What to Do When You Have Hypoglycemia

0:00
Welcome to the Diabetes Digital Podcast.

I’m Wendy.

And I’m Jess, and we’re best friends, registered dietitians and diabetes educators.

Through our telehealth platform, Diabetes digital.co, we offer accessible and personalized virtual nutrition counseling for people with diabetes and pre diabetes.

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Visit diabetesdigital.co That’s Co to book your first appointment.

We accept insurance and offer affordable self pay options.

Now let’s get into today’s episode.

Welcome back everyone.

Thank you so much for tuning into the Diabetes Digital Podcast presented by Food Heaven.

0:36
We are going to be covering a very important topic that isn’t often talked about when it comes to diabetes and that is hypoglycemia.

And if you’re wondering hypo, what hypo who hypoglycemia means low blood sugar.

0:52
And we are going to talk about our top ways for preventing low blood sugar and also managing it because it is something that can happen quite frequently, especially if you’re taking blood sugar lowering medications.

Also, this podcast is for informational purposes only and should not be considered a substitute for medical advice.

1:11
Now before we jump in, I just want to point out that many people think that eating for diabetes means eating low carb.

I can’t tell you the number of times we get a new client, a patient, and they say that they have diabetes, they’ve recently been diagnosed and they have cut out all carbohydrates or all sugar.

1:32
And they believe, and sometimes they’ve been also told by their doctor that they need to do this for their health.

But not eating enough carbs can actually lead to hypoglycemia or low blood sugar, which we’re going to talk about in this episode.

Yeah.

And the thing with hypoglycemia is that often times you might not have symptoms, but for many people it’s kind of a toss up, right?

1:55
Some people, they don’t have symptoms, some people do.

Especially like I said, if you’re on those medications, that can drop your blood sugar below 70.

So some of the common symptoms might include shakiness, sweating, you’re irritable.

Think about how you feel when you’re really hungry.

2:13
So I mean, because I’ve used a glucose tracker like one of those CGM’s and it very much aligns.

Like when my blood sugar drops in the 40s, fifties and 60s, I’m like, OK, I mean, for me personally, I can feel it immediately.

So it’s like even if you don’t have diabetes, I’m sure that you can relate where like if you’re feeling hungry and you haven’t had food in hours, your blood sugar is going to drop and it’s super unpleasant.

2:37
Yeah.

And it’s really important to maintain your blood sugar levels within the recommended ranges.

And we’re going to talk about what those ranges are, especially for people who have diabetes because what this is going to do is help stabilize your energy levels.

You’ll also have better mental function.

2:53
So as Wendy mentioned she does not have diabetes.

But whether you have diabetes or not, or pre diabetes, when your blood sugars are all over the place, it doesn’t feel good mentally and physically.

Nothing is worse than feeling hungry, feeling irritable, feeling confused.

3:08
I know for me one of the symptoms of my blood sugar is dropping is I struggle to concentrate and I get very very irritable.

I sometimes have to give my husband a warning that my blood sugars are low.

So stay.

Away.

Also, hypoglycemia can be really, really dangerous when it happens often.

3:27
And I think people don’t realize this and maybe think, Oh, my blood sugar is low.

So that’s a good thing, but it’s actually a dangerous thing.

And when you have diabetes, you really have to be able to identify the symptoms of hypoglycemia and know how to treat it so you can avoid having to go to the ER.

3:43
The other thing I want to point out is that symptoms vary from person to person.

And some people may experience headaches consistently where other people may get different symptoms or they might get 5 symptoms at once.

So it’s really important to pay attention to what is happening within your specific body.

3:59
Yeah.

So let’s talk about what hypoglycemia is concerned considered.

So I mentioned this earlier, but if you have a blood glucose that is lower than 70, that is considered to be hypoglycemia.

We mentioned some symptoms, but I wanna provide a more extensive list so that you’re able to better identify them.

4:20
If you’re shaking or trembling, this is a very common sign of hypoglycemia.

It can affect your hands, other parts of your body.

You might start sweating, even if it’s not necessarily warm.

That could be like a red flag that your blood sugar is dipping too low.

4:38
The mood changes that just mentioned, you know, and that’s like, I think that’s very relatable.

When you’re hungry, you start becoming very irritable.

You get hangry.

It’s just you’re not feeling so good.

I’m hungry.

That’s another one where it makes a lot of sense.

4:54
If you haven’t eaten, your blood sugar is falling.

It’s like your body sign to you that, like it really needs some food and it needs to bring up that blood sugar feeling weak and fatigued.

That is also another common symptom, especially if you find that it’s really difficult to perform like your everyday task that you usually do.

5:13
Other symptoms include feeling dizzy or lightheaded.

These are common for me as well.

Some people may experience dizziness and Lightheadedness, especially when they stand up quickly.

So pay attention to that difficulty concentrating.

As I had mentioned before, that’s a big one for me too.

5:30
It can impact your cognitive function and you can feel like you’re not able to think as clearly or you have brain fog and that can really be low blood sugar.

Also, blurred vision, changes in vision, such as blurriness can occur during an episode of hypoglycemia headaches.

5:46
We mentioned this as well, and one symptom that people don’t often think about is nausea.

So feeling nauseous or having an upset stomach can also be associated with low blood sugars.

Yeah.

So if you’re wondering, well, why would I be getting hypoglycemia, there’s so many different reasons.

6:06
I mean, sometimes the obvious answer is like, you didn’t eat, but it could be a lot more complicated than that.

There are medications that are known to cause hypoglycemia.

Insulin is like the biggest one.

So if you’re taking either type of insulin, whether you’re taking a basal or bolus insulin or like an intermediate, all of those can cause hypoglycemia, especially if you didn’t eat and you still use your insulin didn’t make that adjustment.

6:35
That is like a very common thing that happens.

Also there are you know other medication classes like Sefano, Rias, Maglitinides, those are oral medications.

One of the Sefano Rias that are most popular is known as glipizide and that commonly will cause hypoglycemia.

6:54
There’s also like combination medication, so metformin, which a lot of people are familiar with, it comes in combination with glipizide.

So when you take those together, because usually metformin won’t cause hypoglycemia, but if you take it as a combination it might.

7:09
So that’s just something to pay attention to.

Also, drinking a lot of alcohol, especially if you’re drinking alcohol on an empty stomach, it could lead to hypoglycemia.

Because the liver’s ability to release glucose, it can be impaired by alcohols.

7:26
It’s just a very scary situation because already when you’re drinking, you might not be in your normal headspace, you might not be paying attention to your body’s cues, you’re losing all inhibition.

And then you might have an incident where you’re like passing out, and it’s just like a bad combination of events.

7:43
So I always recommend if you’re going to be going out for drinks, if even if you’re having drinks at home, whatever.

Just make sure you have something to eat.

Make sure you have some kind of appetizer, a meal so that you’re not doing it on an empty stomach.

A couple of other things that can cause hypoglycemia include other medical conditions.

8:02
So for example, liver disorders, kidney disorders, some conditions that affect the liver like hepatitis or liver disease can have an impact on the organs ability to release stored glucose which can contribute to low blood sugar.

And in terms of kidney disorders, certain conditions that affect kidney function can have an impact on the ability of your body to get rid of insulin and other medications which can lead to hypoglycemia.

8:31
And then one of the most common, in addition to the things that Wendy had mentioned, like being on insulin is delayed or missed meals.

So going too long without eating, skipping meals, not eating enough carbohydrates, they can all result in low blood sugar levels.

8:48
Which is why it’s so important to try and get a balance of different food groups on your plate and eat consistently and adequately.

Yes.

And with that, we specifically mean not having less than three meals a day, OK.

So if you know that you’re prone to hypoglycemia, you don’t want to be skipping meals, especially if you’re on some of these blood sugar lowering medications.

9:11
So you have to have your three solid meals a day always include some kind of carbohydrate and then you can include your snacks in as well.

You don’t have to force it.

It’s not like you have to force yourself to eat if you’re not actually hungry, but I would say at least having three meals and and if if your body can use some additional snacks for energy, 123 snacks throughout the day just to keep your blood sugars as stable as possible.

9:37
Physical activity I want to mention as well because when you’re working out, your body is using up glucose in the blood and so it makes sense that you know it can increase your risk for getting lows.

So something that I recommend is having a snack before you work out.

9:53
And this is going to be especially relevant if you’re on some of those medications that we mentioned earlier.

So it doesn’t have to be anything crazy because I get that it could be uncomfortable to like, eat something that’s a little heavier before working out, like maybe your stomach hurts.

So let’s say you have a snack.

10:10
What are some of your like favorite pre workout snack stress?

Banana or half a banana?

Yeah, that’s pretty much my go to.

Just because you get that quick release of glucose of sugar into the bloodstream, it doesn’t take a long time for it to break down.

10:26
It’s easy.

What about you?

Yeah, I think fruit is like my goal to as well because it breaks down easily.

I usually if I eat something even like the slightest bit heavy, like if it has any kind of fat, like nuts for example, I start getting reflux while I’m working out.

10:41
So it has to be just very gentle, even too much fiber.

It might cause some reflux for me.

So I’ll do something simple like watermelon where it’s like really easy to digest.

Or I’ll just kind of blend up some fruit and water and drink that.

Everyone’s different, right?

10:56
So if you can stomach like something like a boiled egg or granola bar before working out then perfect.

But you know always try to just have something to feel your workout so you’re not working on an empty stomach.

Also hormonal imbalances, I feel like that is not spoken about enough.

11:13
I actually had a patient recently, she had type 2 diabetes and she was getting consistently hypoglycemia and it was really interesting because her A1 CI believe it was like around the 7% range.

So it wasn’t like her A1C was like 4%, but she would consistently get these lows like in the 40s and 50s, and it didn’t necessarily align with the A1C.

11:38
And she had really unpleasant side effects to the point where like she couldn’t even leave the house.

Sometimes she would be scared because she would she would start getting like just really weak.

I think at one point she like passed out while she was outside and turns out she had like some kind of disruption in her endocrine system.

11:57
She had to see an endocrinologist.

There’s a lot of different conditions related to, you know, hormone imbalance, but that could definitely be something too.

Like, if you see that, it’s like you’re consistently getting these lows.

You’re eating, you’re eating one, taking your medications, you’re not maybe even on insulin, and it’s still dropping like 40s, fifties, 60s, then that’s definitely something to ask your doctor about, and maybe even see if you can get a referral to see an endocrinologist.

12:25
Agreed.

And the reason why we’re doing all this And we want to get tested and all these things because it’s so important to detect early and manage the condition.

I know we probably said this before this podcast, but the worst type of diabetes is uncontrolled diabetes or diabetes that you’re not managing.

12:44
As we mentioned, you really want to notice those warning signs we discussed earlier, make sure that you’re regularly monitoring your blood sugar if you do have type one or type 2 diabetes.

And the reason why we don’t want to have continued hypoglycemic episodes is because they can lead to confusion, seizures, unconsciousness and in some extreme cases, coma.

13:07
So this is one of the most important things that we as dietitians look at with our patients who have diabetes is are they having these low episodes?

What’s causing them and how can we prevent them moving forward?

And also for some people, like if you’re getting hypoglycemia frequently, you might develop something called hypoglycemia unawareness, which means that your body is not even registering the typical warning signs of blood sugar.

13:33
So you might not be getting dizzy or hungry or having the shakes and this makes the risk for severe hypoglycemia even higher.

So you know, I mentioned earlier like timing your meals and snacks is going to be really important, making sure to include carbs, protein and fat in your meals.

13:54
And even with your snacks, you know, like for example, let’s say you have a fruit, you can pair it with some cheese or with some nuts just so that you have a better balance of protein, fat and carbs.

This will help to provide some stability as well.

Now I think it’s going to be helpful just if we go over some things that people should have on hand if they do have hypoglycemia, because the reality is that it happens, You know, this is real life.

14:17
So we want to give you some snack ideas or just like things that are important to carry, so that if you do get hypoglycemia, you’re well prepared.

OK, so some of the portable and convenient on the go options that we recommend are having things that contain 15 grams of carbohydrates and little to no fat or protein.

14:38
You also want things that are easily consumable.

So if there’s something that has a bunch of wrappers or it’s hard to kind of get out of the thing when you’re having low blood sugar, that’s not going to be ideal as it go to.

So here are a couple of things that you can try to have on hand.

One is fruit juice.

14:54
Even those little fruit juice pouches that you can put in your purse or bag that are easily accessible.

Orange juice, anything that has those quick sugars that will bring your blood sugar up.

Also soda.

The sugar content in soda can help raise your blood sugar quickly, so that’s something that you may want to have in your purse as well.

15:14
And a couple of other examples are candy, honey, glucose tablets, sugar tablets, gummies, All of these things typically can contain about 15 grams of carbohydrates and help bring your blood sugar up.

Now in terms of the process for if you are having hypoglycemia, it’s kind of like this 15 rule.

15:34
So number one, as I’ve already mentioned, you want to make sure to consume 15 grams of carbohydrates and all the things that I mentioned, the fruit juice, the gummies, the soda, the candy, honey, those all contain, for the most part, pure carbohydrates and will include the 15 grams.

15:51
The second thing you want to do is after you consume the food or juice is wait 15 minutes.

That’s going to give your body a chance for your blood sugar to go back up to target and get out of that hypoglycemic range.

And then after the 15 minutes, you recheck your blood sugar and make sure that it is above 70.

16:09
And if it’s not above 70, you’re going to repeat this process, the 15 grams of carbs, waiting 15 minutes until you get to the 70 mark.

Exactly.

And with the soda and with the juice, because I know for my people that have diabetes, they buy a lot of diet alternatives.

16:26
Please do not drink diet soda or diet juice.

It’s not going to bring up your blood sugar because it has artificial sugar.

So you’re still going to remain in the hypoglycemia range.

So make sure it is just regular, regular juice and soda that has real sugar in it.

16:44
Because you know, like typically for people that have diabetes, these aren’t things that are considered the healthiest.

Like, Oh yeah, I have candy, I have soda.

But you have to remember, like, doing this will be life saving because it’s going to be quick.

It’s going to raise your blood sugar within those 15 minutes.

And that is the whole point.

17:00
We’re not saying just like eat these things on the regular.

It’s like you want to eat it specific to like this entire scenario and have them on hand.

All right.

So we hope you learned something new.

Thank you so much for tuning in and we will catch you next week.

And if you are looking for a holistic and personalized approach to diabetes management or prevention, look no further than Diabetes Digital.

17:24
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17:48
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18:11
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18:31
We’ll catch you later.

Bye.