“Most medical doctors don’t inform diabetics that their sugar can drop and it may be harmful”

“Most medical doctors don’t inform diabetics that their sugar can drop and it may be harmful”
“Most medical doctors don’t inform diabetics that their sugar can drop and it may be harmful”
While we frequently speak about excessive blood sugar which is rising amongst Indians at an alarming fee, low blood sugar by some means looks like a negligent downside.

Dr. Dheeraj Kapoor, Chief – Endocrinology, Artemis Hospital Gurugram explains, “High blood sugars are sometimes talked about as a result of we have been informed that they trigger issues just like the cardiac illness, stroke, neuropathy, nephropathy, retinopathy, which implies, uh, kidney harm, nerve harm, eye harm. And now liver harm is being talked about. But most of us don’t notice the gravity of what a hyperglycemia can do.
Low sugars could be probably disastrous and disaster. And since most of us do not realize the gravity, we do not speak about it. The different concern is that we expect that decrease the higher, so if we maintain sugar very, very low, we would keep away from issues, however on the identical time it is very important notice that we should always not neglect hyperglycemia.”

“Most diabetics will not be conscious of hypoglycemia”

63-year-old Ganga Thakur who takes insulin to handle her sugar ranges was taking her night stroll when she out of the blue collapsed. Fortunately, her son was along with her to get her again house safely. On prognosis, she was informed her sugar dropped, which left her shocked, “How can my blood sugar drop when I’m taking medicines to manage excessive sugar?” She is just not alone. Most diabetics are unaware that their sugar can drop and it’ll want quick consideration.

Hypoglycemia is widespread in individuals with diabetes who’re taking treatment to extend insulin (sulphonylureas) or insulin itself. In such sufferers, hypoglycemia can happen if there’s an imbalance between treatment, meals and train, shares Dr. Ambrish Mithal, Chairman & Head -Endocrinology & Diabetes, Max Healthcare.

Dr Kapoor explains, “
The first is that they aren’t conscious that this situation exists as a result of within the busy OPDs most medical doctors don’t clarify this. The second is that if the affected person’s sugar is persistently low then the physique will get used to these low sugars and subsequently if there’s a marginal lower, perhaps 65 or 60 mg % of glucose the physique may not acknowledge as a result of it’s used to the 75s and 80s, that known as hypoglycemia unawareness. Yes, with lengthy standing diabetes sure hormones may grow to be low. These are the hormones which produce signs of hypoglycemia. So, if these hormones are low the signs of Hypoglycemia is probably not evident and subsequently this may occasionally occur. So, we now have three causes: the affected person has not been educated, blood sugar is under regular and lack of hormones which set off the signs of hypoglycemia.”

Dr. Harish Kumar, Clinical Professor and Head, Centre for Endocrinology and Diabetes, Amrita Hospital, Kochi shares, “Actually, I believe all sufferers with diabetes ought to be way more cautious about low blood sugars. Because when the blood sugar goes low, it may well result in a really harmful scenario and so there should be extra consciousness about hypoglycemia.
Even if the blood sugars are working excessive in sufferers with kind II diabetes, there’s usually no quick hazard to well being or life but when the hypoglycemia goes very low then it can lead to a state of unconsciousness and result in critical penalties. So I believe consciousness about hypoglycemia is a should. Hypoglycemia is comparatively uncommon however sufferers ought to take into account that hypoglycemia can happen and definitely consciousness about that is extraordinarily essential.”

All diabetics ought to be conscious that if they’re on therapy for diabetes with both tablets or oral hypoglycemic brokers, then if their meals is delayed or they miss a meal, then it’s fairly probably that the blood sugar would possibly drop down just a little bit. So they should be at all times conscious of the potential of hypoglycaemia. Generally, I believe they should look out for signs of hypoglycemia. The second they expertise hypoglycemia, then they need to do one thing about it.

What they’ll do is that if the subsequent meal is due say, you’re having a hypoglycemic episode at 12pm, you usually have lunch at 1 or 1:30 within the afternoon, don’t await lunchtime, you possibly can most likely have an early lunch, or if you’re not in a scenario the place you possibly can have an early lunch, then you must have a snack perhaps you possibly can have a cup of tea with sugar or you possibly can have a few biscuits or banana or one thing which is able to prop up the sugar till your supper time arrives. So you must take corrective motion with a view to forestall hypoglycemia from coming extra extreme,” he provides.

Signs of low blood sugar

Dr. Mithal shares traditional signs of hypoglycemia

Some preliminary indicators and signs of hypoglycemia embody:

Looking pale


Dizziness or lightheadedness


Hunger or nausea

An irregular or quick heartbeat

Difficulty concentrating





Tingling or numbness of the lips, tongue or cheek

If hypoglycemia is not handled, indicators and signs of hypoglycemia worsen and might embody:


Unusual behaviour

Loss of coordination

Difficulty talking or slurred speech

Blurred imaginative and prescient

Inability to eat or drink

Muscle weak spot


Severe hypoglycemia might trigger:

Convulsions or seizures


Treating blood sugar at house

If the affected person is affected by an episode of hypoglycemia, no must panic. The affected person and the caregiver ought to concentrate on methods to handle it at house.

Dr Kumar explains, “Mild hypoglycemia could be very straightforward to deal with, simply the affected person wants to pay attention to it so they should both have a candy drink or take a small snack. As I discussed earlier, if the supper time is due, they may most likely have the meal early. That will abort gentle hypoglycemia. All these could be simply executed clearly at house or throughout your common routine. Even if you’re at work, all these corrective actions could be taken.

But if the hypoglycemia is extra extreme and the affected person is unwell, he might need assistance. When the affected person wants assist, that may be a extra extreme diploma of hypoglycemia. So the individuals round him should additionally bear in mind that he has diabetes and will probably develop hypoglycemia. When the affected person is unable to assist himself and when he’s confused and behaving in an odd style, people who find themselves with him ought to encourage him to eat one thing candy, have a snack or drink some glucose if the sugar is fairly low. All this may be executed at your property, college or workplace so far as kids with kind 1 diabetes are involved. If the episode is extra extreme and the affected person is unconscious, then a glucagon injection must be injected. So for all sufferers who’re susceptible to extreme hypoglycaemia, it is strongly recommended that glucagon injection ought to be saved at house and the bystander ought to be skilled in giving a glucagon injection which might carry up the blood sugars quickly. But usually, blood sugars would hardly ever go all the way down to that degree. Usually, hypoglycaemia could be very gentle or average and could be simply corrected with the consumption of energy which might carry the blood sugars up.”

Low sugar could be handled at house. The rule of 15 works by which if the sugars are under 70, in actual fact between 55 and 69, 15 gms of carbohydrates ought to be given and sugar ought to be checked after quarter-hour, and this course of ought to be repeated until the time the sugar is just not within the vary. Now how one can calculate 15 gms of carbohydrate? Roughly one teaspoon of sugar is round 4 and a half grams of carbohydrates. Short of that you might give juice, honey, and glucose. At this time limit, I might counsel that you do not waste your time making candy tea or sherbet as a result of to start with each second is treasured, so don’t waste time in getting ready. Obviously, the tea is scorching, and the particular person can not gulp it in a single go, subsequently it’s best prevented. The finest option to go is juice, glucose and naturally sugar. Now if the affected person is unconscious, please don’t give him any juice or something to eat, as a result of it is going to go into the windpipe and the trachea and should choke the affected person. So, by that point what you are able to do is that you might make a paste out of sugar and rub it on the mouth, under the lips or contained in the cheeks, explains Dr Kapoor.

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