Low Blood Sugar Causes

DISCLAIMER: The content on " low blood sugar causes " & www.diabetes-blood-sugar-solutions.com is for informational purposes only and not to be used as medical advice. Reading beyond this notice implies you've read and agree to the terms in the disclaimer . You should contact your physician or health care team with concerns about your diabetes or health. Thanks for staying safe folks!

Related:

Causes of hypoglycemia: common and rare
Hypoglycemia: definition and concerns
Symptoms of hypoglycemia.
Treating Low Blood Sugar: The fastest fixes.

The most common low blood sugar causes in diabetes are due to injected insulin or insulin secretagogues (pills that make insulin). Many lifestyle factors can be triggers for low blood sugar in people using these medications, as you'll see in the list below. However, there are some uncommon or even rare low blood sugar causes. In people without diabetes, "reactive hypoglycemia" might not even be low blood sugar.

Please take the time to find out about low blood sugar and reasons for it in yourself. The more you understand the low blood sugar causes, the better able you'll be at preventing it. And the safer you'll be.

• Type of diabetes medications: Insulin and diabetes pills that make insulin (insulin secretagogues) are the most common of low blood sugar causes. Check with your pharmacist to see if you are taking an insulin secretagogue. There are numerous brand names on the market including some of the following:

  Low Blood Sugar Causes: Insulin Secretagogues

  • Diabeta or Micronase (glyburide)
  • Diamicron (gliclazide)
  • Gluconorm or Prandin (repaglinide)
  • Starlix (nateglinide)
  • Amaryl (glimepiride)
  • Glucotrol (glipizide)

• Recent diabetes medication added. If you take insulin or an insulin secretagogue like Diabeta and then start taking Avandia, Actos or Glucuphage (metformin) you may experience lows. The Avandia, Actos and Metformin (glucopahge) are not directly responsible - so don't stop taking them. It's simply that they each act to make your insulin work better - this includes the extra insulin that the Diabeta/glyburide (or other insulin secretagogue) asks your body to make. The metformin also tells your liver to make less sugar. If getting low sugars more than 1-2 times a week, see your doctor as you may need a decrease in your Diabeta (or other insulin making pill). See the doctor immediately if you've had a low blood sugar that required the help of someone else.

  P.S. It usually takes the Avandia and Actos 2-3 months to start working. Although, I saw a lady last week who started having lows shortly after 1 month on Avandia. The addition of this pill was one of the contributing low blood sugar causes.

• Missed or late meal or snack. This can happen for various reasons. Could be shiftwork or job related. Or poor memory alone or due to dementia, depression or sleep apnea. Or simply poor appetite. If missed or delayed meals are low blood sugar causes for you, see your doctor to discuss different options for medications.

• Not enough carbohyrdate. A meal or snack with not enough starch, fruit, milk (carbohydrate) may be one of the causes of hypoglycemia if you are on insulin or insulin making pills. This includes going out to dinner and enjoying a steak with salad and green beans. Not much carb there. So not surprisingly, this meal could become one of the low blood sugar causes. You can talk with your doctor or diabetes educator about how to handle situations like this with either quick changes to meds or diet.

  Important. . An Atkins type diet or no-carb / low carb diet can be unsafe and become one of the low blood sugar causes unless you FIRST check with your doctor and diabetes educator. Of course, as a registered dietitian and certified diabetes educator I'm not keen on the nutritional adequacy of Atkins diets anyway. But . . . you make your own decisions. So I'm just cautioning you to make them safely. I've seen a few people on insulin whose low blood sugar causes (and paramedic's visits) were directly related to starting the Atkins diet.

• A very low glycemic index meal with humalog or novorapid could be one of the low blood sugar causes. Low glycemic index foods like kidney beans raise the blood sugar very slowly whereas Humalog and Novorapid drop the blood sugar quickly. For example, a meal like chili with no bread could result in a low sugar a few hours after the meal.

• Extra activity or exercise - yes, even vacuuming! I recall a woman whose blood sugars always dropped every Thursday - when she vacuumed!! So now you know. Low blood sugar causes include housekeeping.

• Accumulated activity: For example, day 3 of "Trading Spaces". Okay, I know they only do 2 days but if there were 3 days then the low sugars would be even worse by then. Accumulated activity you see! (Nothing at all to do with running from some of the crazy decorators. Although, could be due to running after the hunky carpenters! Ahem ... sorry about that.)

• Weight loss. Weight loss is one of the more desirable causes of hypoglycemia. (If weight loss is intentional!). Insulin works better when we carry less fat. A friend of mine recently questioned why her daughter was getting so many low blood glucose levels until she realized - aha!- her teenager had lost significant weight through better food choices.

• Alcohol induced low blood sugar. One of the causes of hypoglycemia that people often overlook is excessive alcohol. Even a few drinks in people taking insulin or insulin producing pills can sometimes tell the liver to make less sugar and be a cause of hypoglycemia during the night.

• Diabetes is changing . Your needs can change. Typically people need more meds over time since diabetes is progressive. But, numerous things can result in needing less just because. . . well. . . because we are human and unpredictable.

• Is the honeymoon starting? No romance involved here. If you were recently diagnosed with type 1 diabetes and started in insulin, you still likely have some beta cells that have not yet been destroyed. However, they probably weren't working too well when your blood sugars got too high. This is called glucose toxicity. (Much like I don't like working outside when the temperature gets too high.) Now that there is injected insulin on board and the blood sugars have decreased, the remaining beta cells feel more comfortable working and making insulin. ( Hey, much like I feel more comfortable working when the heatwave passes.) This period where the remaining beta cells decide to work again is called "the honeymoon". Your insulin doses might need to decrease during this period. Any no, we aren't sure how long this period will last. Could be a few months to the outside chance of a few years.

• Early pregnancy. The first trimester of pregnancy can cause lower blood sugars. It is usually the third trimester that the blood sugars rise.

• Inadequate rolling or mixing of insulin. Cloudy insulins like NPH, N or mixed insulins (eg. 30/70) require adequate "rolling" or "mixing". Without the "rolling" your insulin may work too fast (or too slow) depending on what you draw up in the syringe.

• Error giving insulin. Occasionally people make a mistake and give their fast acting insulin instead of their long acting insulin. In these situations, be sure to let someone know and eat a large amount of fast sugar (see treating hypoglycemia. ) Ideally, call the doctor, educator to ask for advice or go to emergency department.

• Adrenal insufficiency. Very rarely in type 1 diabetes the adrenal glands that sit on the kidneys stop making enough cortisol. This is called adrenal insufficiency. It is typically autoimmune in nature (the body attacking itself, like in type 1 diabetes). Although occasionally can be secondary an improperly functioning pituitary gland. Cortisol is a hormone that works in a fine dance with insulin. It works to increase blood sugars. Without enough of it, the insulin works way too well! It can result in dramatic low blood sugars. Symptoms of adrenal insufficiency in type 1 diabetes are: sudden large and unexplained drops in insulin; low blood sugars, nausea, vomitting, weight loss. See your doctor if you have these symptoms.

• Renal failure or kidney disease. This is very different from the point just above. And this is more common. Kidney damage is one of the complications of diabetes. In advanced renal disease it is suspected that the body makes less sugar during the night. Also, there may be less of the hormones working against insulin. People might have more overnight low sugars and require amazingly small amounts of insulin at night compared to the dose they take in the morning or during the day.

• Menstraul cycle. Yes, many women do have their sugars drop during their period, whereas others have the opposite.

• Hypoglycemia unawareness. For some people, particularly with type 1 diabetes, the body loses the ability to sense low blood sugars early.These people can't detect the occasional mild low blood sugar that is usually seen in most people with type 1. The sugar continues to drop until these people are quite low (perhaps under 2.8 mmol or under 50 mg/dL) and experiencing more severe symptoms of lows sugar that require the help of someone else. People with hypoglycemia unawareness are usually encouraged to run their blood sugars higher as well as practice blood glucose awareness training (BGAT).

• Gastroparesis. This is the delayed emptying of the stomach that can be caused by damage to the autonomic nervous system. It is one of the possible complications of uncontrolled diabetes. Typically, people with gastroparesis can have fluctuating blood sugars from lows to delayed highs due to the variability in digestion times. This complication is diagnostic with gastric emptying tests.

• Dumping syndrome. People with diabetes are being referred more often for gastroplasty (or stomach stapling). Dumping syndrome is a frequent side effect of stomach stapling. It is the dumping of food too early into from the stomach into the small part of the intestine.

• RARE,RARE: Insulinoma. Please do not jump to conclusions. The presence of insulin producing tumors in the pancreas is rare! Less than 1 in a million will have this as one of the low blood sugar causes. Chances are, if you have diabetes, you don't have an insulinoma!
  
  
  
  
  

  Reactive Hypoglycemia or Diet-Induced Hypoglycemia

  In some people without diabetes, the pancreas pumps out too much insulin in response to a meal. The blood glucose thens drops too quickly. Although in theory this could be one of the low blood sugar causes, the body usually has the smart ability to prevent the blood glucose from dropping too low. It the body pumps out two hormones that increase blood sugar - adrenalin and cortisol. These hormones in excess can cause the symptoms of low blood sugar even though the blood sugar still tests normal.

  It is believed that many people who experience "reactive hypoglycemia" are actually experiencing the effects of too much cortisol and adrenalin in response to too much insulin. There is some hypothesizing that these people might be at increased risk for getting diabetes since the higher levels of cortisol could tire the pancreas out like in Cushing's disease.

  Regardless of the low blood sugar causes, a true low blood sugar should be treated immediately to rid yourself of the symptoms of low blood sugar and the risk of injury.

  <<< PREVIOUS

  Related:
  Hypoglycemia: definition and concerns.
  Treating Hypoglycemia: The fastest fixes.
  Symptoms of hypoglycemia.
  Back to Low Blood Sugar Causes
  Home to: How to Manage Blood Sugars

  Because the answer to your question is important, please keep searching if you didn't find it. Good health!

  	Web www.diabetes-blood-sugar-solutions.com

  References:
  1. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
  2. Canadian Diabetes Association 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2003;27(Suppl 2):S1-152. 2005

  DISCLAIMER