While many doctors focus on avoiding the harm high blood sugar levels can have on people wth Type 1 diabetes, low blood sugars can “ruin” the quality of life for people with the disease, according to a column posted on Diabetes Health written by Robert J. Tanenberg, MD, a member of the publication’s advisory board. Most diabetics suffering from mild or moderate hypoglycemia experience tell-tale signs, such as sweating, trembling of the hands, hunger, nervousness, or palpitations. They can correct these low sugars relatively quickly by eating sugar or fast-acting carbs. However, if the patient does not experience the symptoms, the blood sugar levels will continue to fall unnoticed.
When blood sugar levels fall below 55 mg /dl, the brain does not function normally. Patients can appear confused and their reflexes are slowed. The condition is considered “severe hypoglycemia” when the patient is unable to help correct the low blood sugar themselves and needs assistance from another.
People with Type 1 diabetes can develop what is called hypoglycemic unawareness, a condition where the patient doesn’t exhibit the typical symptoms of low blood sugar levels. This, in turn, makes it more difficult for them to address the dangers of low blood sugars.
Hormonal changes make it more difficult for the body to naturally fight low blood sugars and increase the risk to patients. Blood sugars below 30 mg / dl can lead to seizures and death. With each severely low blood sugar, the patient can become more lucid during the episodes, raising the risk of seizure or death. This tends to happen with people that have tight A1C control as defined by an A1C score of less than 6.5%.
Exercise in the late afternoon is often believed to be the cause of nighttime hypoglycemic episodes, according to the article. Drinking can also lead severe hypoglycemic events.
The doctor recommends that physically active people with Type 1 diabetes check their blood sugar regularly, at bedtime and 3:00 AM if the exercise is after 4:00 PM. He also says to reduce nighttime insulin intake after exercise and to consider raising blood glucose targets for those with severe hypoglycemic episodes, especially if they sleep alone.