 15g of carbohydrates, which represents 2 tablespoons of white sugar, more or less. Below 50mg / dL, you need to increase your intake to 30g.

The ideal is to wait about 15 minutes and measure the blood glucose level. If it is still below 70mg / dL, it is necessary to ingest something again.

Nutritional tables always contain the amount of carbohydrates in the food. If you look at a soda, for example, a can contains about 30g, which is enough to balance severe bouts of hypoglycemia.

In addition, if the next meal is too far away (more than 1 hour), it may be recommended to have a small snack in the next few minutes, preventing a new hypoglycemic episode from occurring.

When the patient is not conscious

If the person passes out or is visibly unable to drink fluids, other forms of glycemic elevation must be used.

An alternative is the use of glucagon injection or the application of glucose directly into the vein, but these options are possible for patients with diabetes (who have insulin at home) or when hypoglycemia occurs in any health center or emergency room.

When the episode occurs on the street, for example, it is possible to put sugar directly on the person’s gums, taking care that the amount is not able to cause gagging. The sugar should be pressed or lightly rubbed into the mucosa, causing the absorption to be accelerated.

Medicines

Medicines to correct hypoglycemia are indicated only for patients who have alterations or pathologies that can cause constant glycemic falls, such as diabetes, liver or kidney disorders.

When the person has frequent bouts of hypoglycemia, the doctor may prescribe a subcutaneous injection of glucagon , which works by increasing the blood glucose level. Among the options is Glucagen Hypokit .

There is also injectable glucose , which among other purposes, can be used to correct blood glucose. Some options are:

  • Glucose Equiplex solution ;
  • Glucose Baxter ;
  • Glucose solution A Isofarma.

In other cases, it is possible to keep glucose or carbohydrate sachets fast (those used in gyms, such as Carb Up Gel Probiotics , where each 30g sachet has 20g of fast absorbing carbohydrates).

They can be found in diabetes stores, pharmacies or even in supplement stores for athletes.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Living together

Hypoglycemia is a warning sign for the body, being an episode quickly resolved after food intake or use of intravenous glucose.

Patients who have frequent pictures of glycemic drop must undergo medical monitoring to investigate the causes and treat the disease or primary condition.

In healthy people, hypoglycemia tends to occur due to physical activity, poor diet or prolonged fasting.

Therefore, when there is a predisposition to falls in blood glucose – due to pathologies or not – it is necessary to adopt preventive measures, such as always having a candy or glucose sachet available, not staying long hours without eating, not practicing physical activities while fasting, and, mainly, keep friends and close people informed about the condition.

For patients with frequent episodes of hypoglycemia, it is also recommended:

Track blood glucose

Diabetes patients must constantly measure blood glucose (using glucometer devices) and carry out effective medical monitoring. Through these two measures it will be possible to identify the need to change medications, dosages or treatment routines, giving better control of the disease.

To reduce the risk of nocturnal hypoglycemia, it is ideal to measure blood glucose before bed. If the value is close to 120mg / dL, it is recommended to ingest some carbohydrate, such as a glass of milk.

In the morning, altered blood glucose levels can also be indicative of hypos during the night. That is, a high blood glucose is not always a lack of insulin, as it can be excess too.

Due to the rebound effect, a fall in blood glucose during sleep can be corrected by the body and cause hyperglycemia. Therefore, the control and monitoring by the glucometer is essential.

Identify yourself

Especially patients with diabetes should take precautionary measures for possible hypoglycemic cases. To identify diabetes, the patient can use bracelets or cards with medical and hospital phones, which are essential in cases of emergency.

Another possibility that has recently emerged is the tattoo of the good, an initiative of tattoo studios and professionals who offer drawings or alerts related to diabetes and with reduced values. In addition to assisting in social awareness and care for the disease, the tattoo serves as a quick alert about the disease.

If the person passes out or is unable to communicate, these warnings and identifiers will facilitate care and speed up the solution of the problem, as it is not always quick to know that the malaise is a hypoglycemia.

Prognosis

Hypoglycemia itself has an excellent prognosis as long as it is quickly corrected. Within minutes, the symptoms tend to subside.

Even if the patient feels ill for a few more hours, the risk of complications or damage to the body remains only as long as the blood glucose level is low.

In general, severe conditions (more or less below 30mg / dL) that occur frequently or last for a long time can cause temporary or persistent neurological damage, especially in children.

Adults, in general, show complete recovery and without persistent damage to brain functions, even when the condition worsens – such as seizures or as a hypoglycemic.

However, a sharp and prolonged fall in hypoglycemia, which reaches a seizure, can trigger brain damage and lead the patient to death.

Complications

The complications most associated with hypoglycemia are neurological damage, seizures, hypoglycemic coma and death.

Children are the most affected when severe episodes of low blood glucose occur, which can cause damage to brain development, learning difficulties and contraction that persist throughout life.

In general, adult people who experience a sudden drop in blood glucose may convulse or need a coma (called a diabetic coma).

In the elderly, there are greater risks of localized strokes due to the associated factors, as well as deaths are more frequent in patients who already have some condition capable of aggravating the organism, such as cardiac dysfunction.

How to prevent hypoglycemia?

The measures to prevent blood sugar from falling are the same for people with diabetes or not. In general, they include identifying situations, eliminating the cause or finding alternatives to avoid hypoglycemia.

Learn more about some of the main preventive measures:

Don’t go too long without eating

One of the main causes of hypoglycemia is prolonged time without eating.

In general, patients with diabetes should maintain more regular meal times, avoiding skipping any. This is because, even adjusting the dosages of the medications, the prolonged fasting causes the glucose reserves to be depleted and the body is not able to keep sugar rates stable.

The ideal is to have small meals throughout the day, avoiding more than 4 hours without eating. In addition to providing a more balanced diet, fractioning meals helps with glycemic stability and facilitates diabetes control.

Beware of intense physical activities

The body needs energy to perform all functions – whether involuntary, such as keeping the heart beating, or voluntary, such as taking an aerobic class.

But during an intense class at the gym, the body needs glucose even more to keep pace, causing blood sugar levels to drop.

It is important to have adequate meals before exercise, including carbohydrates – preferably of slow absorption, such as whole grains. They will take longer to be digested and, therefore, the body has a source of energy available during the activity.

In the same sense, exercising on an empty stomach for those who are predisposed to hypoglycemia or have diabetes should not even be considered.

If the classes are very intense or long, it is possible to use fast-absorbing carbohydrates, sold in supplement stores, for example. They are products that are easy to carry and to be consumed, avoiding the need to leave the class in the middle due to malaise.

Another important point is that it is not only during physical activity that there is a risk of hypoglycemia, as the effects of high energy needs can remain high for up to 48 hours after that class pulled in the gym, causing hypoglycemia to occur a few hours later .

Therefore, people who use antidiabetic drugs should adjust their dosages with their doctors and maintain an adequate diet even after exercise.

Take care with medications

People who use drugs to control blood glucose should pay attention to the times of ingestion or application, as well as taking care with drug interactions.

Sometimes, changes in routine (such as a later lunch) or the application of dosages without an adequate amount of time can result in a drop in blood glucose.

Likewise, it is necessary to keep an eye on the dosages used.

The use of medications such as acarbose , metformin , thiazolidinediones, pioglitazone , sitagliptin , vildagliptin , saxagliptin , exenatide alone do not cause changes in blood glucose, but if the patient already uses antidiabetics or insulin, falls in blood sugar may occur.

Avoid restricted diets or sudden changes in food

Changing the diet can be the reason for hypoglycemia, especially when there is a big and sudden change. For example, removing a lot of carbohydrates, greatly reducing the amount of food eaten, or opting for low-carb food.

Although it is possible – and sometimes recommended – to change some eating habits, the process must be gradual, giving time for the body to adapt to the new diet. In addition, it is important to always consult a nutritionist before starting any changes.

Beware of alcohol consumption

Among the various damages that excessive or constant consumption of alcohol can cause, is hypoglycemia.

In general, it occurs when there is a very high intake of alcoholic beverages, causing the liver to become overloaded and unable to control glycemic rates.

Therefore, the ideal is that drinks are not eaten on an empty stomach and, preferably, that each drink be mixed with a little water, avoiding dehydration.

It is also important to drink calmly, allowing time for the effect of alcohol to be reduced in the body, as alcoholic hypoglycemia usually occurs when the person drinks large amounts of alcohol very quickly.

Another point that must be considered is the composition of the drinks, as many of them are made with fruits, condensed milk, white sugar and liquors that have high glycemic indexes.

What may seem favorable on the one hand is actually quite harmful, as the body receives a large amount of carbohydrates and releases insulin in proportion to it.

However, these carbohydrates are all simple, that is, they will be quickly spent or consumed by the body. With insulin still circulating in the blood and the liver busy with the metabolism of alcohol, the body cannot maintain the proper blood glucose level and hypoglycemia can occur much easier.

Treat the source of the problem

If hypoglycemia is not triggered by any behavior, such as fasting or physical activity, it is necessary to investigate possible causes, such as pathologies, hormonal changes or tumors.

In this case, specific tests are needed for each suspicion that the doctor considers, according to the patient’s reports and history.

If there is any change involved in hypoglycemic episodes, it is through proper treatment that new occurrences are prevented.

Hypoglycemia are more common episodes among patients with diabetes, but they can occur in any healthy person, usually due to eating behavior or alcohol intake.

Generally, the condition becomes more severe when it is constant and the cause is not known or for patients who have very severe and severe episodes of hypoglycemia, with a history of seizures.

But observing the routine, adjusting the diet and keeping up with health are effective ways to reduce and prevent episodes.

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