HELP ON DIABETES

Treatment of Hypoglycemia

Treating hypoglycemia is fairly straightforward: eat or drink any food that has a lot of glucose and is easily absorbed.

Sources of glucose include glucose tablets and gels that you can buy at your pharmacy. Fruit juice and nonfat milk are also good sources. Foods with a lot of fat such as chocolate are not as good because the fat will delay the absorption of the glucose. Fructose does not raise the blood glucose, but most foods that have fructose, such as honey and fruits, also have a lot of glucose.

Most times about 15 grams of carbohydrate is sufficient—but if your glucose is below 50 mg/dl, then 30 grams might be more appropriate. You should check your blood glucose fifteen minutes afterward, and if the glucose is still low take another 15 grams of carbohydrate and check the levels again in another fi fteen to twenty minutes. Keep doing this until the glucose is in the safe range. It is important not to overdo your ingestion of carbohydrates because the glucose levels then go very high. In most people, 15 grams of glucose will raise the blood glucose level by about 40 mg/dl.

GLUCAGON INJECTION

Injection of glucagon causes release of glucose from glycogen stores in the liver. If you are on insulin, keep an  emergency glucagon kit at home and at work. Family members and colleagues at work should be educated about low glucose reactions and trained to inject glucagon in case you become very confused or lose conscious­ness due to hypoglycemia. You do not want to find out after the event that no one knew where the glucagon was kept and no one felt comfortable giving an injection.

A glucagon kit has a vial with 1 mg of powdered glucagon and a syringe contain­ing diluting solution. To prepare the glucagon, inject all of the solution in the syringe into the vial of glucagon. Shake the vial to dissolve the glucagon and draw the solu­tion back up into the syringe. Inject into the thigh, buttock, or arm. Glucagon injec­tion works faster if it is injected into a muscle. For children who weigh less than forty-four pounds, inject half the contents of the glucagon syringe. Glucagon can cause nausea, and so the person being treated should be put on her side in case she vomits. The glucose level does not stay up for very long, and so once the person is awake, give her additional glucose by mouth. Using glucagon can allow the patient to be treated at home and avoid having to be admitted to the hospital, but paramed­ics should be called if the patient is having a seizure or is not responding within ten to fifteen minutes after the glucagon injection. If you know that the coma in the

person you are treating is due to sulfonylureas, do not give glucagon, because under these circumstances glucagon can paradoxically cause a fall in glucose levels.