Hypoglycemia in type 2 diabetes mellitus: types, symptoms and treatment

Diabetes and blood pressure surges will be a thing of the past

Diabetes is the cause of almost 80% of all strokes and amputations. 7 out of 10 people die due to blockages in the arteries of the heart or brain. In almost all cases, the reason for such a terrible end is the same - high blood sugar.

You can and should beat sugar, there is no other way. But this in no way cures the disease itself, but only helps fight the consequence, not the cause of the disease.

The only medicine that is officially recommended for the treatment of diabetes and is also used by endocrinologists in their work is the Dzhi Dao Diabetes Patch.

The effectiveness of the drug, calculated according to the standard method (the number of recovered patients to the total number of patients in a group of 100 people undergoing treatment) was:

• Normalization of sugar – 95%
• Elimination of vein thrombosis – 70%
• Eliminate palpitations – 90%
• Relief from high blood pressure - 92%
• Increased vigor during the day, improved sleep at night - 97%

Manufacturers of Zhi Dao are not a commercial organization and are funded by the government. Therefore, now every resident has the opportunity to receive the drug at a 50% discount.

Healthy people don’t even think about what complex processes occur in their body after a regular breakfast. The digestive organs process incoming carbohydrates and saturate the blood with sugar. The pancreas, in response to increased glucose levels, produces the required amount of insulin. The latter, in turn, signals to the tissues that it is time to eat and helps sugar get inside the cell. Several chemical reactions occur in the cell, as a result of which glucose breaks down into carbon dioxide and water, and the body receives the energy it needs. If a person goes to work out, the muscles will need more sugar, and the liver will borrow what is missing. During the next meal, glucose reserves in the liver and muscles will be restored.

With diabetes, patients are forced to manually regulate the process of glucose absorption by controlling its intake from food and stimulating its absorption by cells with the help of glucose-lowering drugs and insulin. Naturally, artificially maintaining blood glucose cannot do without errors. When there is more sugar in the blood than it should be, it begins to destroy the patient’s blood vessels and nerves, and hyperglycemia occurs. Sometimes there is not enough glucose and hypoglycemia develops.

The task of a diabetic patient is to ensure that these fluctuations are minimal and to promptly eliminate deviations in blood sugar from the normal level. Diabetes without sudden spikes in sugar is called compensated. Only long-term compensation of diabetes guarantees an active and long life.

Additionally : Impaired glucose tolerance - what does a diabetic need to know about it?

Glycemic disorders

Hypoglycemia is a condition characterized by a decrease in blood glucose concentration. This condition is manifested by the appearance of adrenergic and neurological symptoms. What it is? Glycemia regulates the activity of all structures of the body. Namely, its decrease is characterized by inhibition of brain activity. Neurological symptoms include headaches, lethargy, drowsiness, sweating, apathy, and mood changes. The adrenergic symptom complex includes small or sweeping tremor, convulsive syndrome, depression of consciousness, even coma.

• nutritional disorders – decreased intake of glucose into the body from food;
• inflammatory processes of the digestive tract that interfere with glucose absorption;
• strong physical activity;
• kidney diseases that increase the excretion of glucose from the body;
• liver diseases that impair the breakdown of glycogen;
• endocrine disorders.

Causes of hypoglycemia

The causes of hypoglycemia are quite varied. They include not only lack of nutrition or overdose of drugs in diabetes mellitus, but also a drop in glucose levels for physiological reasons and due to pathology of various organs.

In diabetes, hypoglycemia can also be caused by errors in treatment:

1. Overdose of insulin or sugar-lowering drugs.
2. After taking medications, a diabetic patient forgets to eat.
3. Malfunction of the glucometer or insulin delivery devices.
4. Incorrect calculation of the dose of drugs by the attending physician or a patient with diabetes - calculation of the dose of insulin.
5. Incorrect injection technique - how to administer insulin correctly.
6. Replacing low-quality insulin with fresh, better-acting insulin. Changing short-acting insulin to ultra-fast insulin without dosage adjustment.

Diet for hyperglycemia

If your blood glucose level is high, you should first eliminate simple carbohydrates from your diet and reduce the consumption of complex carbohydrates to a minimum. It is poor nutrition that becomes the main cause of a disease such as hyperglycemia.

Symptoms of metabolic disorders can be eliminated with dietary nutrition. The diet is not strict, it is only important to follow certain rules:

• to drink a lot of water;
• avoid long breaks between meals - that is, eat little and often;
• minimize the consumption of spicy and fried foods;
• eat large amounts of fresh vegetables and fruits (mostly unsweetened);
• increase the amount of protein foods in the diet (meat, eggs, dairy products);
• For desserts, use only dried fruits or sweets intended for diabetics.

Drinking plenty of fluids and exercising (in particular, gymnastic exercises) will quickly reduce your sugar level.

Symptoms: first signs of hypoglycemia

The severity of symptoms increases as blood sugar drops. Mild hypoglycemia requires treatment within half an hour after occurrence, otherwise the decrease in glucose progresses. Most often, the signs are quite obvious and easily recognized by patients. With frequent hypoglycemia, constantly low sugar levels, in elderly people and with a significant history of diabetes, the symptoms may be erased. In such patients, the likelihood of hypoglycemic coma is the highest.

Hypoglycemia during sleep can be recognized by clammy, cold skin and rapid breathing. A diabetic patient wakes up from a disturbing dream and feels tired after waking up.

VERY IMPORTANT: WHAT TO DO IF YOUR BLOOD SUGAR FALLS SHARPLY

Diagnostics

Like fever, hypoglycemia is a sign of another problem. Diagnosing hypoglycemia is easy because a simple blood test can determine whether your blood sugar levels are too low. However, if you do not have diabetes, your doctor will need to find out what is causing the hypoglycemic state or hypoglycemia-like symptoms.

How to give first aid correctly

As soon as a diabetic feels any symptoms that can be attributed to the consequences of hypoglycemia, he immediately needs to measure his blood sugar. To do this, you should always have a glucometer with strips with you. First aid for hypoglycemia is the oral intake of fast carbohydrates. For a slight increase in sugar, this is enough to completely normalize the patient’s condition.

Low blood sugar before meals is not a reason to delay treatment of hypoglycemia in the hope that carbohydrates from food will eliminate it. A diabetic diet requires a significant restriction of easily digestible sugars, so hypoglycemia may worsen even before the food is digested.

Relief of hypoglycemia at the beginning of development is carried out with the help of glucose tablets. They act faster than other drugs, since absorption into the blood when used begins in the oral cavity, and then continues in the gastrointestinal tract. In addition, the use of tablets makes it easy to calculate the dose of glucose that will eliminate hypoglycemia, but will not lead to hyperglycemia.

On average, in a person with diabetes weighing 64 kg, 1 g of glucose provokes an increase in blood sugar by 0.28 mmol/l. If you weigh more, you can calculate the approximate effect of a glucose tablet on your sugar levels using the inverse proportion.

With a weight of 90 kg there will be an increase of 64*0.28/90 = 0.2 mmol/l. For example, sugar dropped to 3 mmol/l. To raise it to 5, you will need (5-3)/0.2 = 10 g of glucose, or 20 tablets of 500 mg.

These tablets are inexpensive and are sold in every pharmacy. If you have diabetes, it is advisable to buy several packs at once, put them at home, at work, in all bags and pockets of outerwear. To eliminate hypoglycemia, you should always have glucose tablets with you.

In extreme cases, sugar can quickly rise:

• 120 g sweet juice;
• a couple of sweets or pieces of chocolate;
• 2-3 cubes or the same number of tablespoons of refined sugar;
• 2 tsp honey;
• 1 banana;
• 6 dates.

Signs of hypoglycemia in diabetes can be observed within an hour after sugar normalization. They are not dangerous and do not require additional intake of sweets.

Normal sugar level

The level of glycemia in plasma, which ensures the normal functioning of the human body, is regulated by insulin.
If this hormone is produced in insufficient quantities, or tissues begin to react to the substance inadequately, then the concentration of sugar in the blood increases.

There are certain approved standards for women, men, children and pregnant women.

In adult women and men

For men and women aged 20 to 49 years, a plasma glucose concentration of 3.5-5.5 mmol/l is considered normal.

As we age, tissue sensitivity to insulin decreases. This is explained by the fact that some of the receptors die and weight increases.

Therefore, for 50-90 year olds, values ​​of 4.6-6.4 mmol/l are considered optimal. For people over 90 years of age, plasma sugar up to 6.7 mmol/l is considered normal by doctors.

The child has

Sugar standards for children are not the same as for adults. In healthy newborn babies from 2 days to a year, glucose is at a level of 2.8-4.4 mmol/l . In the period from one year to 14 years, this figure rises to 3.3-5.0 mmol/l. For 15-19 year olds the standard is 3.3-5.3.

In pregnant women

Typically, in women carrying a child, the glycemic standard is 3.5-6.6 mmol/l.

But, if pregnancy occurs at the age of 30, then minor deviations are acceptable.

Expectant mothers should monitor their sugar levels: since there is a risk of developing gestational diabetes due to a decrease in amino acids and an increase in the number of ketone bodies. Usually, during a normal pregnancy, sugar increases towards the end of the second or third trimester. Then a value of up to 7.8 mmol/l is considered optimal.

When determining the glucose content, it is necessary to take into account what kind of blood was used for analysis: from a finger or a vein. After all, the results may differ slightly. So, for capillary blood the norm is 3.5-5.5, for venous blood - 3.5-6.1 mmol/l.

How can you treat and stop hypoglycemia?

If a diabetic patient has already begun to starve the brain, he is not able to help himself on his own. Impaired ability to chew food makes treatment difficult, so glucose will have to be given in liquid form: either a special drug from a pharmacy, or sugar or honey dissolved in water. If there is a tendency to improve the condition, an additional 15 g of complex carbohydrates should be given to the patient. It could be bread, porridge, cookies.

When a diabetic patient begins to lose consciousness, he should not be given oral glucose due to the risk of asphyxia. In this case, hypoglycemia is treated with intramuscular or subcutaneous injection of glucagon. This drug is sold in pharmacies in the form of emergency kits for diabetes. The kit includes a plastic case, a syringe with solvent and a bottle of glucagon powder. The lid of the bottle is pierced with a needle and the liquid is squeezed into it. Without removing the needle, shake the bottle well and draw the drug back into the syringe.

Glucagon stimulates the rise of sugar, causing the liver and muscles to release glycogen residues. Consciousness should return to the patient within 5 minutes after the injection. If this does not happen, the patient’s glucose depot is already depleted and a second injection will not help . You need to call an ambulance, which will administer glucose intravenously.

If a diabetic feels better, after 20 minutes he will be able to answer questions, and after an hour almost all symptoms will disappear. During the day after glucagon administration, increased attention should be paid to blood sugar and a glucometer should be used every 2 hours. A repeated drop in performance at this time can be rapid and deadly.

What to do when a diabetic loses consciousness:

1. If you have a glucometer, measure your sugar.
2. If the level is low, try pouring a sweet liquid into his mouth, making sure that the patient swallows.
3. If you don't have a glucose meter, you should assume that giving carbohydrates to a diabetic is less dangerous than not giving them.
4. If swallowing is impaired, administer glucagon.
5. Place the patient on his side, as he may vomit.
6. If the condition does not improve, call an ambulance.

Treatment

According to statistics, 4% of patients diagnosed with diabetes die every year from hypoglycemic coma. About 10% of people (non-diabetics) experience unpleasant symptoms of a severe drop in glucose levels. To avoid bad consequences, you need to know how to provide first aid for hypoglycemia, how to get rid of frequent attacks.

First aid for a hypoglycemic attack

If the glucose level has decreased due to fasting, malnutrition, or an overdose of diabetic drugs, then you need to eat food containing fast carbohydrates:

• chew 4-6 candies;
• take 2-3 glucose tablets;
• drink a glass of milk;
• eat a tablespoon of honey;
• drink half a cup of some sweet drink;
• eat a tablespoon of sugar.

After a quarter of an hour, you should test with a glucometer. If your health has not improved, and the device showed a result below 3.5 mmol/l, then you still need to eat something from the above. If the condition does not return to normal, then emergency assistance is called.

In order to prevent a recurrence of the attack, it is recommended to eat a product containing long carbohydrates (porridge, bread, cookies).

Medicines

To relieve an acute attack of hypoglycemia, a 40% glucose solution in an amount of 40-60 ml is administered intravenously to a person. If this does not give the desired effect, then 0.3-0.5 ml of a solution of adrenaline hydrochloride with a concentration of 0.1% is administered parenterally. Diazoxide or Octreotide are also used.

The drug Octreotide

Chronic hypoglycemia can be treated with the following drugs:

• Prednisolone;
• Dexamethasone;
• Glucagon.

Folk remedies

Some plants have hypertensive properties and normalize glucose metabolism. These are St. John's wort, rose hips, lingonberries, garlic, oregano, sea buckthorn, yarrow. Decoctions of them are often used to treat and prevent hypoglycemia.

The following fees are also effective:

• plantain, wheatgrass, chamomile, St. John's wort, marsh cudweed, burnet are taken in the amount of two grams, and wormwood and licorice - one gram each. The herbs are mixed and poured with 400 ml of water. Boil for 45 minutes and leave. The resulting medicine is taken daily for a month, three times a day;
• Leuzea and lemongrass are mixed, brewed and drunk three times a day.

Medicines and traditional methods must be used correctly so as not to cause hyperglycemia. To do this, you should carefully select the dose and monitor it with a glucometer.

Diet

You can avoid attacks of hypoglycemia by adjusting your diet and using a balanced diet.
You need to avoid eating simple carbohydrates and give preference to complex ones.

You need to eat in small portions, but often. It is better to increase the calorie content of the diet to 2500 kcal.

If fluctuations in sugar occur due to a lack of vitamin C, then the menu should be enriched with fresh vegetables, herbs and fruits. Recommended are liver, walnuts, kidneys, eggs, heart, cheese, bran. It is better to limit potato dishes: they can disrupt glucose metabolism.

Watch your nutrition!

⚠ Treatment of hypoglycemia depends on the cause of its occurrence and is aimed at eliminating this very cause. Diet plays an important role in its treatment.

⚠ Refined sugars (including honey, molasses, sugar, etc.), white flour and other products containing pure starch must be excluded from the diet.

⚠ Food is taken in fractional portions at least six times a day (instead of three in larger quantities).

⚠ Six meals a day should contain enough protein in the form of meat, fish, poultry and dairy products with a free choice of fruits, vegetables and unground grains. Caffeine-containing medications and products (such as coffee and cola) should be avoided.

WARNING, DANGER!

✅ Hypoglycemia in diabetes sufferers appears sharply and quickly, like an attack . In this case, a person may even lose consciousness.

✅ Some people with diabetes experience hypoglycemia without warning, starting immediately with loss of consciousness .

✅ Hypoglycemia without warning may also be caused by diabetes patients taking the drug anaprilina (obsidana) .

✅ Nighttime hypoglycemia in diabetes can manifest itself as nightmares and sweating at night. The person may also wake up sweating with palpitations and feeling hungry.

✅ Sometimes a diabetic patient with hypoglycemia develops confusion, then he can behave “ like a drunk .”

Fact

If the father in the family has type 1 diabetes, then the risk of developing diabetes in the child is 6%, if the mother is sick - 1%. The risk level for type II diabetes is completely different: for relatives of patients, the risk of developing the disease after 40 years of age is 25-30%, and if both parents are sick, then the risk is already 65-70%.

What to do in case of hypoglycemia: advice to the patient

After taking sugar during an attack, you should eat a sweet apple, then lie down for 10 minutes , waiting until all symptoms disappear.

Thus, you can independently relieve an attack with the help of products that contain sugar, which is absorbed very quickly and increases the glucose level in the blood within 5 minutes.

However, this does not yet allow the attack to be completely relieved, since the eaten sugar causes a rapid increase in glucose, which then drops just as quickly due to the continued action of insulin.

To compensate for the 2nd wave of a hypoglycemic attack, you need to take a product containing “slow” sugar, for example, a sandwich with rye bread.

Source: diabetes.guru

Stages of the disease

Medicine considers four stages of hypoglycemia, including coma.

First degree, mild

Decreased performance, lethargy, hand tremors. Determined by the patient himself, it is relieved by taking easily digestible sugars - candy, cookies, sweet tea.

Preschool children cannot assess their condition themselves; adult supervision is required.

Mild hypoglycemia causes them to become lethargic and want to eat “something sweet,” after which the child’s activity is restored.

Second degree, moderate

The patient can observe his condition, communicate with others and turn to them for help, but he can no longer provide help to himself - the state is semi-fainting.

Possible irritability, tremors, sticky cold sweat. Moves with the help of others, but can drink sweet drinks and eat foods with fast carbohydrates.

It may be necessary to use insulin-lowering drugs. It is recommended to consult a specialist.

Third degree, severe

The patient is on the verge of a coma, consciousness is confused or absent, convulsions, low temperature with hypoglycemia are a common occurrence.

Medical intervention is necessary and urgent therapy is required to prevent hypoglycemic coma.

Fourth degree, coma

The patient is unconscious, there may be a lack of breathing, muscle hypertonicity, and a near-death state. Risk of cardiac and brain arrest, urgent medical attention required!

Hypoglycemic coma develops rapidly within minutes, less often hours. Be sure to call qualified doctors and take the patient to a medical facility.