Don’t let diabetes get you down

One minute you’re feeling fine and the next you’re sweaty, shaky and dizzy. If you have diabetes, you might be having symptoms of low blood sugar. This condition is called hypoglycemia. It’s important to recognize and treat low blood sugar symptoms right away. Quick action can prevent an emergency.

What is a low blood sugar emergency?

Hypoglycemia (low blood sugar) is sometimes called “an insulin reaction”. It can develop quickly and can lead to a sudden loss of consciousness. It may occur if you:

* Have too much insulin in your body

* Don’t eat enough

* Exercise too much

* Take certain medicines

Be on the lookout for warning signs

Learning to recognize warning signs of hypoglycemia may help you avoid a low blood sugar emergency. These signs may vary from time to time. They can also differ from person to person. They include:

* Low blood sugar levels

* Dizziness

* Shakiness

* Sweating

* Heart palpitations (heart pounding)

* Hunger

* Pale skin

* Trouble concentrating

If you have had diabetes for many years, you may not always be able to recognize the subtle signs of hypoglycemia. This is known as hypoglycemic unawareness. It occurs more in people who have neuropathy (nerve damage) caused by diabetes, or who take certain medications for heart disease or high blood pressure. Although you may not feel the physical symptoms of low blood sugar, you may still have mental symptoms of hypoglycemia, such as:

* Trouble concentrating

* Slowed speech

* Coordination problems

Tell your doctor if your blood sugar level drops below 50 and you do not have any symptoms of hypoglycemia.

Be prepared!

To help prevent a low blood sugar emergency, you need to plan ahead. Wear a medical alert bracelet and always have the following at hand:

* A blood sugar (glucose) meter.

* Glucose tablets, hard candies or another form of sugar.

* A syringe of glucagon (a hormone that quickly raises blood sugar). Ask your doctor to prescribe it and show your family, friends and coworkers how to inject you.

Tips for preventing a low blood sugar emergency

To help prevent low blood sugar, check your blood sugar levels as often as your doctor tells you to. And keep your blood sugars in your target range.

If you do become hypoglycemic:

* Eat something with sugar in it, such as:

o Three glucose tablets

o One-half cup of fruit juice, or

o Five to six pieces of hard candy

* Then wait 15 minutes and check your blood sugar levels.

* If your blood sugar level is still low and you still have symptoms, have the same amount of sugary food again.

Be sure to act fast – hypoglycemia can quickly cause you to lose consciousness. If you do pass out, you’ll need a glucagon shot right away. If this is not possible, someone needs to call 9-1-1 to get you immediate medical assistance.

Why would I need an oral glucose tolerance test?

This test measures the levels of blood sugar (glucose) after ingesting a standard amount of sugar. A high blood glucose level can indicate that you have diabetes. Your physician may want you to have this test to evaluate your sugar metabolism, to check for or to confirm diabetes, or to diagnosis abnormally low blood sugar levels, called hypoglycemia.

An oral glucose tolerance test is the most accurate way to check for diabetes or to determine if a pregnant woman has gestational diabetes, a form of diabetes that develops during pregnancy. During the test, sugar levels in the blood and urine are monitored for three hours after drinking a sugar solution.

Your doctor may have you take this test if you have risk factors for diabetes. These include:

* A family history of diabetes.

* Having had gestational diabetes (which occurs during pregnancy) or previously delivering a baby who weighed 9 pounds or more at birth.

* Being African-American, Hispanic American, Asian American, Native American or a Pacific Islander.

* Obesity.

* 45 years or older.

* High blood pressure, high blood cholesterol or high triglyceride levels.

* Having a condition known as impaired fasting glucose.

If I am pregnant, when should I have this test?

An oral glucose tolerance test is usually done between the 24th and 28th weeks of pregnancy. Women who are considered at high risk (including women who have had gestational diabetes in a previous pregnancy) are often initially screened at an early prenatal visit and, if test results are normal, screened again at 24 to 28 weeks. According to the American Diabetes Association, women younger than 25 who have no risk factors for diabetes do not need screening because they have a very low chance of developing gestational diabetes.

How do I prepare for this test?

Follow a high-carbohydrate diet for three days. Carbohydrate-rich foods include bread, cereals, potatoes, vegetables and fruit. You’ll then need to fast for 10 to 16 hours before the test. Do not smoke, drink coffee or alcohol, or exercise vigorously for eight hours before the test. Water is permitted before this exam.

What happens during the test?

This test requires five blood samples and often five urine specimens. Blood is drawn from a vein in your arm for an initial fasting blood sample. A urine specimen is collected immediately following. You then drink a solution containing dissolved sugar. Blood samples are drawn at 30 minutes, one hour, two hours and three hours after you drink the solution. Urine specimens are collected at the same intervals.

You may feel some discomfort from the needle punctures. If you feel faint at any time, lie down.

Does the test have risks?

If you develop severe hypoglycemia, the test is discontinued and you’ll be given a drink containing orange juice with extra sugar to normalize your blood sugar. Signs and symptoms associated with hypoglycemia include nervousness, irritability, confusion, weakness, pallor, clammy skin and excessive sweating. If you have these symptoms, tell someone at the testing center. If necessary, you may receive intravenous sugar to reverse the reaction.

What are normal results?

If you don’t have diabetes, your glucose levels rise and then fall quickly. Normal blood glucose levels peak at less than 160 milligrams of glucose per deciliter (mg/dL) to 180 mg/dL of blood within 30 minutes to one hour after consuming the oral sugar solution. Blood glucose returns to fasting levels or lower within two hours. Urine sugar tests remain negative throughout. The News

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