You have started a patient on a sulfonylurea agent for her T2DM. How would you counsel them about recognizing and treating hypoglycemia?
Hypoglycemia means your blood sugar is less than…
4.
You may feel some or all of the following symptoms (list 5):
- Racing heart
- Sweating
- Shaking
- Headache
- Confusion
This can happen if (list 4):
- Medication is too strong
- Drinking alcohol
- Exercising
- Eating less carbohydrates than usual
This is what you should do (list 4):
Check blood sugar if possible. If <4 (or can’t check, but have symptoms), go on to the next step:
- Eat/Drink 15 g of carbohydrates (e.g. 3/4 cup juice or soft drink, 6 lifesavers, 1 Tbs honey, etc.) for a sugar of 2.5-4; 20 g for a lower sugar
- Recheck sugar every 15 minutes until >4 mmol/L
- Have snacks with carbohydrate and protein (e.g. half a sandwich, or crackers with peanut butter/cheese) if more than 1 hour until next meal
For the long-term, you should consider (list 2):
- Buying a Medic Alert bracelet
- Having a glucagon emergency kit on hand
- Always having a source of simple sugar available
