Diabetes Self-Management Blog

The dangers of low blood glucose are familiar to most people who have Type 1 diabetes, but a new survey designed by the American College of Endocrinology shows that a majority of people with Type 2 diabetes have experienced low blood glucose as well. Roughly 24 million people in the United States have been diagnosed with Type 2 diabetes.

Low blood glucose, also known as hypoglycemia, is generally considered to be a blood glucose level below 70 mg/dl. Symptoms can include weakness, drowsiness, confusion, hunger, dizziness, paleness, headache, irritability, trembling, sweating, rapid heartbeat, and a cold, clammy feeling; in severe cases, hypoglycemia can lead to a loss of consciousness or coma. Common causes of hypoglycemia include skipped meals, intense exercise, and certain diabetes medicines, such as insulin, meglitinides (brand names Starlix and Prandin), and sulfonylureas (Diabinese, Diabeta, Glynase, Micronase, Glucotrol, Glucotrol XL, and Amaryl).

The online survey, which sought to determine people’s knowledge of and experiences with hypoglycemia, was conducted in November and December 2010 and looked at 2,530 adults who had been diagnosed with Type 2 diabetes. It found that 55% of those surveyed had experienced low blood glucose, with many of the episodes occurring during daily activities such as working, driving, and exercising. The survey also found that a portion of people with Type 2 diabetes was not familiar with the common causes of hypoglycemia.

Etie Moghissi, MD, FACP, FACE, vice president of the American Association of Clinical Endocrinologists and associate clinical professor of medicine at the University of California, Los Angeles, notes that “The survey shows that it’s important to inform patients about the causes, symptoms, and how to address hypoglycemia… Low blood sugar can be an alarming experience for people with Type 2 diabetes, and failure to recognize and treat symptoms in a timely manner can cause serious complications. Low blood sugar can be avoided, so it’s important for patients to know what can cause blood sugar levels to drop and talk with their doctor about how they can reduce the frequency of future episodes.”

Treatment for low blood glucose typically involves eating or drinking something with sugar in it, such as candy, juice, or glucose tablets or gel.

Fore more information about the survey, read the article “Patients With Type 2 Diabetes Lack Knowledge About Hypoglycemia.” And to learn more about what causes hypoglycemia and how you can prevent it, check out the article “Understanding Hypoglycemia” or see the survey’s affiliated Web site, BloodSugarBasics.com.

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Comments
  1. Ahmen to those comments. When my pancrease decided to add more insulin on top of my treatment - look out one can have real fun as well as when one is really doing hearty exercise.

    I canned my starlix pills, changed insulin type from 75/25 to standard Humalog lispro and dropped the dosages and use cgms to tightly control without grief. 12 hour lasting insulin and 10.5 hour lasting glyburide can be right pain in backside.

    Posted by jim snell |
  2. It seems to me that Type 2’s are generally undereducated in just about every aspect of diabetes care. Good diabetes education is MORE important than the routine doctor’s visit. Try telling the insurance companies that. And to many Type 2’s their diabetes doesn’t seem to be that much of a big deal, because in the beginning, they feel just fine. A Type 1 HAS to learn about diabetes, because if they don’t do things just right they get very sick, and maybe die. A Type 2 can ignore it until complications set in. Frequent visits to a CDE would really help hammer in the point that Type 2 is just as serious as Type 1, and diabetes education with more than just one visit should be covered everywhere.

    Posted by Natalie Sera |
  3. Nataie:

    Yes very valid points and in fact after my stroke I spent extensive time checking out on web and elsewhere attempting to learn all the data and issues I should have learned years ago.

    Not just user but the 20 minute 3 question interview at Doc’s office and its Eureka instant answer - here are pills and call me in morning contribute seriously to what you describe.

    In fact liver glucose leakage and partially working pancreas do in fact mask conditions till body stumbles.

    I always had trouble getting rational numbers on finger stick meter but thanks to 1 a day/4 a day tests back then and grunts from Doctor could not resolve from 30 years back.

    Today; extensive fingersticks and then CGMS, dam rights - got it. Dam liver and liver dumps is a serious issue badly handled by medical industry.
    Its all in your brain, no sweat - just walk more.

    Today with metformin - 5 doses 500 mg; 2 at night and 3 throughtout meals - 1 hour before and now I get ratioanl waveforms and data, a1c from 13.3 to 6.9 and proper insulin support in low doses and now running properly.

    Lack of education - hell yes and on many fronts I might add.

    Posted by jim snell |
  4. I am happy to see research has taken this direction. I was diagnosed Type 2 after having a stroke. I was under a lot of stress and I was just recovering from the worst sinus infection ever when thee stroke hit. This was astounding news as I had been told by a doctor 3 months before that I did not have diabetes…then WHAM!!! I have had to change doctors 4 times because of their concentration on obesity and not on the “whole” person. I found out the hard way that the drugs they put me on only made me gain more weight, which caused hypertension, etc. I always suspected my diabetes had an autoimmune element and possibly a strss component. I finally took charge of my health, switched to an almost vegetarian diet, test daily, take high grade supplements, eliminated excess sugar, etc. My A1c went from 11.7 to 5.7 I have not had a sinus infection in 3 years!!!
    My niece had Type 1 and died at 22 due to complications. I watched her valiantly struggle from age 5 and never thought of her condition as “separate” from mine. We are all in this together and anything that helps toward a “cure” is very welcome.

    Posted by Mary G |
  5. My doctors didn’t treat my diabetes as a big deal at first,so I didn’t either. Then leakage was found in both eyes, and I needed them lasered. That was my wake-up call.

    I have a lot of trouble controlling my blood sugar, so much so that a pump has been recommended for me. I haven’t agreed to it yet, but probably will very soon, since my sugars can go from 40 to 400 in a few hours time, especially now that I am considered insulin-dependent. Shouldn’t that make me a Type 1 1/2?

    Posted by Pat Weiser |
  6. My lowest glucose wakeup reading was 88 and my highest was a 162. My wakeup averages were:
    Jan - 121; Feb - 123; Mar - 127; & Apr - 121.

    My lowest bedtime glucose reading was 86 and my highest was a 238. My bedtime agerages were:
    Jan - 146; Feb - 144; Mar - 154; & Apr - 162.

    I have a 6 ounce glass of red wine three evening meals in any week. I do not drink beer or hard liquor and now that the warmer weather is here, I will begin walking again. 1.5 miles at least four days a week and I watch my diet. No ice cream, no candy, no white rice or white flour. I am 70 years old. I was going on Actos, but received a warning from the manufacturer and I do not take diabetes medication.

    I have been a type 2 diabetic for three or four years.

    Giving up beer and ice cream are major items to get away from, followed by chocolate.

    When I fail a reading, I make a computer entry regarding what I feel caused the high reading such as what I had to eat and did I exercise.

    Posted by Dave Ex |
  7. am glad to see at least some is doing some reasearch on hypoglysimia, I do not have diatetes either typo 1 or 2 but I was diagnos hypogysimic when I was 25 yo, and I have to know when my sugar is too low, below 20mg/dl, normal for me is around 40mg/dl to 50mg/dl, but I been as low as 10mg/dl, all those simtoms are thru, I remeber once my glucose level when so far down that I loss conciense while driving and almost crash the vehicule I was driving.

    Posted by zak |
  8. going through tons of hypogylcemia at present and working diligently and failing all over long acting levemir down from 24 units twice a day to ten and still no respite and the novalog short acting from 3carbs per unit to now 7 per unit some days it’s good and some days it right on the floor can’t do anything and worst of all no symptoms anymore really except the feeling of a big hole in the stomach at 80 it is too late but when i don’t catch it it is usually 65 and then takes 20 minutes to come back up and once falling it crashes fast and i’ve been doing this stuff 20 plus years and don’t even know where to start thinking right now jeez

    Posted by marylittle |
  9. my hypoglycemia was as low as 58 i ate ice crame it came up to 111 it happen when i was working in my garding my symptoms was sweating and weakness

    Posted by charlie c |
  10. I have been diagnosed with type 2 Diabetes several
    times by several doctors. They put me on oral
    medications and then later take me off the meds.
    I have had several hypoglycemic episodes and they
    are not a fun experience. My AM readings run
    from 95 to 115 now. I am not taking any medication
    at the present time. I keep a cereal bar with me
    at all times as I don’t know when I will have an
    episode when I feel the ‘light-headed–anxiety laced–heart racing’ feeling of doom that is what
    I experience. The only way I can avoid this is
    to keep track of when I last ate and how long it
    is going to be before I will again have food. My
    last experience with this was Easter Sunday. I
    had eaten Breakfast at 8:30AM and we were going
    to travel to relatives to eat Lunch at 2PM. I ate
    a half sandwich before we left home and took a
    cereal bar with me. We did not eat until 3:30PM.
    I was eating from a veggie tray by that time, and
    was getting nervious. I fust have to be prepared.

    Posted by Alice D. |
  11. Great article, Dianne! Brief, concise, well-thought.

    I’m a “recent member of the Type II Club” - it’s been about six months since my diagnoses. My hope is that I can keep the whole thing in check with diet and exercise… and it appears hopeful: Although I’m still using Glucotrol XL, my blood sugar has been coming down consistenly since I’ve begun consistent exercise and more closely watch my diet.

    For those of you who may not have experienced it, hypoglycemia can be FRIGHTENING. I didn’t take it seriously… couldn’t imagine my blood sugar dropping that low. But like Zak, I came close to losing consciousness recently while on an extended walk. I hadn’t eaten for nearly three hours when I left [STUPID!], and had no food with me on the walk. [STUPID x 2!] Luckily, a bicyclist came by and shared his lunch with me. Talk about good samaritan!

    Needless to say, BE CAREFUL and DON’T TAKE CHANCES. Diabetes is SERIOUS stuff, but for the vast majority of us, it CAN be controlled with relative ease!

    Posted by MARK MICHENER |
  12. I have had hypo. many times. At least my husband was there to caLL 911. Now my husband is gone and I live alone and this has really scared me. My sone insisted that I get a continuous glucose meter. It is very expensive and not covered but has made my life much better. It wakes me at night if it goes to low or too high. A real life saver!

    Posted by Ada Rayn |
  13. I’m a yo-yo! Up, down, Down too low, eat something and then it goes high. Don’t seem to be able to be consistent. Last A1c was below 7, but I know the next will be above. I’m on chemo and wonder how much this effects my Type 2. My endocrinologist is out on maternity leave, but when she returns I’m going to ask.

    Posted by Charlene Sydow |
  14. I’m almost 75 and underestimated the onset of Diabetes 2, tossing it off as genetic and not too concerned until a bus accident and plummeting of blood glucose to 36. A wake-up call! Life-threatening!

    The good news is I now read everything I can find (and thank you for this email and info.), I check my blood glucose 4 times a day and pay attention to eating times. I have an excellent endocrinologist and think that connection is very important. I have several little meals a day and don’t skip, watching balanced nutrition. I have more energy with the new regime and believe attitude change was very important. “The Sugar Solution” by Sari Harrar and The Editors of Prevention is fabulous and paves the road to balancing your blood sugar naturally to avoid disease, lose weight, gain energy, and feel great. You’ll love it! Janet

    Posted by Janet Powell |
  15. I had to insist with my Doctor that I had to test more than once a day. His argument was my Medicare would only let me test once A day because I was not on Insulin My respons was what am I going to do If I am feeling funky like something is wrong and I don’t have the strips to test to test with? He finally agreed to send a script to my to my med supplyer to let me test twice a day because I had flucuating blood sugar supplier agreed to send strips I have been testing whenever I feel something wrong ever since. Doctors really quite know what to do or how to prescribe meds you get bottle tha says take once a day twice a day when? morning afternoon? before meal after meal what time before meeal what time after meal? there so many vaiables you just don’t know you work it out the best you can. I think it would be a good idea if the Pharmacuetical companys would come out with guide for the diferent pills that they have. I am taking Glyburide sulfonylurea-type.

    Bernie

    Posted by Bernie A |
  16. I was diagnosed in 1995 as Type 2 diabetic. For years I controlled it with diet and exercise. Then pills and now insulin. I have gone low and I really hate that feeling! I can’t communicate with anyone, I am dopey, and all I want to do is sit down no matter where I am. I always carry something with me just in case this happens because I can’t really let my companions know what is wrong and what I need. Most of them know the signs and just to be on the safe side will treat the episode like it is hypoglycemia, which is what I told them to do. Nothing feels like that. Sometimes I even feel like I have a hangover the next few hours: headache, thirst, tired. I never leave the house without my bracelet identifying me as a type 2 insulin user. It is really an unpleasant and dangerous thing to experience.

    Posted by Cathy |
  17. I have type 2 Diabetes and yes I do have problems
    with hypoglaucemia. My blood glucose is higher
    in the mornings then I take my metformin and go
    to the gym. By 10:30 unless I have some carbs I am
    hypoglaucemic. It will happen again if I don’t have my lunch between 11:30-12:00. As long as
    I have some carbs at lunch ie sandwich I am okay
    in the afternoon. I do have fruit in the afternoon also. Then I generally eat low carb in the evening. Usually proteen and veggies. Because of my Hypoglaucemia I am having a hard time losing weight even though I exercise quite a bit.

    I used to take Glyburide also but since I have been going to the gym I have been able to get off it except for maybe a 1/2 of a 2.5 dose in the evening depending what I have had for dinner.

    My doctor has suggested I take one 500 mg metforminbefore I go to the gym after eating a good breakfast and then take one 500 mg when I get home for the gym. This seems to make things a little better.

    Posted by Janice |
  18. This type 2 is for the birds! I am so fed up with all the miss information. Being under medicated, over medicated, eat less, eat more, sugars too high, sugars too low, etc. I’m beginning to wonder if this is not all some sort of conspiracy set up by drug companies and insurance companies. They seem to be the only ones making out on these deals. And what’s with the General Practitioners telling us that it is not necessary to go to an Endocrinologist? I have an HMO and cannot get a referral to save my life!

    Posted by Lynne |
  19. Batter up!

    Many good comments:

    Testing: one a day or thereabouts only works if your body BG is slowly moving and still under some control so there is some consistency day to day. If bad dawn effect plus liver dumps during day - once a day is stupid/dumb ( and as type 2, such testing approach is utter useless. Three degree’d morons that postulated such nonsense without consideration of edge cases is disgraceful.)

    30 years later and up to 32 hand pricks a day; I finally captured this mess. Got CGMS and finally got correct medication - liver - metformin and standard humalog lispro insulin and reduced insulin doses. Also method of taking pre meals can be a riot if Pancrease still dumping proper and/or sizeable insulin meal bolis.

    I find adding after meal and as BG starts rising over 170/180 works fine without crashing BG to basement and thus it assists pancreas effort. I have stopped eating glucose tablets like mad and fact not used one for weeks. This is also a demand/as needed so that if BG does not get very high I skip dose and stop hypoglycemic riots. CGMS is essential in monitoring and driving.

    Today, BG gently rising and falling and consistent day to day. Here again watch out for 10/12 hour duration glyburide pills and fast insulin with 12 hour duration stuff. Lantus does not seem issue and I take one shot of 15 units at 9:30 pm every night. Humalog Lispro Breakfast and meal shots - 3 times a day usually 4 units per meal; some times 6 to 8 units in some situations.

    For type 2 people, question remains how much pancreas is working and adding insulin and also it may be varying somewhat all interacting with pre-injected insulin and causing lows on meal front end and then being insufficient on back end when gut/digestion gets rolling.

    Only a layman’s 30+yr fight with type 2 diabetes.
    And wading thru all the well intended BS out there.

    Posted by jim snell |
  20. It is not true that type 2s can ignore diabetes until physical symptoms set in. I get very confused and sometimes even a bit paranoid when my blood sugar gets too low. I have driven the wrong way and gotten lost on roads and freeways I am familiar with. I have become so disoriented I was not even sure what street I was on, or what direction I was going. Until I contracted diabetes my sense of direction was very good and I rarely got lost. Having a sharp mind in my job is very important. At times, when I have had low blood sugar, I have been in the middle of a sentence, and I have completely forgotten what i was saying. More often than not, this has occurred at inopportune moments. This rarely happened before I was diabetic.

    I grow tired of type 1s who feel they have it worse than type 2s. I am also sick of the implication that type 2s, asked for the disease. Many people who have contract type 2 are frail people. On the flip side, many people who are morbidly obese do not get diabetes at all, ever.

    I also feel, that for type 1, intense ongoing research is done to find a cure. In contrast, for type 2 , all too often, the common belief is that eduction will prevent it, and that if one is unfortunate enough to get it he/she should have a body distorting surgery to cure it. I have meet people who have gained weight just so that they could qualify for the surgery. Enough bashing, my health plan has educated me. I say let’s find a cure for both types

    Posted by Debbie Williams |

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