Nutrition Feature: Diabetes

Hypoglycemia:

Hypoglycemia(Hypo: low or less; Glycemia: state of blood sugar) means a state of low blood sugar.A blood sugar of 60mg % or less is usually considered low.

Cause: Even vigorous diet or exercise does not produce hypoglycemia.For eg.people totally starving for want of food supply or for religious fasts do not suffer from hypoglycemia.In these situations, hypoglycemia can only occur if there is significant liver or kidney disease.When diabetics are given oral hypoglycemic agents or insulin, possibility of hypoglycemia becomes real.Some oral drugs are less likely to produce hypoglycemia, like metformin, acarbose, glitazones.Others like sulfonylureas or repalglinide are more likely to produce hypoglycemia.Insulin both plain and NPH/lente variety can produce hypoglycemia.Unaccustomed or severe physical exercise or less food intake can precipitate hypoglycemia with the use of drugs mentioned above.

Symptoms: Symptoms of hypoglycemia vary, but each diabetic should note the pattern of symptpoms he manifests when sugar gets low.Some people are found to have no symptoms but notice a low blood sugar on frequent self-monitoring.This is called asymptomatic hypoglycemia.When blood sugar is >=60mg% without symptoms, there is no cause for concern and minor adjustments can be made in food or drug dosage in a planned manner.Blood sugar below 60mg% often produces symptoms, in a sequential fashion as sugar gets lower and lower.

Blood Sugar Levels And Hypoglycemic Symptoms

The golden rule to remember is that any unusual and sudden development of symptoms is likely to be hypoglycemia until proven otherwise and should be treated as such.This can prevent quite, few catastrophies and hospitalisations.

Management: People with diabetes must learn to manage hypoglycemia.Thier relatives or peers, should also have this information in confidence.

Prevention: A good understanding of the interaction between food exercise and medications(oral agents or insulin) can prevent hypoglycemia.Frequent self-monitoring of blood sugar gives good insights into such interactions.It is also important to understand the sick-day routine.In case an unusual physical exertion is anticipated the medication dose can be modified in advance.In case of unanticipated physical exertion, it is advisable to have an extra snack before the exercise.For sustained and prolonged exercise an extra snack is included every 2 hours.

Treatment:
1.Have a small helping of sugar, glucose powder directly or a few toffees or candies, aerated drinks(Coke, Thums-Up, Limca, Pepsi) or fruit juice.It is obvious that a diet Coke or Pepsi is not likely to help in this situation.
2.A helping of regular food like a sandwich, biscuits or milk should follow the above sugar intake.This snack is important in preventing recurrence of hypoglycemia.

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