Managing hypoglycemic unawareness -
Unawareness of hypoglycemia increases the risk of severe low blood sugar reactions when they need someone to help them recover. People who are unaware of their hypoglycemia are also less likely to be awakened from sleep when hypoglycemia occurs at night.
People who are hypoglycemic but are unaware of it must take extra precautions to monitor their blood sugar levels regularly. This is especially true before and during critical tasks, such as driving.
When blood sugar levels are low or begin to fall, a CGM can sound an alarm. Such a device can be a great assistance to people with HU [ 12 , 15 ].
With continuous BG monitoring, children and adults with T1DM spend less time in hypoglycemia and simultaneously decrease their HbA1c level [ 33 , 34 ]. A prior study showed that diabetic patients with reduced beta-adrenergic sensitivity may be unaware of hypoglycemia, and the best suggestion for these patients is to strictly avoid hypoglycemia [ 35 , 36 ].
Our patient was also advised to have emergency glucose tablets, intermuscular, or intranasal glucagon injections at her disposal all of the time to avoid hypoglycemic attacks. The glucagon injection pen was not available in Iran at the time of the episode described here, neither was a CGM, so she was recommended to follow educational sessions on carbohydrate counting and perform excessive SBGM.
The patient was given strict advice based on her job and profession, as well as the need to control her blood sugar level to the extent that it did not interfere with her professional and daily functioning [ 12 ]. She was advised to see her endocrinologist to adjust her insulin dose based on her unawareness of hypoglycemia attacks and her work schedule, which may not allow her enough time to rest and consume enough carbohydrates, potentially leading to life-threatening attacks, especially since her coworkers were unaware of her medical condition.
It is strongly advised that people with diabetes, especially patients like this case, wear some sort of identification, such as a bracelet, or carry a card that state their condition [ 15 ].
Normalization of autonomic response takes 7—14 days on average, but it can take up to 3 months to normalize the threshold of symptoms, neuroendocrine response, and glucagon response although glucagon response is never fully recovered [ 37 , 38 ]. Another suggestion was to switch human insulin to the analog type of insulin.
Hypoglycemia is a fairly common complication in diabetic patients receiving oral or insulin therapy. However, in a subset of patients who are unaware of hypoglycemia for a variety of reasons, these warning signs do not exist, resulting in severe and life-threatening hypoglycemic episodes.
As a result, patients who have multiple episodes of HU are advised to raise their blood sugar control threshold for at least 2 weeks and to wear at all times a bracelet or label indicating their medical condition.
In addition, in these patients, the use of CGM equipped with alarms in the occurrence of severely low blood sugar can be a perfect option.
Patient data and information can be accessed for review after obtaining permission from the patient without any disclosure of her name.
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A continuous glucose monitor CGM can sound an alarm when blood glucose levels are low or start to fall. This can be a big help for people with hypoglycemia unawareness.
If you think you have hypoglycemia unawareness, speak with your health care provider. This helps your body re-learn how to react to low blood glucose levels. This may mean increasing your target blood glucose level a new target that needs to be worked out with your diabetes care team.
It may even result in a higher A1C level, but regaining the ability to feel symptoms of lows is worth the temporary rise in blood glucose levels.
This can happen when your blood glucose levels are very high and start to go down quickly. If this is happening, discuss treatment with your diabetes care team.
Your best bet is to practice good diabetes management and learn to detect hypoglycemia so you can treat it early—before it gets worse. Monitoring blood glucose, with either a meter or a CGM, is the tried and true method for preventing hypoglycemia.
Studies consistently show that the more a person checks blood glucose, the lower his or her risk of hypoglycemia. This is because you can see when blood glucose levels are dropping and can treat it before it gets too low. Together, you can review all your data to figure out the cause of the lows.
The more information you can give your health care provider, the better they can work with you to understand what's causing the lows. Your provider may be able to help prevent low blood glucose by adjusting the timing of insulin dosing, exercise, and meals or snacks.
Changing insulin doses or the types of food you eat may also do the trick. Breadcrumb Home Life with Diabetes Get the Right Care for You Hypoglycemia Low Blood Glucose.
Low blood glucose may also be referred to as an insulin reaction, or insulin shock. Signs and symptoms of low blood glucose happen quickly Each person's reaction to low blood glucose is different. Treatment—The " Rule" The rule—have 15 grams of carbohydrate to raise your blood glucose and check it after 15 minutes.
Note: Young children usually need less than 15 grams of carbs to fix a low blood glucose level: Infants may need 6 grams, toddlers may need 8 grams, and small children may need 10 grams. This needs to be individualized for the patient, so discuss the amount needed with your diabetes team.
When treating a low, the choice of carbohydrate source is important. Complex carbohydrates, or foods that contain fats along with carbs like chocolate can slow the absorption of glucose and should not be used to treat an emergency low.
Treating severe hypoglycemia Glucagon is a hormone produced in the pancreas that stimulates your liver to release stored glucose into your bloodstream when your blood glucose levels are too low. Steps for treating a person with symptoms keeping them from being able to treat themselves.
If the glucagon is injectable, inject it into the buttock, arm, or thigh, following the instructions in the kit. If your glucagon is inhalable, follow the instructions on the package to administer it into the nostril.
When the person regains consciousness usually in 5—15 minutes , they may experience nausea and vomiting. Do NOT: Inject insulin it will lower the person's blood glucose even more Provide food or fluids they can choke Causes of low blood glucose Low blood glucose is common for people with type 1 diabetes and can occur in people with type 2 diabetes taking insulin or certain medications.
Insulin Too much insulin is a definite cause of low blood glucose. Food What you eat can cause low blood glucose, including: Not enough carbohydrates. Eating foods with less carbohydrate than usual without reducing the amount of insulin taken.
SF: Writing—original draft. NIH support DK, DK to SF, DK to YL, TL1TR to MD, as well as support from the University of Kentucky Barnstable Brown Diabetes Center and the Diabetes and Obesity Research Priority Area. The authors would like to thank and acknowledge NIH support DK, DK to SF, DK to YL, TL1TR to MD, as well as support from the University of Kentucky Barnstable Brown Diabetes Center and the Diabetes and Obesity Research Priority Area.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers.
Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
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One Mansging the more distressing unadareness in diabetes is Herbal remedies for wellness unawareness. Normally, a person will feel warning symptoms when Managing hypoglycemic unawareness blood sugar goes low, such as shaking and sweating caused hypogljcemic the release unawarenesss stress Lycopene and weight loss. Unawarendss, Lycopene and weight loss with unawzreness unawareness have reduced hypoglgcemic signals and do not recognize they are low. Even if they happen to do a blood sugar test they may not realize what they need to do to treat the low. Luckily, stress hormone release is usually adequate to eventually raise the glucose level, although this may take several hours to work. That hypoglycemia unawareness could occur during sleep is not surprising since people wake up for less than half of the lows that occur at night, but it happens with equal frequency when people are awake. Lycopene and weight loss R. White; Managong Contribution Lycopene and weight loss Medications to Hypoglycemia Unawareness. Diabetes Unawsreness 1 Herbal remedies for memory enhancement ; 20 2 hypoglycenic 77— Hypoglycemia unawareness unawarness defined as the onset of neuroglycopenia before the Managihg of autonomic warning symptoms. However,much is known regarding risk factors, biochemical causes, and populations at greatest risk for the development of hypoglycemia unawareness. Less is known regarding the impact of medications on the development or recognition of this condition in patients with diabetes. Several medications are thought to worsen or promote hypoglycemia unawareness, whereas others may have an attenuating effect on the problem.
Wirklich auch als ich darüber früher nicht nachgedacht habe