Hypoglycemia and hyperglycemia are most often the result of errors in the diet, non-compliance with the diet, violations of dosages and the scheme of taking hypoglycemic drugs. As a result, the blood sugar level is sharply reduced or increased, which is accompanied by characteristic symptoms. A person with diabetes, as well as his relatives, it is important to be able to identify these conditions and know how to help in such cases. Correct actions can save the health and even the life of the patient.
Hypoglycemia is a condition that occurs when the blood sugar level drops below normal, that is, below 3.3 mmol/l.
Hypoglycemia can develop for various reasons:
- Overdose of insulin or hypoglycemic drugs in tablets. In patients with type I diabetes, hypoglycemia is otherwise called insulin shock.
- A large time interval between a meal and an insulin injection.
- Violation of the food regime – skipping meals.
- Strict diets with a sharp restriction or exclusion of carbohydrates in the diet, fasting.
- Inadequate physical activity that requires significant energy costs.
- Alcohol intake. Alcoholic beverages can be taken by people with a compensated form of diabetes and in very limited quantities.
Alcohol inhibits the breakdown of glycogen in the liver, stimulates the release of adrenaline, which suppresses the synthesis of insulin.
Risk factors for hypoglycemia are concomitant chronic diseases of the kidneys, liver, heart and blood vessels, and thyroid hormone deficiency.
The heart and brain need a lot of energy to function, so these organs are the most sensitive to glucose deficiency. Against the background of low sugar levels, neurological symptoms develop – weakness, sweating, headache and dizziness, trembling in the muscles, sometimes convulsions, incoherent speech, blurred vision, anxiety, excitement and aggression. The work of the cardiovascular system is disrupted, which is manifested by an increased heart rate, a violation of the heart rhythm, a decrease in blood pressure and the development of heart attacks. A characteristic symptom of hypoglycemia is a pronounced feeling of hunger.
The symptoms of hypoglycemia are very similar to those of intoxication. Therefore, people suffering from glucose deficiency may not be properly given first aid.
If you ignore the signs of sugar deficiency, the symptoms progress to unconsciousness, which indicates the development of a hypoglycemic coma.
Diagnosis of hypoglycemia
People who suffer from diabetes for a long time may not feel the symptoms of hypoglycemia due to the adaptation of the body. And on the contrary-hunger, weakness, headache and other characteristic symptoms can be on the background of normal blood glucose levels.
A blood glucose test will help determine the diagnosis. You can measure your blood sugar level at home with a blood glucose meter. Taking into account the fact that this device can give a slightly distorted result, a low sugar level of less than 3.5 mmol/l is considered low.
First aid for hypoglycemia
Carbohydrates with a high glycemic index – sugar, glucose in tablets, candy, honey, fruit juice, sugary drinks or fruit-will help to fill the glucose deficit. A diabetic should always have something sweet with him in case of an emergency.
With hypoglycemia, the recommended doses of glucose in tablets are 2 pcs, refined sugar-2 pieces, 1 glass of fruit juice, 2-3 teaspoons of sugar, 1 candy caramel or 2 teaspoons of honey. If symptoms persist after 15 to 30 minutes, repeat the same dose.
Emergency medications for more severe forms of hypoglycemia, which are accompanied by loss of consciousness, are glucose and glucagon. Glucose is administered intravenously, and this should be done by health workers. But glucagon can be administered intramuscularly (in the buttock), and this procedure is quite capable of the patient’s relatives. Glucagon is an insulin antagonist, it reduces the level of this hormone, and also stimulates the breakdown of glycogen in the liver with the release of glucose.
If hypoglycemia is a consequence of alcohol intake, then glucagon will not help. We need to call an ambulance immediately.
Prevention of hypoglycemia
- Regular nutrition, restriction of carbohydrates in the diet, but not their complete exclusion. People who are first diagnosed with diabetes tend to panic and dramatically cut back on all the carbohydrates, and this is wrong. Without the energy that glucose carries, we can not do without it. You need to choose products with small indicators of bread units and glycemic index.
- Correct selection of doses of hypoglycemic drugs. This is more true for people with type I diabetes. The doctor will select the drug and teach you how to calculate its dosage depending on your diet.
- Regular measurement of glucose levels will help to identify the problem in time and take appropriate measures.
- Excessive physical activity and stress require a lot of energy. Therefore, it is advisable to avoid such situations.
- Refrain from taking alcohol or take it in small amounts and very rarely. A feast for a diabetic should be limited to 70 ml of strong alcoholic beverages or 200 ml of dry wine. Beer, liqueurs, champagne, and sweet wines are strongly discouraged.
- Close people should be able to identify the symptoms of hypoglycemia and provide first aid.
Hyperglycemia is diagnosed with an increase in blood sugar levels above normal. A glucose value of more than 6 mmol / l is considered elevated, and the symptoms characteristic of hyperglycemia may appear with an increase in the sugar concentration above 8 mmol/l.
Hyperglycemia in diabetes mellitus can lead to:
- Insufficient dosage of hypoglycemic drugs or skipping the reception.
- Errors in the diet – taking an excessive amount of glucose. We are talking about any carbohydrates with a high glycemic index and a large number of bread units.
- Stress-stimulates the release of adrenaline, which is a counterinsular hormone.
- Taking medications for the treatment of cardiovascular diseases-beta-blockers reduce the secretion of insulin, and statins reduce the sensitivity of peripheral tissues to this hormone. Certain antibiotics, amitriptyline, thyroxine, carbamazepine, diuretics, and amlodipine can also increase blood sugar levels.
Symptoms of hyperglycemia
The body seeks to reduce the concentration of sugar in the blood by all available means – it needs to be diluted and removed. With hyperglycemia, you are constantly thirsty, the kidneys work in an enhanced mode, removing salt and minerals along with glucose. Excessive amounts of sugar damage the walls of blood vessels, which leads to a number of complications of diabetes, primarily affecting the heart, kidneys, brain and reproductive system.
Let’s analyze the first symptoms of hyperglycemia in order to take timely measures and prevent the development of complications:
- Constant, pronounced thirst
- Frequent urination
- Dry skin and mucous membranes
- Headache, fatigue
- Heart rhythm disorder
- Loss of attention and clarity of vision
Hyperglycemia leads to ketoacidosis-a violation of fat metabolism. As a result, fat is broken down to form ketone bodies. Ketones are detected in the blood, urine, and exhaled air. A characteristic sign of ketoacidosis is the smell of acetone from the mouth. This is a rather dangerous condition, as ketone bodies cause intoxication. The patient may lose consciousness, which is a sign of the development of a ketoacidotic coma.
Signs of ketoacidosis:
- The smell of acetone from the mouth
- Nausea and vomiting
- Tachycardia and shortness of breath
- Signs of dehydration
- Disorientation, loss of consciousness
Diagnosis of hyperglycemia
The main diagnostic criterion for hypoglycemia is the determination of blood sugar levels. It is important to evaluate it on an empty stomach (the break between meals should be at least 8 hours) and 2 hours after eating.
A high level of sugar on an empty stomach indicates an excessive formation of glucose by the liver. If hyperglycemia is detected after eating, then this is evidence of a violation of the mechanisms of its breakdown and assimilation.
The presence of ketoacidosis in hyperglycemia can be confirmed by a urine test. At home, it can be carried out with the help of test strips.
First aid for hyperglycemia
First of all, you need to make an injection of short-acting insulin. For an adult, the optimal dose is 2 units. In hospitals with severe hyperglycemia, 4-6 units of insulin can be administered once, but at home it is better to refrain from such dosages in order to avoid a rapid decrease in sugar up to hypoglycemia.
After 2-3 hours, we re-measure the sugar level. If it remains at the same level or has decreased slightly, we introduce 2 more units of insulin.
The second step is to restore the lack of fluid and minerals. For this purpose, alkaline mineral water is ideal. There are also special solutions in powders that contain the necessary electrolytes. They can be purchased at a pharmacy, dissolved in water according to the instructions and given to the patient to drink.
With the development of ketoacidosis, the patient should be taken to the hospital, since the treatment of this condition requires intravenous administration of drugs. During the day, the patient should receive 6-10 liters of fluid, which can not be done at home.
Target sugar reduction levels for people with diabetes
An important question is to what level to reduce glucose in the treatment of hyperglycemia? It would be logical to assume that since the norm is 3.3-5.5 mmol/l, then it is necessary to strive for this level.
But this is not quite true. The fact is that hypoglycemic drugs have side effects, and the higher the dosage,the more they manifest themselves. And a sharp decrease in sugar can be dangerous for your health. Therefore, the American Diabetes Association recommends reducing the fasting glucose level to 7.2 mmol/l, and after eating – to 10 mmol/l. These indicators are considered normal for a diabetic “with experience”. If diabetes is diagnosed recently, then you need to strive for more ideal indicators. The closer to normal, the better.
Prevention of hyperglycemia
Very often, the culprit of sudden spikes in sugar is the person himself. Diabetes is a lifestyle in which you need to approach your health responsibly. First of all, this applies to food control. Whether we like it or not, we need to limit our carbohydrate intake. This also applies to fruits, some vegetables, cereals, and naturally flour and sweet.
Diabetes mellitus involves taking medications daily. According to statistics, not every patient exactly follows the doctor’s recommendations. Reducing the dosage, skipping the reception – not isolated cases that lead to disastrous consequences.
The muscles consume a decent amount of glucose for their work. Dosed physical activity will reduce the level of sugar.
The main task of treating diabetes is to achieve the target blood sugar level, that is, compensation. The appearance of hypoglycemia or hyperglycemia indicates that it is not possible to do this for some reason. In any case, a lack or excess of sugar in the blood is a reason to go to the doctor.
Providing first aid for hypo-or hyperglycemia does not require special skills. It is important to have a glucose meter for measuring sugar and first aid.
Follow the diet, follow the doctor’s recommendations and let your sugar always be normal!