No, not a hippo; the other thing. No, not a hypocrite either. A hippogriff is something else, too. We’re talking about a hypos and low blood sugar.
It’s not a common word for most people without diabetes. But those who do have diabetes are, or will become, extremely familiar with the term hypo. It often goes hand-in-hand with diabetes treatment, and it therefore deserves attention.
We’ve got the answers to all the questions you might have about hypos! If you want to learn the basics of hypos, or if you’re familiar with them but want to know even more of the nuts and bolts – then you’ve come to the right place.
In this article (click to scroll down!):
What is a hypo?
What Causes low Blood Sugar?
Can you have Hypos with type 2 Diabetes?
Why do People with Diabetes need to Lower Blood Sugar?
Are Hypos Dangerous?
How do you Treat a hypo?
Why can’t the body Raise Blood Sugar with Diabetes?
What does a Diabetic hypo feel like?
What is hypo Unawareness Exactly?
What are the Symptoms of a hypo?
How many Hypos a week is too many?
Can you Drive if you get Hypos?
What’s up with Night-Time Hypos?
How do you Prevent Hypos?
A hypo – or hypoglycemia to use its full name – is when blood sugar levels are too low.
Usually, the body takes glucose from the bloodstream to use as energy. A person has low blood glucose when that glucose in the bloodstream has been used up, which in turn means not having enough energy.
It’s something that is particularly common for people with diabetes due to medication that is used. It’s also important that those with diabetes pay attention to hypos because the body usually can’t regulate its own blood sugar.
Low blood sugar is about how the body takes glucose from the bloodstream. There can be many different reasons why the body uses up the glucose. For instance, aerobic exercise requires energy, and this will result in lower blood sugar.
Anyone can have low blood sugar but people with diabetes are more likely to get blood sugar that’s too low (a hypo, that is). This is because those with diabetes take medication that deliberately lowers blood sugar.
Since the body of a person with diabetes can’t regulate its blood sugar, these medications have the potential to lower blood sugar too much.
Whether a person has a hypo depends on the medication they use. Some people with type 2 diabetes don’t need to use blood sugar-lowering medication: they are generally not likely to have low blood sugar.
Others with type 2 diabetes might use insulin or other drugs such as metformin when used with sulfonylureas. These can cause hypos.
Diabetes is a condition where the body isn’t able to lower blood sugar on its own. This is because people with diabetes are not using their own insulin (the hormone that would usually lower blood sugar) either as a result of not being able to produce enough or not being able to respond to insulin effectively.
This means that many people with diabetes have to increase insulin sensitivity or control the amount of glucose in the blood.
Hypos are fairly straightforward to treat, and so, they’re not usually dangerous.
However, hypos still should be taken seriously because they can be dangerous if they’re not treated. Without getting the energy that you would normally get from glucose, the body can end up in a coma.
Fortunately, people with diabetes know to carry around a snack for treating hypos with.
The solution to blood sugar that’s too low: eat sugar. It’s pretty easy.
To be more accurate, carbohydrates should be taken (sugar is one kind of carbohydrate). Carbs are converted into glucose in the body, which then raises blood sugar levels.
The “rule of 15” is usually used for treating hypos, so called because you would eat 15g of fast-acting carbs and wait 15 minutes to see if blood sugar levels have risen to safe levels.
When looking for ways for how to fix low blood sugar, you also don’t want to go overboard with the carbs and end up in the other direction with blood sugar that’s too high. So, it’s always easier to carry around a snack that has the exact amount of carbs that you need.
It’s clear that with diabetes, the body can’t lower blood sugar when it needs to. So why can’t it raise blood sugar when it needs to either?
It’s to do with how the pancreas – the organ that’s usually responsible for insulin – works. Within the pancreas are the beta cells which produce insulin. The pancreas also has alpha cells which produce glucagon (which later increases blood sugar) in case the body needs to raise blood sugar levels.
The alpha and beta cells basically work in harmony, receiving signals from one to the other to regulate blood sugar.
For some people with diabetes (often type 1 diabetes in particular), the beta cells are not producing insulin. So, when the beta cells aren’t producing insulin, the alpha cells also don’t function as they should.
As a result, some people with diabetes don’t produce enough glucagon when they have hypoglycemia.
The role of alpha cells in diabetes is still being researched upon. A study from Uppsala University found that the alpha cells no longer respond to the signals from insulin, meaning they constantly produce glucagon at the same rate, regardless of whether a person has high or low blood sugar.
This means that the alpha cells are producing too much glucagon when a person is hyperglycemic (when blood sugar is too high) and too little glucagon when a person is hypoglycemic.
A hypo results in having low energy. And so, the feelings of a hypo are those which you would associate with low energy, such as tiredness, hunger, anxiety, or poor concentration.
At the same time, there are people who don’t have a particular feeling when a hypo occurs – they don’t notice that they’re having a hypo. This is called hypo unawareness.
It’s always a good idea to check blood sugar levels regularly, just in case you can’t notice a hypo.
Hypo unawareness does what it says on the tin: it means being unaware of the symptoms of hypos because the body doesn’t send the signals.
It’s not too clear why hypo unawareness happens, but sometimes it’s partly to do with the body becoming too accustomed to low blood sugar.
As for the technical side of hypo unawareness: it’s where the body doesn’t release epinephrine (i.e. adrenaline) that in turn kick-starts the symptoms associated with hypos.
To add to the aforementioned “feeling” of hypos, let’s have closer a look at the possible symptoms of a hypo:
- Feeling anxious
- Blurred eyesight
- Trouble concentrating
- Feeling confused
If you want to have a general idea for numbers of hypos, JDRF suggests contacting a doctor if you’re having more than 3-4 hypos a week.
In an ideal world, you should have no hypos at all. But instead of focusing on how many hypos you might be having, try to focus on how to keep blood sugar stable to the best of your abilities. Try not to have hypos too often because it can lead to hypo unawareness.
Equally, don’t be too hard on yourself when you do go low; it will happen at some point.
If you’re particularly worried about how many hypos you’re having, it’s always a good idea to speak to your healthcare professional; they might suggest readjusting your medication dosage.
If you’re using medication that lowers blood sugar, like insulin, you should always test your blood sugar before driving. If you’re driving for a longer period, take breaks to test your blood sugar.
This will give the opportunity to treat blood sugar before a car journey and to avoid any hypos while driving.
Ultimately, if you have too many hypos, a doctor will usually be responsible for informing the relevant driving licensing authorities (although this depends on the country). So, hypos can have an impact on your driving licence if they are not under control.
You might wake in the night with the symptoms of a hypo or wake in the morning feeling tired and sweaty. This would be a case of nocturnal hypoglycemia.
It’s not unusual to have night-time hypos, but it’s also a situation which you might want to avoid. Our blog post, Diabetes and Sleep gives more in-depth suggestions.
However, if you are having night-time hypos frequently, consider eating a snack before bed or readjusting your medication in consultation with your doctor.
The first step with preventing hypos is testing blood sugar levels regularly. That way you can hopefully gain an insight into your blood sugar before it gets too low.
Aside from that, paying attention to your lifestyle will help you notice when exactly you get hypos. For instance, do you notice that you get hypos the morning after exercising? Which might make you ask “does exercise lower blood sugar?”.
Certain exercises can indeed lower blood sugar, and, if taking insulin, you might want to lower insulin levels in the hours after exercising. If so, do consult with a doctor.
Try to keep a record of your episodes of low blood sugar to see if a pattern arises. Use Hedia’s diabetes tracker for this: data entry is easy (blood sugar levels can even be added wirelessly from certain blood glucose meters) and you’ll get to use a logbook while seeing a graph giving an overview of your blood sugar.
Naturally, we would also suggest using diabetes software to help prevent hypos. Avoid errors in mental maths by using Hedia’s calculations to give you insulin and carb recommendations based on the information you give.
We’re feeling positive – hypositive, if you will – that you’re becoming an expert on hypoglycemia. In order to treat hypos, it can be worth truly getting to the bottom of this fascinating glycemic circumstance. Well done for finding out more!
Want to find out even more? Get the answers to the different diabetes definitions with Hedia’s Diabetes Dictionary right here!