How To Avoid Hypoglycemia in Type 1 and 2 Diabetes

Dr. Jean-Francois Yale, MD, CSPQ, FRCPC, Endocrinologist, discusses how to avoid Hypoglycemia in Type 1 & 2 Diabetes.

So hypoglycemia is when there's not enough sugar or glucose in the blood And glucose is a source of energy for many of our organs, the muscles, the heart, but particularly the brain. So it causes a series of symptoms when people have hypoglycemia and therefore we try to avoid that.

When people are treated with insulin, particularly patients with type I diabetes, it’s almost everybody that has had at least some episodes of hypoglycemia, certainly well over 80%. When patients are treated, with type II diabetes, are treated with medications that do not cause hypoglycemia, and there are many, then usually they don't get it. They will get it if there treated with certain pills that do cause that, for example, glyburide or glipizide or with insulin.

And overall, when we take patients with type II diabetes treated that way, it's about 40% that had at least one episode of hypoglycemia. So when people get hypoglycemia, something that's very scary and therefore people do a series of things to try to avoid getting them again. Some of these things are good, some are not as good.

So people, for example, will talk to their physicians, that's good. They will try to change insulin dosages appropriately, that's fine. Things that are not as good are, for example, skipping insulin injections, eating a lot more, avoiding doing physical activity, that's not good approaches. So the point is to test more often, people often do that, and talk to the health professional.

A lot of things can be done to reduce the risk of hypoglycemia. First, we can try to use medications that cause less hypoglycemia. We know, for example, that with the insulins, some of the insulin preparations cause less hypoglycemia than others. Within all the medications, some medications cause less hypoglycemia than insulin. So all of this should be considered.

Once we continue with a medication, such as insulin that causes hypoglycemia, the important thing is to monitor frequently so we know what happens to adjust the dosages correctly not only by themselves but also in relation to food intake and physical activity.

So there's no doubt we can reduce the number of hypoglycemic episodes. The most important is to ask patients if they had hypoglycemia. When we asked them they tell us, but if we don't, often they won't.

The other thing is that a large proportion of patients actually do not know what are the symptoms of hypoglycemia. It's important to teach them, but also when we ask them to ask questions such as did you have nightmares during the night, do you have episodes where you sweat and you’re nervous, rather than just ask if they had low blood sugars.

So it's important to go after to get the information we need. So if you think you have a problem with hypoglycemia, it's important to realize that something can be done. And it's important to go and get the help. The help you can talk about it to your pharmacist, to a nurse educator, to your family physician or to an endocrinologist. But the important thing, go and get some help because something can be done.

Presenter: Dr. Jean-François Yale, Endocrinologist, Montreal, QC

Local Practitioners: Endocrinologist