As diabetics chances are we’ve all experienced those dreaded lows, but what are they? What can we do as type 1 diabetics to avoid them and more importantly, what can we do to prevent them? Lets take a closer look and examine hypoglycemia!
The body’s most important fuel is glucose, a type of sugar. When you digest most foods, sugar is released, and that sugar ends up in your bloodstream as glucose.
Your body, particularly your brain and nervous system, needs a certain level of glucose to function — not too much, and not too little. If your blood glucose level isn’t right, your body will react by showing certain symptoms.
Hypoglycemia occurs when a person’s blood sugar levels are abnormally low, and it’s a potentially serious condition. If you know someone who has diabetes, you may have heard them talk about “insulin shock,” which is the common name for a severe hypoglycemic reaction.
People with diabetes may experience hypoglycemia if they don’t eat enough or if they take too much insulin — the medicine most commonly used to treat diabetes with those who suffer from type 1.
Causes Of Hypoglycemia:
Most cases of hypoglycemia in adults happen in people with diabetes mellitus. Diabetes has two forms, type 1 (loss of all insulin production) and type 2 (inadequate insulin production due to resistance to the actions of insulin). People with type 1 diabetes must take insulin to control their glucose level; if they skip meals or have a decreased appetite without changing their insulin dose, BAM, you guessed it, bring on the low!
Insulin is also used to treat some people with type 2 diabetes. If a person with type 1 diabetes accidentally takes too much insulin, or a person with type 2 diabetes accidentally takes too much of their oral medications or insulin, he or she may develop hypoglycemia. Even when a diabetic patient takes medications correctly, improper meals, odd mealtimes, or excessive exercise may result in hypoglycemia.
Classic Signs Of Hypoglycemia:
Symptoms of a low blood sugar will vary depending on the individual, but here is a list of most of the common ones that I’ve personally experienced. It should be noted that low blood sugars can occur suddenly and the most common low sugar symptoms include:
- blurry vision
- rapid heartbeat
- sudden mood changes
- sudden nervousness
- unexplained fatigue
- pale skin
- difficulty sleeping
- skin tingling
- trouble thinking clearly or concentrating
- loss of consciousness
If you have hypoglycemic unawareness, a condition in which you do know your blood sugar level is dropping, your blood sugar can drop so quickly you may not even have warning symptoms. When this occurs, you can faint, experience a seizure, or even go into a coma.
Its a fantastic question and was a test that was run on me to confirm my type 1 diagnosis. A c-peptide! What is it? What is the purpose and why do they use this particular test in order to confirm a type 1 diabetes diagnosis? Lets take a closer look!
What Is C-Peptide?
C-peptide, similar to the hormone insulin is produced in the pancreas. Both are released simultaneously from the pancreas where a compound called pro-insulin is split into two pieces.
As we are aware by now, Insulin is responsible for regulating the body’s glucose levels. Glucose, the body’s main source of energy, is a sugar that comes from foods. After a meal, our bodies break down the foods we eat into glucose and other nutrients, which are then absorbed into the bloodstream to give us the energy we need in order to fuel our bodies. Glucose levels in the blood rise after a meal and trigger the pancreas to make insulin and release it into the blood, and when insulin is released, so is C-peptide.
Although both are released into the blood stream simultaneous, C-peptide has zero effect on our blood sugar levels. That being said, it is extremely useful as its used as a marker of insulin production, since the pancreas typically releases C-peptide and insulin in about equal amounts.
In a nut shell, high C-peptide levels are associated with increased insulin production, while low C-peptide levels indicate decreased insulin production.
When it comes to diabetes management, blood sugar control is always the central theme. After all, keeping by keeping our blood sugars in check can help us live a long and healthy life. One of the central themes when it comes to glucose control is maintaining a good A1C.
By now most of us are aware of what an A1C and eAG test are, but why are they so important? What does an A1C actually measure? How about an eAG? Can one make it easier to understand your overall numbers or provide better insight as to what’s going on? All great questions, so lets take a closer look!
What is An A1C?
By now, this is the one you are probably most familiar with. You know, you go into the endo’s office and the first thing they do is sit you down and take a finger stick, only to zoom off into another room to measure the results and report back. An A1C test is a blood test that provides information about a person’s average levels of blood sugar over a 3 month period, but how does it all work?
Per the National Institute of Health:
The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent.
So what is this hemoglobin that they are talking about? Well, hemoglobin is the protein specifically found in red blood cells and is responsible for transporting oxygen throughout the entire human body. When blood sugar levels are elevated, some glucose attaches to hemoglobin and since red blood cells normally have a lifespan of 120 days, the A1C test is useful because it offers an indication of longer term blood sugar levels.
So how about an eAG?
What Is An eAG?
eAG also know as estimated average glucose is a newer term you may see talked about by your doctor. The American Diabetes Association introduced this term in order to help us translate our A1C tests into numbers that would more closely represent our daily glucose meter readings. How does this all work?
Well, your eAG number is calculated from the result of your A1C test. Like the A1C, the eAG shows what your average blood sugars have been over the previous 2 to 3 months, but instead of a percentage, the eAG is in the same units (mg/dl) as your blood glucose meter.
Below is small reference guild that will help you calculate your estimated average glucose level from your A1C result.
Or if your looking to calculate your very own, after your next doctors visit feel free to do so by using the following formulas:
28.7 x HbA1c – 46.7 = eAG (in mg/dl)
1.59 x HbA1c – 2.59 = eAG (in mmol/L)
Ok, so what’s up with this term that people keep throwing around called the dawn phenomenon? As type 1 diabetics we’ve all been there, up at 1:30 in the morning testing our blood sugars and come back with a perfect reading of 100 mg/dl only to wake up a couple of hours later with a glucose level of 400 mg/dl! Why is this? What’s happening to our bodies during that 2 1/2 hour period that sends sends our blood sugars into the stratosphere! Welcome to what is called, the dawn phenomenon. Lets take a closer look at what this is all about and what we can do to try and stabilize our blood sugars.
What Causes The Dawn Phenomenon:
The body prepares for waking up by secreting several different hormones. First, between 4:00 and 6:30 a.m. it secretes cortisol, epinephrine, and norepinephrin. You may recognize these as the hormones involved in the “fight or flight response.” In this case, their job is more benign, to give you the energy to get up and moving.
Besides giving you a burst of energy, these hormones raise blood sugar. You aren’t going to be able to make any kind of energetic response if you don’t have fuel, and after a long night’s sleep, the fuel your body turns to in order to get you going is the glucose stored in the liver.
So after these stress hormones are secreted, around 5:30 a.m., plasma glucose and insulin starts to rise.
Though a non diabetic will get a rise in insulin to help cells use the morning glucose, as type 1’s, we know that’s not always the case and instead of giving our cells a dose of morning energy, all we get is a rise in our blood sugars.
So what’s the deal when it comes to metformin? We are all aware of the great job it does when it comes to helping type 2 diabetics better control their blood sugars and studies are even beginning to show that it can actually help you live longer compared to those without the disease, but what about the negative side effects? We were discussing on my Facebook page the other day about the long term side effects, so lets take a closer look!
What Is Metformin?
So what does metformin actually do?
Metformin is used alone or with other medications, including insulin, to treat type 2 diabetes (just to recap, a condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Metformin is in a class of drugs called biguanides. It helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver.
Metformin also increases your body’s response to insulin, a natural hormone that controls the amount of glucose in the blood. I’m also beginning to see where metformin is used in addition to insulin to treat type 1 diabetes (again to recap, a condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood) and fellow type 1 diabetics are actually gaining better control when introducing metformin to their regular treatment plan.
Metformin has been show to be a great/effective treatment option for helping control ones blood sugar, but what about the associated side effects that some experience? Lets continue reading.
Metformin And Lactic Acidosis:
Although rare, lactic acidosis is potentially the most serious of the side effects. The uptake of lactate by the liver is effected in a negative way. If the kidneys do not process the excess lactate the blood of the patient will acidify which can lead to a whole slew of problems. Most of which are similar to the feeling one gets after an intense workout. For example: anxiety, hyperventilation, irregular heart rate nausea and in some cases vomiting. This is the reason that it is generally only prescribed to people with a healthy kidney function. This side effect is potentially lethal and when you experience any of the symptoms you should immediately contact your doctor or a local hospital.
Metformin And Hypoglycemia:
Since the primary role is to reduce high levels of blood sugar, it has the potential to lower glucose below what is considered the normal levels. With minimal amounts of glucose in the bloodstream weakness, dizziness, shaking and sweating are all signs of low blood sugar. In a situation in which a person feels some or all these symptoms, they must raise the blood sugar immediately to avoid complications such as coma. Therefore, individual need to always have available hard candy or natural juice or glucose tabs to counter this side effect.