Tell me about low sugar

A diabetes patient injecting insulin.
PHOTO: Shutterstock

Just a couple of nights ago, I suddenly had a bout of dizziness and chills. I was very worried, because I thought that I was having a heart attack. I took a cab to a private hospital. They took my blood and told me I had hypoglycaemia. What is hypoglycaemia?

Hypoglycaemia means low sugar in the blood. There are many conditions which can cause hypoglycaemia. It isn't really a disease in itself, but a condition that arises from other conditions and/or diseases.

But I did not feel hungry at all. I always thought that you would feel very hungry when you have hypoglycaemia, correct?

Not necessarily. Sometimes, you can experience hunger, but a lot of people who suffer from hypoglycaemia don't.

Here are some of the symptoms you can look out for to know you are experiencing hypoglycaemia. A lot of these symptoms can be attributed to other diseases as well, so it can be difficult to diagnose.

Read also: Only five and living with diabetes

However, hypoglycaemia is usually one of the things doctors look out for when you mention these symptoms, or combination of symptoms:

• Heart palpitations

• Tiredness

• Dizziness or giddiness

• Pale skin

• Trembling or tremors

• Anxiety

• Sweating

• Feeling faint

• Hunger

• Irritability

• Tingling sensation around the mouth

• Crying out during sleep

• Confusion, abnormal behaviour or both

• Blurred vision

• Seizures or fits

• Loss of consciousness

Read also: 7 tips to managing your blood sugar levels

If I am feeling all these, I might be too anxious to recognise it, right?

It is also possible for people around you to recognise that you are not all right. This is especially important for people living with diabetic patients.

People who have very bad hypoglycaemia may appear as though they are drunk with alcohol. They may also slur their words and be very clumsy.

I don't have diabetes. Why am I having hypoglycaemia?

You have to understand how your body regulates sugar to understand why hypoglycaemia is giving you all these symptoms.

When you eat carbohydrates like rice, pasta, bread, cakes or drink sugary drinks like sodas and fruit juices, your body breaks these down to glucose.

Glucose immediately enters the bloodstream. It is then aided by the hormone, insulin - produced by the pancreas - to enter blood cells from the bloodstream so that the body can use it for energy.

The very presence of glucose itself in the blood signals the pancreas to release insulin.

Read also: There are no bad foods in diabetes, just bad diets

Insulin then helps the glucose from the bloodstream to enter our cells, thus lowering the glucose in the bloodstream. This in turn is a signal for the pancreas to decrease insulin production and release.

This entire feedback loop works pretty well in maintaining blood glucose level to a certain parameter. Excess glucose is stored in the liver and muscles as glycogen, to be used when glucose levels become too low - just in case you can't find anything to eat!

If need be, the body can also manufacture glucose via a process called gluconeogenesis.

If you don't have diabetes, anything that interferes with this entire feedback loop can give you hypoglycaemia.

Tips on living well with diabetes

  • People with diabetes know that they need to take control of their eating habits because blood sugar levels in the body are directly affected by the foods we eat.
  • A diabetic diet is an eating plan that is high in nutrients and fibre, low in fat, sugar and salt, and moderate in calories
  • The only difference is that you need to pay more attention to your food choices
  • Controlling carbs: If you have diabetes, excessive intake of carbohydrates will lead to high blood sugar levels and poor control of diabetes.
  • Load up on greens: Loading up on vegetables, especially green leafy ones, will assist in blood sugar and weight control, and promote a healthy heart.
  • Choose wisely when eating out: Reduce your food portion size by requesting for less noodles/rice, and avoid dishes with thick gravy or fried foods with flour/bread coating
  • Order more vegetables and have a serving of fruit for dessert.
  • Regular mealtimes: For individuals who are on fixed doses of insulin and/or taking oral medication for diabetes, it is important to maintain regular mealtimes to prevent fluctuation in blood sugar levels and to optimise the effects of the medication.
  • Be active: The reason exercise is so important is because it increases cell sensitivity towards insulin. This means that cells are better able to use any available insulin to take up glucose during and after each physical activity.
  • You can start slowly with a 30-minute brisk walk three times per week and work your way towards a more intensive regime.
  • This helps you to have better blood glucose control and maintain a healthier body weight.
  • If you have diabetic complications such as heart disease, nerve problems or kidney failure, seek the advice of your doctor or an exercise specialist about appropriate exercises to do.
  • Shoes that fit: Comfortable footwear is also important as diabetes causes nerve insensitivity in the feet.
  • Poorly-fitted shoes can lead to foot complications such as ulcers, blisters or corns.
  • Stick to medications: In order to ensure blood sugar targets are achieved, most people with type 2 diabetes will require oral medication and/or insulin, along with living a healthy lifestyle.
  • Keeping clinic appointments: You need to take a proactive role in the management of your healthcare in order to prevent or delay the development of diabetic complications.
  • It is very important to follow the medication dose and timing prescribed by your doctor. It is dangerous to skip medication, or adjust medication dosage and timing without checking with your doctor.
  • Self-monitor blood sugar levels: Regular monitoring of your blood glucose gives you a basic understanding of how your diet, medication and physical activity affects your body and how you can manage it.
  • In general, individuals with diabetes should have comprehensive physical examinations once a year and have their diabetes assessed at least every three to six months.
  • Too little sleep can increase the risk of diabetes, and if you already have diabetes, sleep deprivation can lead to poor blood sugar control.

Can you give examples?

The most common cause without diabetes is that if you did not eat enough, or if you skipped a meal. Or if you exercised too heavily, and you did not eat enough. Different people react differently to fasting and skipping meals.

Another common example is if you drink too much alcohol, and forgot to eat. Alcohol can fill your stomach up and intoxicate you, causing you to forgo regular meals.

Some diseases of the liver like hepatitis can also interfere with the liver's ability to regulate the sugar process, thus leading to hypoglycaemia.

In rare cases, a pancreatic tumour called insulinoma may produce too much insulin, causing too much glucose to be depleted from the bloodstream.

Why do diabetics get hypoglycaemia? I thought the condition leads to excess glucose in the bloodstream.

If diabetic patients take too much diabetic medication or insulin, this can cause too much sugar to enter the body's cells, thus causing hypoglycaemia. That is why it is so important for the doctor to help you find the right dosage of insulin or medication to regulate your blood glucose.