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Are you being intensively treated for diabetes? Beware of hypoglycaemia

Are you being intensively treated for diabetes? Beware of hypoglycaemia
Hypoglycaemia is a condition when blood sugar level falls below the normal level. © Shutterstock

Hypoglycaemia is a common problem associated with diabetes and it can cause serious complications and even death. Read on to know all about this condition.

Written by Jahnavi Sarma |Published : August 18, 2019 7:00 PM IST

Diabetes is a metabolic disorder that causes high blood sugar. Today, this disease has assumed epidemic proportions on a global level. Proper treatment can contain the disease and regular medication is needed for this. But sometimes, over-treatment can land people in hospital. This is because over-treatment can cause hypoglycaemia.

This is a condition when blood sugar level falls below the normal level. This is dangerous and, at times, can even be life threatening. Immediate corrective measures are essential to avoid serious repercussions. Hypoglycaemia can increase the risk of cardiovascular disease, bone fractures and even death.

Treatment needs to be individualised to avoid hypoglycaemia: Experts

According to a new study, more than 20 per cent of US adult diabetes patients received medication that bring their blood sugar levels too low. This resulted in almost 4,800 Emergency Room visits and 4,700 hospitalisations over a two-year period. The study was recently published in Mayo Clinic Proceedings.

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Researchers from Mayo clinic say that the findings suggest that treatment plans for diabetes patients need to be more individualised and evidence-based to prevent visits to the emergency department.

According to the Centers for Disease Control and Prevention, more than 30 million Americans, about 9.4 per cent of the population, suffer from diabetes and another 84 million are at high risk of diabetes. People with this condition have excess glucose in their bloodstreams. Patients are often prescribed medications like Glyxambi, NovoLog and Precose to manage their blood sugar.

Balanced treatment is essential

Researchers looked at data from the National Health and Nutrition Examination Survey between 2011 and 2014 and the OptumLabs Data Warehouse. They used levels of haemoglobin A1c (HbA1c), the average level of blood sugar, to examine whether patients were being over-treated.

Normal levels for those without diabetes fall between four per cent and 5.6 per cent. Levels between 5.7 per cent and 6.4 per cent are associated with a higher risk of developing diabetes and levels 6.5 per cent or higher mean that you already have diabetes.

During the course of the study, about 10.7 million adults with diabetes were identified. Researchers saw that almost 22 per cent diabetics were intensively treated. These patients were either taking one medication to get HbA1C levels of 5.6 per cent of lower. Some of them were on at least two medications to achieve HbA1C levels between 5.7 per cent and 6.4 per cent. This led to 4,774 hospitalisations and 4,804 emergency care visits

Researchers concluded that while it's important for diabetes patients to take medication to bring down their blood glucose levels, doctors should treat patients on an individual basis. For this treatment plans must be individualised. There should be no under- or over-treatment. A balance is required.

Risks of diabetes

Diabetes manifests when there are too few beta cells in the pancreas to produce insulin or when they produce very little insulin. Insulin is the hormone that maintains glucose levels in the bloodstream and channels it to cells. If left untreated, this disease can cause serious health complications like kidney damage, vision loss, heart disease, stroke and nerve problems. High blood glucose levels over time can cause severe complications. Hence, medical intervention and proper medication is very important if you have diabetes.

Causes of hypoglycaemia

Hypoglycemia is a condition caused by a very low level of blood sugar. It is not a disease but an indicator of a health problem. If your blood sugar levels are at 70 milligrams per decilitre (mg/dL) you need to take immediate action to raise it. To do this you can consume sugar-rich foods or drinks or you may need medications.

Hypoglycaemia may result from many health reasons. Ageing is one of them. There are several chronic health conditions that may induce this condition. But this is very common in diabetic patients and it is usually the result of over medication.

Symptoms of hypoglycaemia

If you are diabetic or have someone in your home who is suffering from this condition, you must know how to recognise hypoglycaemia. Symptoms may be an irregular heart beat, fatigue, tremor, slurring, paleness and excessive sweating. Sometimes, you may experience anxiety for no reason, hunger, irritability and a tingling sensation around the mouth. In severe cases, it can induce confusion and abnormal behaviour. Blurred vision, seizures and sometimes even loss of consciousness can occur in very severe cases.

Sometimes too much insulin or other diabetes medications may cause your blood sugar level to drop too low, causing hypoglycaemia. This may also happen if you don't eat less or skip meals after taking your diabetes medication or if you exercise too much.

Risks of hypoglycaemia

It can cause serious adverse health complications and long-term harm to patients. Researchers of the above-mentioned study say that severe hypoglycaemia, defined by the need for another person to help the patient treat and terminate their hypoglycaemic event, is associated with increased risk of death, cardiovascular disease, cognitive impairment, falls and fractures and poor quality of life.

What you can do

Be proactive in your diabetes management plan. Have regular discussions with your doctor regarding your condition. Check your sugar level regularly and if there are any fluctuations ask your doctor how to correct it. Eat small meals every two hours and exercise regularly.

If you are on any new medication, you need to be extra vigilant. Report any changes in blood sugar levels immediately. Your doctor may recommend a continuous glucose monitor (CGM) device in such cases. These devices insert a tiny wire under the skin. This sends blood glucose readings to a receiver. You may have to wear one for 48 hours. And yes, always carry something sweet with you.