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Low ypoglycemia or a ‘hypo’ means having a below 70mg/dL and usually only occurs in people who take certain tablets or injectable medication to treat their . Hypoglycemia is usually avoidable, however, it is important that if you do experience a low blood sugar level, you know how to recognize and importantly treat the situation. Prevention of low blood sugar levels is H the primary goal. The “Rule of 15”

Blood sugar less 15 grams quick Recheck blood sugar Repeat 15 grams than 70mg/dl acting carbs in 15 minutes of quick acting ( tablets, carbs until blood juice, regular sugar is above 70 soda, or candy) mg/dl

What are the Symptoms of Hypoglycemia? There are two stages of symptoms or signs associated with low blood :

These first stage symptoms are our First stage symptoms or signs Second stage symptoms or signs safety symptoms that warn us of low (usually 55‐70mg/dL) (usually less than 55mg/dL) blood sugar levels. It is important to listen and respond to these symptoms. Sweating Irritability They usually occur with blood sugar Shaking Confusion levels between 55 – 70mg/dl. If you Weakness / Feeling tired Inability to think clearly have had elevated blood sugar levels Anxiety Drowsiness above 200mg/dl for a period of time, Fast heart beat If very low, risk of unconsciousness you may feel low at normal blood sugar levels of 80 – 100mg/dL. Tingling of the lips / mouth

These second stage symptoms are dangerous. Blood sugar levels in this range, usually less than 55mg/dl, may require someone else to help you treat the low blood sugar level because you are not thinking clearly to treat it yourself.

Hypoglycemia unawareness is the term given when people do not experience the first stage symptoms and are unaware that their blood sugar levels are low. Possible reasons for this include frequent low or untreated blood sugar levels, long standing diabetes and nerve damage. South Eastern Florida Regional Diabetes Program Diabetes Education Service 1450 Northwest 10th Avenue, Miami FL, 33136 Phone: 305‐243‐3696 Fax:305‐243‐5791 © 2009

Hypoglycemia: What to do

Causes: Treatment: If you are aware of possible causes of low blood Unless a person is unconscious or very drowsy, the sugar levels, then you have the opportunity to pre‐ ‘Rule of 15’ should be followed in all circumstances vent it from happening again. Causes of low blood for all blood glucose levels below 70mg/dl – yes, sugar include: that means a blood sugar level of 69mg/dl! If you do not have your meter but feel low, treat it as if you  Taking too much have a low blood sugar level.  Not eating enough foods Suitable 15gram quick acting in‐  Too much cludes:   4 glucose tablets or  4oz of juice or REMEMBER!  6oz of regular soda or  soft pure sugar candy that is easy to chew. (i.e. Sweet Tarts/ Starbursts) If you take medications that lower blood sugar levels, you should: These 15 grams are only likely to raise your blood sugar a maximum of 45mg/dL. If you are not going  Learn your body’s warning signs of a to eat within the next hour, or if you are active, take low blood sugar a snack, [15 grams of carbohydrate with protein or  Always carry quick acting glucose with fat i.e. crackers and peanut butter]. you – remember the ‘Rule of 15’

 Wear some form of diabetes identifica‐ Note 1: High fat carbohydrates such as chocolate tion such as a neckchain or bracelet. are not appropriate treatments for low blood sugar levels. These foods take too  Check your blood sugar level before long to digest and therefore take too long driving

to raise a low blood sugar level.  Explain the possible sign / symptoms and treatment of low blood sugar lev‐ Note 2: If the blood sugar level is below 50mg/dL, els to relatives, friends or workmates it is recommended to take 30 grams of so they will know how to help you. quick acting carbohydrate and recheck the sugar in 15 minutes.  Don’t go to bed with a blood sugar level below 100mg/dL. Good bed‐time snacks include 8oz milk or 3 crackers and ½ teaspoon peanut butter or 3 crackers and cheese.

Always think prevention...

South Eastern Florida Regional Diabetes Program Diabetes Education Service 1450 Northwest 10th Avenue, Miami FL, 33136 Phone: 305‐243‐3696 Fax:305‐243‐5791 © 2009