Dear Alice,

Is there any chance that because I get low blood sugar occasionally, I may become a diabetic someday? And what can you keep with you to take when your levels do drop, and you can't get to any food or juice?

Thanks,

Shaky Sharon

Dear Shaky Sharon,

You can rest assured that having occasional issues with low blood sugar, or hypoglycemia, hasn't been linked to diabetes risk in the future. That being said, there is a relationship between diabetes and hypoglycemia, in that folks with diabetes (type 1 or type 2) are more likely to develop hypoglycemia during the course of their treatment (more on this later). And, while those prone to severe hypoglycemic episodes can take something when they can’t get to food or juice, treating the root cause and incorporating some healthy lifestyle behaviors (for both diabetics and non-diabetics) may help to prevent bouts of low blood sugar in the first place.

In general, patients and health care providers frequently attribute symptoms of anxiety, irritability, or hunger to hypoglycemia without actually documenting the presence of low blood sugar. It may surprise you to know that hypoglycemia (with blood sugar levels below 50 mg/dL), generally occurs in only about five to ten percent of the people presenting with symptoms. For most, the actual cause is unclear. However, food intake — either the food that is eaten or the time it takes for the food to move through your stomach and intestinal tract — have been associated with low blood sugar.

When a spat of low blood sugar hits, replenishing blood sugar is key. This can be done by consuming foods that are quickly converted into sugar in the body (such as candy, regular soda, or fruit juice, as you mention). But, if you know that getting to food or juice might be a challenge, have you thought about keeping snacks handy, such as hard candy, in your purse or backpack? That way, you can get to it quickly if you need it, without any serious disruptions to your day.

Additionally, utilizing strategies, including (but not limited to) chowing down on small, frequent meals throughout the day and making sure those meals are balanced, can help to keep your blood sugar steady and may curb your low blood sugar issues in general. Since you mention this is an issue you’ve experienced a number of times, it may also be time to see whether there is something else going on. Partnering up with a medical professional to investigate and treat a possible underlying cause can address the root of your blood sugar issues and hopefully prevent dips in the future. Depending upon the severity of your episodes, s/he may advise you to carry a glucagon kit with you, which is an injectable medication used to raise blood sugar in an emergency.

Lastly, because you broached the connection between diabetes and low blood sugar, it bears mentioning that different strategies may be utilized to handle it for those living with diabetes. The insulin taken by individuals with diabetes in order to maintain glucose levels can cause blood sugar levels to drop too low, especially if too much insulin is taken relative to the amount of blood glucose. As such, not only is it recommended that diabetics have carbohydrate-rich snacks or glucose tablets at the ready, but those undergoing insulin therapy are also advised to have a glucagon kit with them to replenish blood sugar levels in the event of an emergency. Changes in medication, diet, or physical activity can also cause hypoglycemia in individuals with diabetes. To that end, it’s crucial to find the optimum dosage of medication to fit with each person’s regular dietary and physical activity habits. The Go Ask Alice! Q&A Meal planning for people with diabetes has even more information about healthy eating and physical activity for those living with diabetes to help keep blood sugar levels in check.

From your inquiry, it really seems that you’d like to put a stop to your bouts with low blood sugar. Speaking with a health care provider is the best way to help inform what actions to take to address individual episodes, determine the root cause of your blood sugar blues, and work to prevent it once and for all.

Alice!

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