Blood sugar, or glucose, is the body’s primary energy source. Insulin, produced by the pancreas, helps glucose enter cells for energy or storage. For individuals who don’t produce enough insulin or can’t use it effectively, insulin therapy manages blood sugar. Maintaining healthy levels is important, as both high and low blood sugar can lead to complications.
Recognizing Low Blood Sugar
Taking insulin when blood sugar levels are already low can be dangerous, as it further reduces glucose, potentially leading to severe hypoglycemia. Hypoglycemia is a condition where blood sugar drops below the healthy range, typically defined as below 70 milligrams per deciliter (mg/dL) or 3.9 millimoles per liter (mmol/L) for most individuals with diabetes. The brain relies on a continuous supply of glucose, and insufficient levels can impair its function.
Symptoms of low blood sugar can appear quickly and vary among individuals. Common indicators include shakiness or trembling, sweating, and feelings of nervousness or anxiety. Other signs may encompass a fast heartbeat, extreme hunger, dizziness, lightheadedness, and difficulty concentrating or confusion. These symptoms arise from the body’s release of stress hormones, such as adrenaline, in response to falling glucose levels.
Responding to Low Blood Sugar
When low blood sugar is identified, immediate action is required to raise glucose levels safely and effectively. The American Diabetes Association recommends a strategy known as the “rule of 15” for mild to moderate hypoglycemia. This approach involves consuming 15 grams of fast-acting carbohydrates. After 15 minutes, blood sugar should be rechecked, and if it remains below 70 mg/dL, the process of consuming another 15 grams of carbohydrates and retesting after 15 minutes should be repeated until levels return to a safe range.
Examples of suitable fast-acting carbohydrates that provide approximately 15 grams include four glucose tablets, half a cup (4 ounces) of fruit juice or regular soda (not diet), or one tablespoon of sugar, honey, or corn syrup. In instances of severe hypoglycemia, where an individual may be disoriented or unconscious, emergency glucagon should be administered if available, and emergency services should be contacted.
Personalizing Insulin Decisions
Insulin dosage decisions are complex and personalized, influenced by many factors beyond the current blood sugar reading.
Recent food intake (especially carbohydrates) and physical activity levels significantly impact insulin requirements, as exercise can increase insulin sensitivity and lower blood sugar. The type of insulin (rapid, short, or long-acting) is important due to different onset times, peak effects, and durations. Time of day, like the “dawn phenomenon” (early morning blood sugar rise), and individual insulin sensitivity also vary. These factors mean an insulin dose appropriate for one situation might be inappropriate in another, such as before a meal.
When to Contact Your Doctor
Regular communication with a healthcare provider is important for effective insulin management. Contact your doctor or diabetes care team for frequent mild low blood sugar episodes or persistent high blood sugar despite your current regimen.
Any severe hypoglycemia requiring assistance or emergency glucagon should be reported. Discuss concerns about insulin dosages, side effects, or your overall management plan with your doctor. Never make significant changes to your insulin regimen without consulting a healthcare provider, as this could lead to dangerous blood sugar fluctuations.