Hypoglycemia in patients with type 2 diabetes

A drop in blood glucose is most often associated with errors in medical treatment or with violations of the patient’s habitual lifestyle and diet. Some features of the body and disease can affect this. Factors that are associated with drugs:

  • improperly selected (too high) dose of insulin or tablets for the treatment of diabetes;
  • switching from insulin from one manufacturer to the same drug from another company;
  • violation of the technique of drug administration (getting into the muscle instead of the subcutaneous region);
  • injection of the drug into an area of ​​the body that has never been used for this before;
  • the impact on the injection site of high temperatures, direct sunlight or its active massaging, rubbing.

It is necessary to periodically check the health of insulin pens, since the wrong dose of the drug with a normal diet can lead to sharp changes in blood glucose levels. A hypoglycemic condition can develop in those situations when the patient switches from using the pump to regular injections. To prevent this, you need to constantly monitor the level of sugar and carefully calculate the amount of insulin.

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The meter should work correctly and accurately, since its false indicators can lead to incorrect calculation of the required amount of medicine

The diet has an important effect on sugar levels, so a person’s diet can also become a risk factor in some situations.

Reasons for a sharp decrease in blood glucose associated with food:

  • eating too little food;
  • long intervals between meals;
  • skipping the next meal;
  • drinking alcohol (especially with meals or at bedtime);
  • active physical activity without dietary correction and blood sugar control.

In addition, such conditions of the body and disease can cause hypoglycemia:

  • pregnancy and breastfeeding;
  • chronic renal failure;
  • early postpartum period;
  • lack of pancreatic enzymes, which ensure the normal digestibility of products;
  • decreased activity of the pituitary and adrenal glands;
  • the first time after suffering any acute infectious disease;
  • slow digestion of food in the stomach due to diabetic nerve damage in this area.

Gipoglikemiya 1 - Hypoglycemia in patients with type 2 diabetes

Hypoglycemia is a condition in which there is a decrease in blood sugar.

It can progress, leading to brain damage and human death. Most often, seizures occur in patients with type 2 diabetes.

To avoid such health problems, you need to know the main causes and initial manifestations of the disorder.

Diabetes mellitus is a common disease that can be accompanied by severe and life-threatening complications. It manifests itself in acute or chronic form. One of the options for its complication is hypoglycemia. This condition is characterized by a sharp decrease in blood glucose.

The attack develops very quickly, usually within half an hour. Its precursors are the following conditions: hyperhidrosis, hunger, weakness. In some cases, they do not appear, and a person immediately loses consciousness.

It is believed that only patients with type 2 diabetes can suffer from hypoglycemia. However, it is incorrect. Symptoms of the disorder sometimes occur in completely healthy people. For example, a decrease in blood glucose is observed with intense physical exertion or with a diet.

Type 2 diabetes is non-insulin dependent. Therefore, at the initial stages of development, hypoglycemia is easily eliminated by simple physical exertion, diet.

In some cases, medications are required whose action is aimed at lowering glucose values.

On the other hand, the process associated with decompensation over time provokes a reduction, and then a final cessation of insulin production. Therefore, replacement therapy becomes a vital necessity.

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Main reasons

Hypoglycemia in type 2 diabetes occurs due to excessive levels of insulin in the body. The amount of this hormone is produced a little more than is required for the full absorption of glucose.

In the treatment of diabetes, the patient is often prescribed drugs whose pharmacological action is aimed at stimulating the production of insulin. These are safe and highly effective medicines.

On the other hand, they can cause hypoglycemia against the background of diabetes.

The thing is that with constant “artificial” stimulation, a gradual depletion of the elements responsible for the production of insulin occurs.

Among the main causes of the development of the disorder, doctors distinguish the following:

  1. The use of sulfonylureas in the initial stage of diabetes. When the patient complies with the nutritional plan proposed by the doctor, the body processes glucose better. If, under these conditions, you do not stop taking the medication, the sugar level will continue to decline. Therefore, competent therapy implies either a complete abolition, or a reduction in the dosage of sugar-lowering drugs.
  2. Lack of diet. Taking medications that reduce the amount of glucose in the blood requires a mandatory dietary adjustment. If you eat poorly or skip meals, diabetes will progress.
  3. Excessive physical activity, before which or immediately after it, the patient does not have the opportunity to take glucose.
  4. Alcohol abuse.
  5. Sugar-lowering drugs are excreted by the kidneys. Their incorrect operation can provoke an increase in the concentration of active substances.
  6. Some drugs enhance the effects of sulfonylureas. Therefore, the independent selection of medicines is unacceptable. They can only be prescribed by a doctor, taking into account the interaction of medicines.

Hypoglycemia can cause concomitant ailments that develop against the background of diabetes. For example, damage to the structures of the brain and central nervous system contributes to the violation of a full metabolism.

clinical picture

Symptoms of hypoglycemia in type 2 diabetes can vary depending on the severity of the pathological process. Every person who has already had a disease should be able to recognize them in a timely manner. In the absence of medical care, paralysis of the systems of internal organs can occur.

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Signs of hypoglycemia begin to manifest in a mild form. In this case, the patient may complain of hyperhidrosis and tremor of the extremities. Some have tachycardia, pallor of the skin. This clinical picture is a consequence of the delayed production of pancreatic hormone.

Nutritional deficiency in the central nervous system is accompanied by other signs:

  • irritability;
  • headache;
  • mood lability;
  • impaired vision;
  • weakness in the lower extremities;
  • sharply appearing feeling of hunger;
  • impotence.

The body constantly needs glucose as one of the sources of energy. It is necessary for the full functioning of the main systems of internal organs. Therefore, the human body reacts quite sharply to a decrease in glucose values ​​to the level of 3,3 mmol/l or more.

As you know, sugar stores in the liver in the form of glycogen. For this substance to successfully transform into glucose, the use of contra-hormonal hormones is required. They are represented by cortisol, adrenaline and glucagon.

Hypoglycemic attacks in diabetes are always accompanied by irritability, fear and pallor of the skin. A sharp release of adrenaline into the blood is responsible for such symptoms. It is also the main cause of hyperhidrosis. Lack of energy in the cells leads to impaired visual function and increased appetite.

If during the next hypoglycemic attack the body does not receive the necessary portion of glucose, its level drops to the level of 1,7 mmol/L. This is a critical condition, also called coma. In this case, various changes can occur in the patient’s body, and some of them provoke a fatal outcome:

  • loss of consciousness;
  • convulsions;
  • stroke;
  • increased aggressiveness;
  • violation of coordination of movements.

Some patients manage to determine in time a sharp drop in blood sugar and take a pill. Others suddenly lose consciousness, as a result of which they may receive additional injuries.

Therefore, patients with diabetes, prone to hypoglycemia, are strictly forbidden to drive vehicles or engage in work on which the life of strangers depends.

In some cases, signs of hypoglycemia in type 2 diabetes mellitus can be extremely mild. This is a blunting of symptoms, which usually happens under the influence of the following factors:

  • chronic form of diabetes;
  • frequent attacks of hypoglycemia, addictive;
  • consistently low glucose values.

At risk are elderly patients and people taking beta-blockers – drugs to normalize blood pressure and prevent heart attacks.

In some patients, the opposite situation may occur, when the sugar levels are restored, and signs of hypoglycemia persist. This violation is due to a sharp release of adrenaline into the blood amid intense adrenal gland function. To adjust the indicators and stop unpleasant symptoms, you need to consult a profile doctor.

Urgent care

When a patient with hypoglycemia with type 2 diabetes cannot control his condition, outside help is required. Usually during an attack, his body becomes lethargic and inhibited.

A person himself in such a period is not able to eat something sweet or take a pill. Therefore, to stop the attack, it is better to use special gels with glucose, which are applied to the surface of the gums.

If the patient is capable of swallowing, he can be given sweet tea or fruit juice.

When the patient has lost consciousness on the background of an attack, it should be extremely carefully turned over on one side. Insert a wooden stick or any other object into your mouth.

This way you can avoid biting your tongue. After this, it is necessary to call a team of medical workers and make an injection of glucose intravenously.

There is no specific treatment for hypoglycemia in type 2 diabetes. To stop attacks, modern medicine suggests using the following methods:

  • take 3-4 glucose pills;
  • eat candy;
  • a meal rich in simple carbohydrates.

Features of the development of pathology

The mechanism of development of hypoglycemia is triggered if the concentration of glucose in the blood is 3,3–4 mmol/L and lower (3,5–5,5 mmol/L is considered normal). The main reason is excessive synthesis of insulin, therefore glucose is completely absorbed. The body is trying to restore normal sugar levels, the reserves of which are deposited in the liver in the form of glycogen.

To turn this substance into glucose, contrainsular hormones (adrenaline, glucagon, cortisol) enter the bloodstream.

If it is not possible to fill in the lack of sugar, severe consequences develop. A hypoglycemic attack has a negative effect on the brain, energy starvation of neurons leads to impaired consciousness, convulsions, coma.

There are 4 stages of hypoglycemia:

  1. Hypoxia of the cells of the nervous system, some areas of the brain, develops. The patient feels muscle weakness, headache, anxiety, severe hunger. A heartbeat and sweating appear.
  2. The lesion of the subcortical-diencephalic region intensifies. A person’s face turns red, movements become fussy, and behavior becomes inadequate.
  3. A condition similar to an attack of epilepsy develops. Convulsions appear, blood pressure rises, tachycardia and sweating intensify.
  4. The functions of the upper parts of the medulla oblongata are disturbed, a coma develops.

In the absence of the necessary measures to restore the normal sugar level, the process intensifies, the pressure drops sharply, the heart rhythm is disturbed. Edema of the brain leads to death.

Types of Hypoglycemia

There are 2 types of pathology:

  1. Fasting hypoglycemia. Sugar falls after sleep.
  2. Hypoglycemia after eating. It appears after 2-3 hours after eating.

There is nocturnal hypoglycemia. She is dangerous because her symptoms are impossible to recognize. The patient is sweating, nightmares begin to dream him.

Hypoglycemia in type 1 diabetes mellitus does not particularly differ in the development mechanism, but it occurs more rapidly. Attacks occur more often (almost 10 times), they are more severe than in patients with type 2 diabetes. Signs of a drop in sugar are sometimes almost absent, a person can immediately lose consciousness.

Causes

  1. Incorrect dose calculation of insulin or overdose.
  2. Incorrect administration of the drug (intramuscular injection instead of subcutaneous).
  3. Changing the injection site or exposure to it. For example, massage leads to faster absorption of the drug, resulting in a jump in insulin.
  4. Prescribing a new drug, to which the patient did not have time to adapt.
  5. Interaction with certain medications. Sensitivity to insulin increase: anticoagulants, barbiturates, antihistamines, aspirin.
  6. Pregnancy, breastfeeding.
  7. Excessive physical exertion, overstrain.
  8. Failure to comply with the diet, skipping meals.
  9. Poor nutrition, low calorie diet.
  10. Slowed down the processes of assimilation of food, emptying of the stomach.
  11. Disorders of the kidneys, liver.
  12. Drinking alcohol, especially on an empty stomach.

A patient with diabetes should be able to recognize signs of hypoglycemia in time. If you do not stop the attack, irreversible changes occur in the body, a person may die or become disabled. There are mild and severe hyperglycemia. In the first case, the pathological condition is manifested by characteristic symptoms, which include:

  • Heavy sweating;
  • Tremor;
  • Blanching of the skin;
  • Rapid pulse;
  • Sudden onset of hunger;
  • Irritability;
  • Anxiety;
  • Fatigue;
  • Muscle weakness;
  • Dizziness;
  • Pain in the head;
  • The appearance of “goose bumps” on the skin;
  • Visual impairment;
  • Numbness of the fingertips;
  • Nausea, diarrhea,
  • Frequent urination.

Such signs appear in the first minutes of the development of pathology. The light form lasts 5-10 minutes. You can stop it yourself.

If the patient could not restore the glucose level, with its further fall (to the level of 1,7 mmol/L and lower) severe hypoglycemia develops. A person can fall into a coma, which is accompanied by irreversible disturbances. Symptoms of severe hypoglycemia include:

  • Violations of attention, vision, coordination;
  • Strong changes in behavior (for example, manifestations of aggression);
  • Hallucinations;
  • Loss of consciousness;
  • Cramps;
  • Muscle paralysis;
  • Stroke.
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With the development of a severe form, a person cannot help himself.

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Doctors note that hypoglycemic attacks in each patient manifest themselves differently, so the symptoms of a pathological condition can be purely individual.

Not all diabetics feel hypoglycemia approaching; at risk are patients who have diabetes for a long time, older people and those who have attacks too often. Sometimes the patient feels only a slight malaise.

Signs of hypoglycemia are dulled for other reasons. These include:

  • Fibrosis, adrenal gland necrosis;
  • A severe form of neuropathy, which develops against a background of impaired conduction of nerve endings;
  • The glucose level is below normal for a long time;
  • Taking beta-blockers, such drugs are often prescribed after a heart attack;
  • Wrong diet containing lots of carbohydrates.

In these cases, it is recommended to regularly measure glucose with a glucometer. With a result below 3,5 mmol/l, measures must be taken to increase it.

A drop in sugar causes the following complications:

  • Impaired brain activity;
  • Increase in blood viscosity;
  • The development of a heart attack, stroke;
  • Decreased sensitivity to hypoglycemia;
  • In children – mental retardation, neurological disorders.

Hypoglycemia during pregnancy increases the risk of birth defects in an unborn baby.

The likelihood of complications increases in older people, especially when overweight. A severe complication is hypoglycemic coma, which leads to disability or death.

Urgent measures are necessary already with the appearance of signs of mild hypoglycemia. The attack is stopped if you ensure the intake of quickly digestible carbohydrates. To do this, fit:

  • Sweet tea;
  • Cookies;
  • Honey (2-3 table. L.);
  • Orange juice;
  • Sweets (it is better to give preference to caramel);
  • Sugar.

Glucose tablets have a more effective effect. In type 2 diabetes, there is a direct relationship between the amount of carbohydrates consumed and the increase in sugar: it rises by 2 units. after taking 2 g of glucose. Such pills will eliminate the need to eat illegal foods and prevent coma. After that, quench your hunger by consuming permitted low-carb foods.

After taking carbohydrates, wait 15 minutes. If there is no improvement, eat the sweet again. Deterioration of well-being is a good reason for urgent medical attention.

If a person is on the verge of losing consciousness, he will not be able to chew sugar or pills. Give him a glucose solution (it is sold at the pharmacy). Instead, you can make sugar syrup yourself. Make sure that the patient is able to swallow the solution. The product will have effect for 5 minutes. After that, you need to measure the level of sugar.

A person who has lost consciousness must be put on a bed (on his side or on his stomach). Use a napkin to free his mouth of mucus, food debris. Access fresh air by opening a window. Then call an ambulance.

With a coma, the introduction of glucagon and a solution of concentrated glucose will be required, this is done by emergency doctors. You can purchase a special kit called Glucagon for emergency care. He is released on prescription. The injection is done intramuscularly, after 20 minutes. the person will regain consciousness.

Prevention

It is very important to pay attention to preventive measures for the development of hypoglycemia, since frequent or too long seizures lead to irreversible consequences.

  1. Monitor your blood sugar daily with a blood glucose meter.
  2. If hypoglycemia is suspected, measure sugar as soon as possible. If the indicator drops by 0,6 mmol/L (compared with the usual norm), apply the measures indicated above.
  3. Consult a nutritionist for the right diet.
  4. Eat throughout the day with short breaks. Servings should be small. It is recommended to eat every 3 hours.
  5. Choose the degree of physical activity depending on the state of health, individual characteristics of the body.
  6. With prolonged physical activity, consume protein foods and foods containing carbohydrates every hour (a meat sandwich is suitable).
  7. Give up alcohol.
  8. Carry glucose tablets (or sweets, sugar).
  9. Keep track of the length of breaks between eating and insulin.
  10. Consult your doctor for possible discontinuation of sulfonylurea preparations. The likelihood of hypoglycemia is reduced when using insulin by the low-dose method.
  11. Notify relatives, friends and colleagues about the signs of hypoglycemia, how to stop it, so that they can help you if necessary.
  12. Carry a note with you where the diagnosis will be indicated. You can purchase a special identification bracelet. This will allow others to provide adequate assistance if you suddenly lose consciousness.

Preventive measures, compliance with the doctor’s recommendations and timely recognition of signs of hypoglycemia will exclude the development of a painful condition. Keep in mind that if you do not help the patient on time, he falls into a long coma. In this case, the forecast is disappointing.

Causes of hypoglycemia

  • An overdose of insulin with an error in the selection of the dose of insulin or with an inadequate increase in the dose of insulin; in the event of a malfunction of the syringe pen or when administering insulin at a concentration of 100 IU/ml with a syringe designed to administer insulin at a concentration of 40 IU/ml.
  • Overdose of tablets of sugar-lowering drugs: an additional intake of drugs or an inadequate increase in the dose of drugs.
  • Violation of the technique of insulin injection: a change in depth or an incorrect change of injection site, massage of the injection site, exposure to high temperatures (for example, when taking a hot shower).
  • Increased insulin sensitivity during exercise.

Reasons related to nutrition:

  • Skipping meals or not eating enough carbohydrates.
  • Increase the interval between insulin injection and food.
  • Short-term unplanned physical activity without taking carbohydrates before and after exercise.
  • Reception of alcohol.
  • Intentional weight loss or starvation without reducing the dose of hypoglycemic drugs.
  • Slowing the evacuation of food from the stomach.

Hypoglycemia in diabetes can be repeated 1-2 times in 7 days with intensive treatment of pathology with the use of insulin or tablets to lower blood sugar. But experts say that if you follow a special treatment program for type 1 and type 2 diabetes, lowering the sugar below the level will noticeably decrease. This is due to the rejection of sulfonylurea and clay.

Causes of hypoglycemia in diabetes mellitus, which is treated according to special methods:

  • a five-hour break between doses of insulin was disrupted, this is especially dangerous at night before bedtime;
  • an insulin injection or pill was taken well before meals;
  • the patient suffered an infectious disease;
  • change of expired, weakened insulin to a fresh preparation without dose reduction;
  • the amount of food taken does not match the accepted dose of insulin;
  • uncontrolled sugar during increased physical exertion;
  • taking medications that lower blood sugar, these can be: antihistamines, aspirin, barbiturates, anticoagulants.

Hypoglycemia in diabetes also occurs with a sharp warming on the street, since during this period a decrease in glucose levels is noted.

Treatment

In a patient in an unconscious state, it is necessary, first of all, to determine the level of glycemia, of course, if there is such an opportunity. At the pre-hospital stage, you can rub a special gel with Gipostop glucose, honey, sugar jam into the mucous membrane of the cheeks and gums. Infusion of a glucose solution through the mouth is very dangerous during this period due to the possibility of aspiration of the liquid.

One of the ways to remove patients from a hypoglycemic state is by injection of the drug GlukaGen Gipokit, which is a genetically engineered human hormone glucagon manufactured by Novo Nordisk, which stimulates the rapid breakdown of glycogen and the release of glucose into the blood. This drug has been used worldwide, and since 1998.

it is available to patients in Ukraine. The indisputable advantage of this method of helping a patient in a hypoglycemic coma is the possibility of subcutaneous and intramuscular administration of the drug GlukaGen Gipokit. Relatives of the patient, his environment can, after a simple briefing, administer this drug to him.

GlucaGen Hypokit is a kit containing 1 mg of lyophilized glucagon powder and a syringe with a solvent, the name means “genetically engineered glucagon.” The drug is administered subcutaneously or intramuscularly at a dose of 0,5 mg (half the dose) for children weighing less than 25 kg under the age of 6-8 years. Adults and children weighing more than 25 kg are recommended to enter 1 mg (the entire dose).

The use of glucagon is not indicated for pheochromocytoma, glucagon, and hypoglycemia arising in patients with type 2 diabetes mellitus, due to its ability to stimulate insulin release, which can provoke repeated severe hypoglycemia. With liver diseases, hypoglycemia after prolonged and severe physical exertion, repeated hypoglycemia, the use of glucagon may be ineffective, as glycogen stores are reduced or depleted.

The advantage of this drug is also the physiological restoration of blood glucose without subsequent high hyperglycemia, while intravenous administration of glucose often results in too rapid a change in the state of hypoglycemia to hyperglycemia, which negatively affects the body.

To quickly remove a patient from a hypoglycemic coma, intravenous administration of 10-20-40 ml of a 40% glucose solution to adults and 1 ml/kg of a 20% solution to children is recommended. This is a manipulation that is usually performed in a hospital or clinic. As a result of prolonged hypoglycemia, damage to brain cells may occur, in such cases it is better to start infusion of a 10% glucose solution.

After removing the patient from a coma, it is recommended to continue treatment with the oral administration of glucose and easily digestible carbohydrates.

Patients with type 2 diabetes mellitus may develop severe hypoglycemia while taking long-acting sulfonylureas (chlorpropamide, glibenclamide). A feature of such hypoglycemia is their severity and duration. Long-term administration of a 5% glucose solution under the control of glycemia is recommended.

As soon as a patient with diabetes begins to experience severe hunger or other symptoms of hypoglycemia, experts recommend immediately measuring glucose with a glucometer.

If the indicators are lower than the established target level by 0,6 mmol/l, then pathology must immediately be stopped. To do this, it’s just worth eating a certain amount of high carbohydrate foods or a glucose pill. The same thing is done with an asymptomatic manifestation of the disease, which is much more dangerous.

And also to stop an attack, patients eat the following foods:

This method works very slowly and often greatly raises blood sugar, which is why it is considered ineffective. Therefore, it is worth using glucose tablets for therapy and prevention.

If the patient is on the verge of losing consciousness, do not waste time measuring sugar levels; it is dangerous to give a tablet or dry food. In this condition, the patient may choke, so a diabetic should be given an urgent glucose solution. In extreme cases, sugar diluted in water or tea. Only after the patient comes to his senses it is worth measuring the level of sugar.

If a diabetic faints due to hypoglycemia, he is first given an injection of glucagon. This hormone very quickly raises blood sugar. Each patient should always have a special first-aid kit next to him, and all relatives should be aware of it.

If there is no emergency kit at hand, you must urgently call an ambulance. During this period, it is contraindicated to pour the patient into the mouth or push the tablets. This often ends deplorably for the patient, since in an unconscious state he is unable to chew or swallow.

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In case of loss of consciousness, you must call an ambulance

Hypoglycemia is called lowering blood sugar. This condition can progress and lead to serious consequences: irreparable damage to the brain and death.

According to official medicine, hypoglycemia reduces glucose to 2,8 mmol/l, when a person feels obvious discomfort, or to 2,2 mmol/l, when the patient does not feel any symptoms.

More often, seizures occur in type 2 diabetes.

Causes of

The mechanism of this disease state is one: there is more insulin than glucose. The body begins to lack carbohydrates, which provide energy. Muscles, internal organs feel “hunger”, and if measures are not taken in time, the consequences can be severe and even fatal.

The causes of the variety.

  • Accidental overdose of insulin or incorrect dose calculation.
  • The use of sulfonylureas, as well as clay. They often become the cause of complications and adversely affect the functioning of other systems and organs. Modern medicine does not recommend using them for treatment.
  • Faulty insulin pen
  • Glucometer adjustment (starts to show too high glycemia that does not correspond to the real state)
  • Doctor’s mistake when prescribing a dosage of sugar-lowering drugs
  • Intentional overdose of insulin by patients themselves with depressive conditions
  • Error in the introduction of medicines – intramuscular injection instead of subcutaneous
  • Changes in the injection site or impact on it. When injected into a part of the body that is more prone to physical exertion, or massage the injection site, it is absorbed faster and gives an abrupt increase in the amount of insulin.
  • The use of a new type of medication, to which the body is not used
  • Poor removal of insulin from the blood due to kidney or liver disease
  • The introduction of “short” insulin instead of “long” in the same amount
  • Unexpected interaction with other pharmacological drugs. Sulfonylurea may increase the body’s sensitivity to subsequent insulin injections. The use of barbiturates, aspirin, anticoagulants, antihistamines can lead to this result.
  • Intense or prolonged physical activity
  • Warming, rising air temperature
  • Impaired hormone secretion by the adrenal gland or pituitary gland
  • Pregnancy, Postpartum, and Breastfeeding

Many cases of hypoglycemia are associated not with medications or chronic diseases, but with dietary disorders and nutritional problems.

  • Malabsorption syndrome. This is a poor assimilation of the nutrients received by the body due to a lack of digestive enzymes.
  • Irregular nutrition or forced skipping of another snack.
  • An unbalanced diet that is low in carbohydrates.
  • Unexpected large physical activity, before or immediately after which it was not possible to take glucose.
  • The desire to lose weight with a very strict diet or a complete rejection of food. In this case, the diabetic does not reduce the dose of insulin and other medicines.
  • Very slow emptying of the stomach and assimilation of food as a result of diabetic neuropathy.
  • Use of fast insulin before meals and delayed food intake.
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Patients with diabetes 2 swamps for normal health should not feel strong attacks of hunger at all – this is the first sign of a lack of blood sugar. Therefore, changes in the diet and treatment should be treated carefully.

Symptoms and signs

Taking sugar-lowering drugs, it must be borne in mind that each patient has his own normal level of glycemia.

A significant lack of sugar is considered to be a decrease of 0,6 mmol/L from the usual individual indicator. Optimally, the indicators should coincide with those observed in a healthy person.

But in some situations, diabetics have to artificially cause hyperglycemia for a certain time.

Signs of a lack of carbohydrates begin to manifest in a mild form and eventually become more pronounced.

The first symptom is a feeling of hunger. Also, with hypoglycemia, there are:

  • pallor
  • profuse sweating
  • acute hunger
  • palpitations and cramps
  • decreased attention and concentration
  • aggressiveness, anxiety
  • nausea

When glycemia drops to a dangerous level, the following can be observed:

  • weakness
  • dizziness and severe headache
  • speech impairment, vision problems
  • feeling of fear
  • motion disorder
  • cramps, loss of consciousness

Symptoms may not occur simultaneously and not all. In some cases, those who often have jumps in glycemia, have long had diabetes, older people, they may not feel them at all or feel a little unwell.

Some diabetics manage to determine in time that glycemia is lower than usual, measure sugar levels and take glucose. And others sharply lose consciousness and may receive additional injuries.

In diabetes mellitus, one of the main factors is nutrition, which must be monitored very carefully. First of all, carbohydrates are taken under control. In order not to earn hypoglycemia, it is recommended to consume complex carbohydrates and starches. It can be:

It should be as neat as possible to eat foods containing fast carbohydrates:

Eating is recommended fractionally in small portions, but throughout the day with small breaks. Patients with hypoglycemia are advised to eat every three hours.

To slow down the absorption of sugar, the patient should eat more fiber, which is found in legumes, vegetables, grains, fruits.

It is advisable to reduce the level of fat in the patient’s diet. The accumulation of subcutaneous fat adversely affects the full functioning of insulin.

It is not advisable to abuse caffeine, and in some cases it is better to exclude it.

And also doctors recommend not to drink alcohol in any form.

Experts recommend that patients with diabetes mellitus go on a low-carb diet, which will help reduce the need for insulin.

Prevention

Given that diabetics are recommended fractional nutrition, a feeling of severe hunger should be an alarming bell and an occasion to once again check the sugar. If the fears are confirmed and the glucose level is close to the limit, you need to eat.

To prevent a sudden drop in blood sugar, patients with type 1 diabetes should:

  • adhere to a certain regime of the day or at least observe the same time intervals between food and medication;
  • know your target blood glucose level and try to maintain it;
  • understand the differences between insulins of different periods of action and be able to adjust your diet to medication;
  • reduce the dose of insulin before intense physical activity (or increase the amount of food eaten before that, which is rich in carbohydrates);
  • refuse to drink alcohol;
  • regularly monitor your blood sugar.

Diabetics should always be accompanied by chocolate, sweets or glucose medications in case hypoglycemia develops. It is important that the doctor informs the patient about the danger of this condition and teaches himself the principles of first aid in case of its occurrence.

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If you stop hypoglycemia at the initial stage of its development, it will pass without a trace to the body and will not bring much harm

Preventive measures, compliance with the doctor’s recommendations and timely recognition of signs of hypoglycemia will exclude the development of a painful condition.

Keep in mind that if you do not help the patient on time, he falls into a long coma. In this case, the forecast is disappointing.

Forecasts

With the right attitude to themselves and their health, patients can avoid hypoglycemia. It is very important for patients with diabetes to take care of the first-aid kit and tell about it to relatives or colleagues. It will help save a life in an emergency.

If help is not provided on time, the patient is able to fall into a prolonged coma. In this case, the forecast will be disappointing. It is very important to monitor your diet, physical and emotional stress, and blood sugar.

Hypoglycemia in type 2 diabetes mellitus – signs and treatment

Hypoglycemia is one of the most frequent acute conditions encountered in diabetes mellitus of both 1 and 2 types. Most patients with diabetes are afraid of its onset, knowing about poor health during an attack and about serious complications that occur if the episode is not stopped. So let’s figure out what is hypoglycemia in diabetes, how to avoid it and what to expect next.

Hypoglycemia is a condition caused by a sharp decrease in blood glucose below critical numbers.

For each patient with diabetes, these numbers are different.

It is believed that with a decrease in blood glucose to 2,8 mmol/L and the appearance of symptoms, or a decrease to 2,2 mmol/L, regardless of symptoms, hypoglycemia occurs.

However, some patients begin to feel bad at higher numbers. Others, who often have hypoglycemia, on the contrary, stop feeling even such low numbers.

It is a mistake to assume that hypoglycemia occurs only in patients with diabetes receiving insulin. Yes, hypoglycemia is more characteristic for this group of people, however, they also occur in those who receive sugar-lowering tablets.

The main cause of hypoglycemia is an excess of insulin relative to the intake of carbohydrates in the body. This leads to:

  1. Excessive administration of insulin to patients. Often patients with diabetes, just starting insulin therapy, incorrectly calculate the necessary dose, which leads to a drop in blood glucose. The second common mistake is the introduction of the previous dose of insulin while reducing the amount of food eaten.
  2. Improper intake of sugar-lowering drugs. Sugar-lowering drugs affect the body in two ways. Some improve the absorption of glucose by body tissues, without causing it to decrease (for example, metformin). Others cause an increase in insulin production, therefore, with an overdose, hypoglycemia develops (for example, glibenclamide).

There are patients who believe that they themselves can adjust the dose of the drug, forgetting that it is impossible to do this without a doctor.

  1. Excessive exercise increases tissue absorption of glucose. This must be considered when administering insulin.
  2. Violation of the technique of administering insulin. For the introduction of various types of insulin, there are parts of the body. For example, insulin injected under the skin of the abdomen is absorbed within 5-15 minutes, and under the skin of the thigh within a few hours. It is also necessary to monitor the serviceability of syringes, syringe pens, glucometers.
  3. Chronic diseases Cardiac, renal, and liver failure violate the mechanisms of action of sugar-lowering drugs and insulin.
  4. Alcohol intoxication leads to severe hypoglycemia. Alcohol blocks the release of glucose from the liver.
  5. Pregnancy in 1 trimester and breastfeeding.

Symptoms and signs

Taking certain medications may also interfere with your problem.

In some cases, patients with such symptoms may behave inappropriately, be confident that their health is in order until the moment of loss of consciousness. An aggressive reaction is possible on tips for taking pills, or on the contrary, an attack of weakness, drowsiness, lethargy.

In children in such cases, it is desirable to measure glycemia at night and reduce the evening dose of insulin or review the diet. In newborns, after the end of breastfeeding, it is necessary to immediately develop a habit of a low-carb diet.

The only way to avoid complications is to constantly monitor your sugar level. If you feel hungry, measure sugar and take measures to stop the attack.

If there are no symptoms, but it is clear that there was no timely snack or physical activity, take tablet glucose to prevent problems. She acts quickly and predictably. Calculating the dose is quite simple, it enters the bloodstream in a few minutes.

After 40-45 minutes, you need to measure the sugar level and, if necessary, repeat, eat a few more glucose.

Some diabetics in such cases prefer to eat flour, sweets, fruits, drink fruit juices or sugary sodas. This can provoke an attack of hyperglycemia, since these products contain not only “fast”, but also “slow” carbohydrates.

They are absorbed more slowly, because the digestive system must spend time processing them. The abundance of “slow” carbohydrates a few hours after eating will cause a sharp jump in sugar. Glucose in combination with water is absorbed instantly from the oral cavity.

It’s not even necessary to swallow it.

You can easily determine how many glucose tablets increase glycemia. This is harder to do with products. With a fright or in a somewhat inadequate condition, there is a risk of overeating and even more harm to health.

If it is not possible to buy glucose, you can carry with you slices of refined sugar and take 2-3 cubes to prevent hypoglycemia.

If the diabetic is no longer in control and unable to take action, the help of others will be needed.

Usually the patient is weak, lethargic and almost unconscious. He will not be able to chew something sweet or eat a pill; there is a risk of choking. It is better to give a sweet drink, for example, warm tea with sugar, or glucose solution.

There are special gels that can be used to lubricate the oral cavity and tongue. They can be replaced with honey or jam. Patients should be monitored during an attack.

When your measures work, and he can answer questions, you will urgently need to use a glucometer and find out how much glucose is needed to normal and what caused the malaise.

The cause of this condition can be not only hypoglycemia, but also a heart attack or kidney pain, a jump in blood pressure, so you need to be very careful.

If the diabetic faints, it is recommended:

  • stick a wooden stick in your teeth so that during the cramps the patient does not bite his tongue
  • turn your head to one side so that it does not choke on saliva or vomit
  • make an injection of glucose, in no case try to drink or feed
  • call an ambulance

As a result of such attacks, there is a risk of worsening the state of health. With hypoglycemia, the brain and the cardiovascular system can irreparably suffer from a lack of energy.

Improper exit from the condition causes a jump in sugar and a new deterioration in health, a jump in hypertension, a heart attack, and kidney failure.

Loss of consciousness can cause serious injury. Any imbalance in blood sugar will be detrimental to overall well-being.

It would seem that lowering blood sugar is what every patient strives for. Then why does hypoglycemia in diabetes not bode well? The fact is that in this condition the sugar level drops dramatically, which can lead to serious disruptions in the functioning of the brain and other vital organs. In addition, with diabetes, low blood glucose is not always good.

The features of hypoglycemia in type 2 diabetes can be found in detail in this article.

For each diabetic, the optimal values ​​of glycemia (blood sugar) are individual. Ideally, they should correspond to similar figures of this indicator in a healthy person. But often, real life makes its own adjustments, and then you have to start from the well-being of the patient with different values ​​of blood sugar.

The normal glucose value for diabetes is from 4 to 7 mmol before meals. This interval is averaged, and the “corridor” of acceptable values ​​should be selected by the attending physician, taking into account the age, weight and type of disease of the patient.

The danger of hypoglycemia is that, due to the lack of sufficient glucose, the brain experiences energy starvation. Its symptoms appear very quickly, and in the most severe case, a person may develop a hypoglycemic coma. It is terrible for its consequences on the part of the nervous system and in itself threatens the life of a person.

gipoglik sah diab 2 - Hypoglycemia in patients with type 2 diabetes

Due to hypoglycemia, a person can become irritable or angry, but his guilt is not here. This is due to the fact that his brain cannot function adequately in conditions of lack of glucose

Hypoglycemia can develop in a person without diabetes. There are 2 types of this condition:

  • fasting hypoglycemia;
  • sugar reduction, developing as a response to food.

In the first case, glucose levels may drop due to alcohol or certain medications in the evening. Also, this condition can provoke a hormonal failure in the body. If hypoglycemia occurs a few hours after a meal, then it is most likely associated with fructose intolerance or a lack of glucagon (this is a pancreatic hormone that is involved in glucose uptake). This also occurs after operations on the stomach, due to which the absorption of nutrients in the digestive tract is impaired.

Symptoms of glycemia are similar to its manifestations in diabetics, and they also occur suddenly. A person may be disturbed by a feeling of hunger, trembling in the body, weakness, nausea, anxiety, cold sweat and drowsiness. First aid in this condition is the same as with diabetes. After stopping the attack, you must always consult a doctor to find out the cause of hypoglycemia and a detailed diagnosis of your health condition.

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ce1738dd7ae83b28c16f798184da7c50 - Hypoglycemia in patients with type 2 diabetes

General nurse. Over 40 years of work experience. Retired copywriter.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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