Maintaining stable blood sugar is essential for good health, especially for people living with diabetes. While high blood sugar (hyperglycemia) is widely discussed, low blood sugar (hypoglycemia) is equally dangerous and requires immediate attention. According to the International Diabetes Federation (IDF) Guidelines, hypoglycemia is a critical complication that must be prevented, recognized early, and managed effectively.
What is Low Blood Sugar?
Hypoglycemia occurs when blood glucose levels fall below 70 mg/dL (3.9 mmol/L). It can happen in people with diabetes who take insulin or certain oral medications, but it may also occur in non-diabetics under certain conditions.
If left untreated, severe hypoglycemia can cause seizures, unconsciousness, or even life-threatening complications.
Causes of Low Blood Sugar
The IDF highlights several causes of hypoglycemia, including:
- Excess insulin or diabetes medication
- Skipping or delaying meals
- Strenuous exercise without adjusting food intake or medication
- Alcohol consumption on an empty stomach
- Hormonal or metabolic disorders (rare in non-diabetics)
Symptoms of Low Blood Sugar
Hypoglycemia symptoms can vary, but the IDF classifies them into early warning signs and severe symptoms:
Early Symptoms
- Sweating
- Trembling or shakiness
- Hunger
- Rapid heartbeat
- Dizziness or lightheadedness
- Irritability or anxiety
Severe Symptoms
- Confusion
- Blurred vision
- Difficulty concentrating
- Slurred speech
- Seizures
- Loss of consciousness
Recognizing symptoms early is essential to prevent progression to severe hypoglycemia.
Risk Factors
Certain individuals are more prone to hypoglycemia, including:
- People with Type 1 diabetes on insulin therapy
- Type 2 diabetes patients using sulfonylureas or insulin
- Elderly patients with multiple medications
- People with unawareness of hypoglycemia (they don’t feel symptoms until it becomes severe)
IDF Guidelines on Management of Hypoglycemia
1. Immediate Treatment (The Rule of 15)
- Consume 15 grams of fast-acting carbohydrates (e.g., glucose tablets, fruit juice, regular soda).
- Recheck blood glucose after 15 minutes.
- If still below 70 mg/dL, repeat the process.
- Once blood glucose is normal, eat a small snack if the next meal is more than 1 hour away.
2. Severe Hypoglycemia
If the person is unconscious or unable to swallow:
- Administer glucagon injection if available.
- Call emergency medical help immediately.
- Do not give food or drink by mouth to an unconscious person.
3. Prevention Strategies
- Regular blood glucose monitoring.
- Adjusting insulin or medication according to activity and meals.
- Never skipping meals.
- Educating patients and families about recognizing and treating hypoglycemia.
Long-Term Impact of Frequent Hypoglycemia
Recurrent hypoglycemia can lead to:
- Reduced awareness of warning signs
- Increased risk of accidents and injuries
- Cardiovascular events
- Reduced quality of life
IDF strongly recommends patient education and regular follow-ups to reduce hypoglycemia frequency.
Conclusion
Low blood sugar (hypoglycemia) is a serious condition that can affect anyone with diabetes, particularly those on insulin or certain oral medicines. By following the IDF guidelines, patients can recognize early signs, treat hypoglycemia promptly, and adopt strategies to prevent future episodes.
Maintaining a balance between medication, food intake, and physical activity is the key to preventing hypoglycemia and living a healthy life with diabetes.
