Preventing Hypoglycemia - Understanding Hypoglycemia: Diabetes A Plan For Living

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Preventing hypoglycemia

Preventing hypoglycemia is preferable to treating it. On the other hand, current intensive therapy for type 1 diabetes isn't an exact science. Your blood glucose levels may be pushed close to the hypoglycemic range, especially during pregnancy, when very tight control is desirable. The art of diabetes care is to balance the long-term need for near-normal control against the short-term risks and discomfort of hypoglycemia.

Whenever you change your meal schedules, activity levels, and medications, step up your monitoring of blood sugar levels, and be ready to adjust your insulin or other blood sugar-lowering medications. Remember to discuss these changes with your health care team. If you're a person with type 1 diabetes following intensive treatment, check your 3 a.m. glucose level periodically to detect hypoglycemia during sleep, and make adjustments to prevent its reoccurrence. Experts also strongly recommend that people with type 1 diabetes check their blood sugar before driving a car or engaging in other potentially dangerous activities.

If you're taking insulin, it's likely that despite your best efforts, you'll experience hypoglycemia at some time, although the risk is higher for people with type 1 diabetes than for those with type 2 diabetes being treated with insulin and sulfonylureas. For the latter, low blood sugar usually occurs only with a change in eating patterns, such as missing a meal. But if you binge-drink alcohol, have irregular eating patterns, or have liver or kidney disease, you are at particular risk.

For people with type 1 diabetes, mild hypoglycemic episodes (involving hunger, slight shakiness, and an exaggerated realization that mealtime is at hand) may occur as often as once a day. More severe reactions, which require another person's help, occur on average once every 18 months in people treated with intensive therapy, compared with once every five years in those treated less intensively. The most severe cases, including seizure or coma, occur on average no more than every 5–6 years with intensive therapy and once every 20 years with conventional therapy.

Keep in mind that these are average estimates from the Diabetes Control and Complications Trial. Not everyone experiences such severe hypoglycemia. However, if you start having major episodes, they're likely to recur if you don't seek guidance from your doctor and follow through on his or her advice.

Last updated:	January 23, 2007