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Hello.

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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.

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Did You Know?

Having one single low blood sugar event increases your risk of having a severe low blood sugar event in the future.

What Causes Severe Low Blood Sugar?

You may have a severe low blood sugar event for several reasons, and many of them are out of your control. But understanding why a severe low blood sugar event may happen in the first place can help you feel more in control—and potentially help you recognize low blood sugar before it becomes severe. Some common causes of severe low blood sugar include:

Taking too much medicine or taking the wrong medicine

Missing a meal or not being able to eat enough

Medicine that may increase the risk of low blood sugar (for example, insulin, glimepiride, or glipizide)

Exercising vigorously or for a long time

Eating foods that are high in fat and low in carbohydrates

Drinking alcohol

CGM* readings that are not accurate

Other medical conditions (for example, kidney disease)

*CGM=continuous glucose monitor

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Did You Know?

Most people with diabetes feel symptoms, such as sweating or anxiety, when they have low blood sugar. Others have difficulty noticing as they do not feel any symptoms, so they don’t know they need to treat it. This is known as “hypoglycemia unawareness” or “impaired hypoglycemia awareness.”

Hypoglycemia unawareness puts the person at higher risk for severe low blood sugar. People with hypoglycemia unawareness need to take extra care to check blood sugar frequently, especially before and during critical tasks such as driving.

To learn more, speak to your healthcare providers and they can help!

Learning About Your Own Low Blood Sugar Events

A nurse showing a lady results on a tablet

If you’re having low or severe low blood sugar events, but you don’t know the reasons, try the tips below. They may help you learn more about what’s causing your low blood sugar.

Keep a logbook (hand written or electronic) every day, or as often as you can. You can write down your:

  • Blood sugar levels
  • Medicines you take
  • How often and how much you exercise
  • Foods you eat and alcohol you drink

Think about your previous low or severe low blood sugar events. Write down any early warning signs or symptoms you noticed. Also, write down any changes in your daily activities around the time of low
blood sugar events.

Discuss your logbook, and CGM data if available, with your healthcare provider. They may be able to
help you see trends related to your low blood sugar event

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Did You Know?

A higher A1C level does not protect you from severe low blood sugar. A1C is a blood test that measures your average blood sugar over the past 3 months. Because A1C doesn’t look at how your blood sugar levels vary from hour to hour, or from day to day, you may still be at risk for severe low blood sugar, regardless of your A1C level.

Blood sugar traces of two people with the same A1C of 8.0%

1 of 2 graphs showing the blood sugar level of a person with A1C of 8.0% over a number of days - this graph shows no event of high or low blood sugar. 2 of 2 graphs showing the blood sugar level of a person with A1C of 8.0% over a number of days - this graph shows several events of high and low blood sugar

Review Your Knowledge

Answer two questions to test your knowledge now

QUESTION 1 OF 2

 

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?

QUESTION 1 OF 2

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.

QUESTION 2 OF 2

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

  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