Hypoglycemia refers to a condition of low glucose (blood sugar) level in your body. When your blood sugar level falls below 70 mg/dl, it requires an immediate attention as hypoglycemia can be fatal if left untreated. Hypoglycemia is most often caused by the medications used to treat diabetes, however, there are other disorders or medications that can lower your blood sugar level.
Symptoms of hypoglycemia
It is important to recognize the symptoms of hypoglycemia so that you can properly treat it. If you experience following symptoms, you should check your blood sugar level. If severe hypoglycemia occurs, one can experience seizures or coma.
Nervous, anxious, irritable
Sweating, chills, clamminess
Weakness, lightheadedness, dizziness
Blurred or tunnel vision
Lack of coordination
Medications / disorders that can cause hypoglycemia
Some medications that are used to treat diabetes have a higher risk of causing hypoglycemia especially if the medication is taken without food. Below are those medications:
Glipizide / glimepiride / glyburide
Nateglinide / repaglinide
Other disorders or medications that can cause
Excessive alcohol consumption
Beta blockers (metoprolol,
atenolol, carvedilol, etc): not only beta blockers may cause hypoglycemia, they
can also mask certain symptoms such as shakiness, palpitation, and anxiety.
Sweating and hunger are not masked.
Ciprofloxacin / levofloxacin
How to treat hypoglycemia
Rule of 15: Steps to treating hypoglycemia
Take 15-20 grams of glucose or simple carbohydrates. Do not use chocolate or peanut butter for initial treatment of hypoglycemia. Added fat will delay absorption of sugar and prolong hypoglycemia.
Recheck blood sugar after 15 minutes
If blood sugar is still less than 70, repeat 15-20 grams of glucose or simple carbohydrates and recheck blood sugar again after 15 minutes
If blood sugar is greater than 70, eat a small meal or snack that contains some carbohydrates, protein, and fat in order to prevent hypoglycemia from recurring. The fat and protein will help to stabilize the blood sugar.
15 grams of glucose or simple carbohydrates
Glucagon is recommended to be prescribed for all diabetic patients at increased risk of severe hypoglycemia. It is only used when the patient not conscious enough to treat their hypoglycemia. Caregivers, school personnel, or family members of these patients should be trained on when and how to administer glucagon. Carbohydrates should be administered as soon as possible after glucagon. It is important to note that glucagon will not work for patients with alcohol induced hypoglycemia due to depleted glycogen stores in those individuals. If no response to glucagon, IV dextrose may need to be administered.
Place patient lying sideways to prevent choking upon return to consciousness. Mix powder for injection by adding 1 mL of manufacturer-supplied sterile diluent or sterile water for injection to a vial containing 1 unit of the drug, to provide solutions containing 1 mg of glucagon/mL. Shake vial gently to dissolve. Use syringe to withdraw glucagon. May administer intramuscular injection in the upper arms, thighs, or buttocks.
Episodes of hypoglycemia are dangerous for patients. They decrease quality of life, and if severe enough can be fatal. Increasing awareness, recognizing causes, and recognizing symptoms can help to prevent disastrous consequences that can arise due to hypoglycemia. Knowing the steps to treatment will help patients and caregivers remain calm and in control during the event. If hypoglycemia occurs often, re-evaluation of current treatment may need to be considered.
Vesper Specialty Pharmacy is the brainchild of Dr Joshua Koroghli. Since graduating from pharmacy school with the prestigious Deans Award from Roseman University of Health Sciences in Henderson, NV, it has been his dream to open a place to call his own. Dr Koroghli has experience in many facets of pharmacy and healthcare, from retail, compounding, specialty to home-infusion. He grew tired of seeing the lack of patient interaction brought on by being in busy corporate pharmacies and it was then when he decided it was time for a change.