A few weeks back SmartCare published an interview about Stine Andersen who was rescued by DiabetesGuard, when a hypoglycemia came suddenly during her sleep. The story led to many discussions on social media regarding the body’s ability to “wake itself up” from hypoglycemia, and the likelihood of actually dying of an hypo. There is nothing we at SmartCare like better than enthusiastic discussions and critical questions concerning the topic of diabetes. Therefore, we will this week confront some common myths about hypoglycemia.
Written by diabetes coach Hildegunn Fossheim
“The body is not able to “wake itself up” from the hypoglycemia”
Many people with diabetes have hypos during their sleep without these being “treated” – this is what we often refer to as “untreated hypo”. An “untreated hypo” means that it passes without one having to consume carbohydrates to provoke the blood sugar level.
Fortunately, our body is amazingly constructed. When you get a hypo, due to a variety of reasons, that you don’t detect or are unable to control the body will in most cases get the glucose level to rise by itself. In the liver we have a sort of reserve supply of glucagon which acts as the body’s “emergency sugar”. The liver normally releases glucagon as a result of a very low blood sugar level during a longer period of time (the terminological name of this process is “counter reaction”).
2. “I can trust the body to “wake itself up” from a hypo, and therefore I do not need to take any actions.”
One should absolutely NOT rely on the body to “fix itself”. You’re smarter than your own body. When you’re treating a hypo you have an idea of how much sugar is required to balance the glucose level (Not awlays a consistency between theory and practice here). After getting the glucose level back up it’s natural to consume a meal, where you most likely will need insulin to further stabilize the glucose level. The problem with the “counter-reaction” is that the process doesn’t stop when your blood sugar has reached a stable level. Instead, the level will only continue to rise higher. Therefore, an hypo where the body “repairs” itself will lead to a continuously fluctuating and unstable blood sugar.
Moreover, on some occasions the “counter-reaction” doesn’t always work. Alcohol and some medications (both prescription and non prescription) will reduce the body’s ability to provide the “emergency sugar”.
3. “I can’t die from an hypoglycemia”
In my time as an diabetes coach and nurse, I actually know of a few deaths related to hypoglycemia. These have then largely been associated with severe hypoglycemia after alcohol intake. It’s the liver’s task to burn the alcohol upon consumption, but as mentioned above it’s also the liver which produces the “emergency sugar” in case of untreated hypo. In other words, the livers ability to “counter-react” is very ineffective when people drink alcohol.
A while back I read an article about a Norwegian man who had been placed in jail because the police suspected he was extremely drunk. This man was found dead in the cell next day. It became apparent that this person had had severe hypoglycemia, and probably died as a result of a combination of alcohol and hypoglycemia.
I have three “simple rules” to anyone who likes a good party now and then:
- Do not consume such large amounts of alcohol that you are not able to measure your blood sugar and protect yourself ( measure more often than otherwise).
- Eat before you go to bed
- Do not go to bed alone. A severe hypoglycaemia will often result in convulsions , and most will wake up to the fact that the person next to you have spasms.
4. “The “counter-reaction” works equally well for all insulin users”
The body’s ability to stabilize the blood sugar level even after an hypo is ineffective with some individuals. This often applies to people who have had diabetes for a long time, or who regularly experiences severes hypos.
5. “There are only positive effects of going to bed with a deliberately high glucose level to avoid hypoglycaemia”
The problem is that you sleep the majority of the day. In fact, we sleep a third of our lifes. When your blood sugar level is at a constantly higher level than reccomended, this will effect your HbA1c value. Not only that, but it’s a vicious circle to always have to struggle to adjust your glucose level in the morning because it has been too high all night.
If you are taking too little insulin over a longer period of time your blood sugar will fluctuate much more than necessary. In addition, you will most likely have a poor “beauty sleep” when your body is high all night. This is detrimental to health, and will increase the risk of complications.