Happy family packing for car trip

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Thanks for joining me for Severe Low Blood Sugar Basics.

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Life is a journey and so much of it happens

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while we are busy making other plans.

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And as much as we would like, we can’t plan for everything.

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Sometimes, even when people with diabetes are taking steps

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to prevent severe low blood sugar

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life can still get in the way.

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A1C is a blood test

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that measures average blood sugar over the past 3 months.

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Because A1C doesn’t look at how your blood sugar levels vary from hour to hour,

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or from day to day, you may still be at risk

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for severe low blood sugar, regardless of your A1C level.

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Now, let’s talk about

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some of the causes of severe low blood sugar.

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In one study, people with diabetes who take insulin reported

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a range of everyday circumstances that

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can lead to low blood sugar emergencies.

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These include not eating enough food,

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unexpected or unusual physical activity,

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taking the wrong amount of insulin,

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situations that cause stress,

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changing blood sugar levels,

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and not noticing signs or symptoms of low blood sugar.

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A severe low blood sugar emergency could happen anytime, and anywhere.

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So, people with diabetes should be prepared with an emergency plan,

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just in case.

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Things to remember.

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One, you may be at risk for severe low blood sugar, regardless of your A1C level.

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Two, a range of everyday circumstances can lead to low blood sugar emergencies.

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Three, be prepared with an emergency plan

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just in case.

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Thank you for joining us for Severe Low Blood Sugar Basics.

Actions You Can Take To Help Prevent
Severe Low Blood Sugar

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When your daily routine changes, test your blood sugar more often to track your levels.

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Watch out for early warning signs of low blood sugar when your daily routine changes.

You may not notice any signs or symptoms, but if your blood sugar is less than 3.9 mmol/L (70 mg/dL), yuou need to take action to treat it.

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Keep snacks with fast-acting carborhydrates with you. Fast-acting carbohydrates are in food like: 

  • Hard candies
  • Fruit
  • Glucose tablets

Treat low blood sugar before it becomes severe by following the 15-15 rule.

15 grams of carbohydrates – 15 minutes
To treat non-severe low blood sugar as soon as signs or symptoms appear:

  • Eat or drink 15 grams of fast-acting carbohydrates, such as:
    • Half a cup of juice
    • 5-6 hard candies
    • 6 large jellybeans
    • 4 glucose tablets
  • Avoid carbohydrates that are also high in fat, such as chocolate. These are absorbed slower and take longer to
    raise your blood sugar.
  • After 15 minutes, if you still have symptoms or if your blood sugar is still less than 3.9 mmol/L (70 mg/dL), eat or
    drink another 15 grams of fast-acting carbohydrates.
  • When your blood sugar starts to return to normal, eat a meal or snack to prevent another low blood sugar event

Ask Your Healthcare Provider About:

Before you take short trips, such as...

images of grandparents taken a child to the park, two people buying tickets at the cinema, someone grocery shopping

Be sure you have your emergency pack with you:

emergancy pack - SHORT trips

Before you take longer trips, such as...

images of a plane, somebody hikingin the mountains, a road going off into the distance between two mountains

Be sure you have your emergency pack with you:

emergancy pack - LONGER trips

What to Do for Low Blood Sugar Events

If you do have a low blood sugar event, use the 15-15 rule to treat it before it becomes severe.

Until your blood sugar is in the safe range, avoid:


Review Your Knowledge

Answer two questions to test your knowledge now



Scenario 1: Jane is a young mother who had to pick up her daughter from school unexpectedly, so she missed her lunch. She is starting to feel shaky and weak, but she finds some hard candy in her purse. After eating it, she feels better.

Is Jane experiencing non-severe low blood sugar or severe low blood sugar?


Well Done!

Jane is experiencing non-severe low blood sugar. Fortunately, Jane noticed that her blood sugar was dropping. She was able to bring her blood sugar back up by finding and eating some hard candy.


Scenario 2: Michael is 70 years old and accidentally injected a higher dose of insulin than normal. He goes to watch some television, not realizing the dosing error. A little while later, he is feeling dizzy and confused, but he can't get off the couch to drink some juice.

Is Michael experiencing non-severe low blood sugar or severe low blood sugar?

Learn More About Severe Low Blood Sugar Below

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Happy family packing for car trip
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A man reading an article online and taking notes
  1. O’Reilly JE, et al. Diabetologia. 2021;64(1):S1-S380. 
  2. EASD 2021 (European Association for the Study of Diabetes), September 27-October 1, 2021; Virtual; Day #2 Highlights.
  3. Kedia N. Diabetes Metab Syndr Obes. 2011;4:337-346.
  4. Lammert M, et al. J Med Econ. 2009;12(4):269-280.
  5. American Diabetes Association. Diabetes Care. 2021;44(1):S73-S84.
  6. Lipska KJ, et al. Diabetes Care. 2013;36(11):3535-3542.
  7. Frier BM. Nat Rev Endocrinol. 2014;10(12):711-722.
  8. Kovatchev B, et al. Diabetes Care. 2016;39:502-510.
  9. American Diabetes Association. Hypoglycemia (low blood sugar). https://www.diabetes.org/healthy-living/medicationtreatments/blood-glucose-testing-and-control/hypoglycemia. Accessed November 1, 2021.
  10. Cox DJ, et al. Diabetes Spectr. 2006;19(1):43-49