What to do for Low Blood sugar? Low blood sugar/hypoglycaemia can cause inconvenience to your daily life. The symptoms are usually unpleasant like shakiness, dizzy and rapid heart beat. Most hypoglycaemia with mild symptoms can be easily self-treated. However, severe hypoglycaemia (low blood glucose levels that require assistance from another person to treat) that causes mental confusion, unconsciousness, or seizures are dangerous and to be avoided! Before diving into what to do for Low Blood Sugar, you might want to learn more about what is low blood sugar, its common causes, signs, and symptoms, click here!

What to Do for Low Blood Sugar – Prevention

Prevention is the best thing to do! The following actions can help to prevent it:

Check Your Blood Sugar Regularly

Monitoring your blood sugar closely can help to keep your sugar level stable and as normal as possible. It also helps to detect and confirm a low blood sugar early, when you start to experience the first symptoms. Hence, you can treat it early and prevent it from going into severe hypoglycaemia. Early detection remains the key to treating low blood sugar. The recommended frequency to check your blood sugar is (based on recommendations from Singapore’s MOH):

Type 1 Diabetes
At least 3 times per day

Insulin Treated Type 2 Diabetes
2-3 times/day for 2-3 days per week.

Non-insulin Treated Type 2 Diabetes
You might not need to check your blood sugar as frequently, but at least check your blood sugar whenever you notice any possible signs of hypoglycaemia.

Checking your blood sugar closely allows you to pick up hypoglycaemia unawareness too. This is a condition when you do not feel or recognise any symptoms during an episode of hypoglycaemia. Always treat your low blood sugar as long as it is below 4.0mmol/L, despite not having any symptoms! Left untreated, it will turn into severe hypoglycaemia.

Other benefits of blood glucose testing are that you can learn how different meals and activities affect your blood glucose levels. This knowledge can facilitate you to better adjust your meal portion and activity level in order to reach your glucose targets. But most importantly, you have to first own a glucometer!

Have Regular Meals

Try not to miss or delay your meals or snacks. This is especially important when you’re on insulin or/and oral diabetes medication like sulphonylureas. These medications will cause your blood sugar to drop too low if there are no consistent and appropriate carbohydrates from your meal. You should have three balanced meals and light snacks in between, throughout the day. The planning of meal timing should take into consideration the insulin injection and medication time. You should also make sure the time gaps between each meal are relatively evenly spaced out. This means ideally not more than 4 or 5 hours apart (other than dinner and breakfast).

It is crucial to have adequate carbohydrate, preferably whole grain to be part of every balanced meal. Your digestive system will break down the carbohydrate into glucose. Glucose will then enter the bloodstream and raise your blood glucose level. Whole grains take a longer time to digest, causing the blood sugar to rise slower. This can ensure a steady and constant supply of glucose into the bloodstream, helping to prevent a sudden drop in your blood sugar.

Keep Snacks with You All The Time

Keep some snacks in your car, bag, at the work desk or anywhere else you spend time. Wholemeal biscuits, nuts, seeds, dried fruits, or Tetra Pak low-fat milk are some healthy snack examples. This is particularly crucial when you have to delay your meal due to some unforeseen circumstances. These convenient on-the-go snacks will come in handy in this kind of situation.

Plan Your Exercise

Physical activity is very beneficial to managing diabetes. This is because it helps to lower the blood sugar. Likewise, physical activity can also bring the sugar levels too low, causing low blood sugar. You should check your blood sugar before and after exercise to learn how your body responds to exercise. If your blood sugar is near or below 4 mmol/L, before you begin an exercise, take some carbohydrates to bring it back within normal range.

Exercise that is long and intense will usually use up a lot of carbohydrates. Hence, you will probably need to eat some carbohydrates before and during your exercise to prevent blood sugar from dropping too low. Always carry a fast acting carbohydrate with you during exercise so you can treat low blood sugar immediately when it occurs. Don’t take for granted that you will be able to find sugar, juice, soda, and candy nearby when you need it.

Consult Your Healthcare Team

You should inject insulin and take oral medication at the right amount and timing as instructed by your doctor or pharmacist. Try not to self-adjust your insulin dosage or oral medication without discussing with your doctor. There are a few circumstances that you might need to revise or review your insulin or oral medication regime. For example, you have not been physically active previously but now decided to start exercising. This increase of activity level may require you to lower your medication. Talk to your doctor about your plan to become more physically active so they can help adjust your insulin dose and/or oral medications.

It is beneficial to also consult a dietitian to discuss your meal plan according to your lifestyle, working schedule, daily routines, and medication regimes. A dietitian will be able to advise you on the amount and type of food to eat to better manage your blood sugar and to prevent low blood sugar.

Alcohol and Low Blood Sugar

Alcohol will hinder your liver from releasing glucose into your bloodstream. This increases your chances of having hypoglycaemia especially if you’re on insulin and/or diabetic medication or drinking on an empty stomach. Some alcohols (beer, wine, liqueur) contain carbohydrate which may make your blood sugar rise initially. This can be tricky! You still need to watch out for the risk of becoming hypoglycemic later on. So, always drink your alcohol with a snack or meal or have a small snack after drinking alcohol. Always check your glucose levels before you sleep after drinking and take some carbohydrate supper if it’s nearing 4 mmol/L.

Be Preventive

Practice all the above. In addition, let your family members, close friends, and trusted colleagues know and learn about your symptoms during a low blood sugar. So that they know how and when to intervene if you have severe low blood sugar. Consider keeping an identity card in your wallet with your medical conditions and emergency contact written on it. So that people can know that you have diabetes and who to call.

Low blood sugar and driving is a bad combination. Driving with low blood sugar symptoms like shakiness, drowsy and confusion is extremely dangerous to you and other road users. Check your blood sugar before driving and at least for every two hours during the journey if it is a long distance drive. Do not drive when you are having a low blood sugar, treat it immediately and avoid driving for the next 45 minutes as you will still be slow in response.

Always carry treatment with you. Keep some hard candies, sweet drinks in your bag at all times to treat any low blood sugar as soon as possible.

What to Do for Low Blood Sugar – Treatment

What to do for low blood sugar? After confirming a low blood sugar with a glucometer, you should treat it immediately with fast-acting carbohydrates. The objective is to raise your blood sugar back to the normal level quickly so that the symptoms can be disappeared. If not treated quickly, mild or moderately low blood sugar can become severe. The “Rule of 15” is a helpful way to remember the treatment.

15 grams of Fast Acting Carbohydrates (Fast Sugar)

What to do for low blood sugar is to take 15g of sugary food and drinks. For example:

• ½ cup (4 oz) of fruit juice
• ½ cup (4 oz) of regular soda (non-diet/not sugar-free)
• 5 or 6 pieces of soft candy (not sugar-free)
• 1 tbsp (US tablespoon, or 3 teaspoons) of honey or sugar

You should avoid taking food or drinks that contain protein or fat like chocolate, cookies, ice-cream to treat a low blood sugar. Taking food with fibre (e.g. a piece of fruit) also is not ideal. Even though they are sweet,  the fat, protein or fibre will slow down the release of sugar into the bloodstream, hence don’t raise blood sugar quick enough. Fast acting carbohydrates are the best to treat a low blood sugar. This is because they are readily and easily absorbed and will raise blood sugar levels quickly.

15 Minutes Waiting Time

After taking 15g of fast acting carbohydrates, it takes about 15 minutes to recover from a mild episode of low blood sugar. Measure your blood sugar again after 15 minutes to see if it has already returned to a normal level (4-7 mmol/L). If it is still low, take another 15g of fast acting carbohydrates before checking your blood sugar level again in another 15 minutes.

When your blood sugar resumes to normal, you should have your next meal on time. If your next meal is more than one hour away, have a carbohydrate snack to prevent your blood sugar from going too low again.

What if I Can’t Treat Myself During Severe Low Blood Sugar?

It is very crucial to let your family members or close friends know about your conditions and prepare them for what to do for low blood sugar when you can no longer self-manage during a severe hypoglycaemia. They should be made aware of the “Rule of 15” when treating you for a low blood sugar.

However, if you have become unconscious, they should not feed you with any food or drinks, because of the risk of choking. In this case, a hormone glucagon injection should be given to you by another person. Glucagon is a hormone that helps to release glucose from the liver into the bloodstream to bring the sugar level back up. Glucagon is usually available in the form of glucagon injection kit which is prescribed by the doctor to those who are at risk of severe low blood sugar. Injection of glucagon requires certain techniques. If glucagon injection kits are not available or there’s nobody available who is trained to administer the injection, call for medical aid immediately.

What to Do for Low Blood Sugar – In Short

With precautions taken, low blood sugar is preventable. Early detection remains the key in treating low blood sugar. Do check your blood sugar regularly and work closely with your healthcare team to monitor your progress in managing diabetes. What to do for low blood sugar? I hope you have got it figured out after reading this post