Gretchen Scalpi, RDN

The symptoms of hypoglycemia (low blood sugar) can happen unexpectedly and are hard to ignore.  Sudden nausea, cold clammy skin, rapid heartbeat, weakness, inability to concentrate, or trembling gets one’s attention pretty quickly.  Low blood sugar can happen to anyone, but people with diabetes or pre-diabetes are particularly vulnerable to this situation.   Several common scenarios that can bring on the  symptoms of hypoglycemia  include:

• going for extended periods of time without eating
• a change in mealtime schedule or delayed meal time
• taking diabetes medications or insulin without eating adequate amounts of food
• improperly dosed much insulin or medication
• consuming concentrated amounts of sugar, followed by a rapid drop in blood sugar
• illness
• vigorous exercise

Someone who has had episodes of hypoglycemia will tell you how very unpleasant the experience is.  The symptoms can create a feeling of panic,  as well as urgency to get out of the situation as quickly as possible. Avoid the tendency to “over treat” hypoglycemia, by consuming too much sugar, too quickly.  While it is important to treat low blood sugar quickly, a stepwise approach called the “Rule of 15” can correct a low blood sugar effectively  in most cases.

Step 1.  Check your blood glucose using a glucose meter.  A reading of less than 70 mg/dl usually indicates the need to treat a low.

Step 2.  Consume 15 grams of carbohydrate, wait about 15 minutes, then recheck your blood glucose level again. If your blood glucose is still low, consume another 15 grams of carbohydrate, then recheck 15 minutes later. Since blood glucose levels may begin to drop again about 40–60 minutes after treatment, it is a good idea to recheck your blood glucose approximately one hour after treating a low.

Steep 3.  If you’ve had to treat the low blood sugar twice,  it’s probably a good idea to have a more substantial snack, that includes a source of protein, as well as carbohydrate:  Example:  cheese & crackers.

The “rule of 15” is an accepted method for treating hypoglycemia, but if you have specific instructions from your diabetes team to do otherwise,  follow those guidelines instead.

Here are several examples of items containing 15 grams of carbohydrate:

• 4 glucose tablets
• 1 dose of glucose gel -1 small tube is one dose
• 1/2 cup of orange juice or regular soda (not sugar-free)
• 1 tablespoon of sugar or 5 small sugar cubes
• 6–8 LifeSavers

Hypoglycemia can occur unexpectedly, so stay prepared by carrying a carbohydrate source with you at all times!

Tags: blood sugar