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What Does a Severe Hypoglycemia Attack Feel Like and What Should You Do?

Hypoglycemia, or low blood sugar, is a condition that primarily affects people with diabetes, especially those taking insulin or certain oral medications. While mild hypoglycemia can be managed relatively easily, a severe hypoglycemia attack can be a frightening and potentially dangerous experience. This article delves into the symptoms, feelings, and necessary actions during a severe hypoglycemic episode, providing you with critical knowledge for prevention and response.

Understanding Hypoglycemia and Its Severity

Before discussing the specific sensations of a severe attack, it’s important to understand the different levels of hypoglycemia. Why Is My Fasting Blood Sugar High 4 Common Reasons And Solutions

• Mild Hypoglycemia: Often characterized by shakiness, sweating, anxiety, and irritability. Easily treated with quick-acting carbohydrates.
• Moderate Hypoglycemia: Includes more pronounced symptoms like confusion, difficulty concentrating, and blurred vision. Requires prompt intervention.
• Severe Hypoglycemia: Represents a medical emergency where the individual is unable to treat themselves and may experience loss of consciousness, seizures, or coma. It requires immediate assistance from others.

What Does a Severe Hypoglycemia Attack Feel Like?

A severe hypoglycemia attack is marked by a significant drop in blood glucose levels, impairing brain function. The experience can vary from person to person, but common feelings and symptoms include: Normal Blood Sugar Levels A Complete Chart For Adults Before Amp After Meals

• Loss of Consciousness: This is often the defining characteristic of severe hypoglycemia. The individual becomes unresponsive and unable to follow commands.
• Seizures: Very low blood sugar can trigger seizures due to the brain's energy deprivation.
• Confusion and Disorientation: Even before losing consciousness, the person might be extremely confused, unable to recognize their surroundings, or answer simple questions.
• Slurred Speech: Similar to intoxication, speech may become difficult to understand.
• Combativeness or Aggression: Paradoxically, some individuals may become agitated or aggressive as their brain function deteriorates.
• Sweating Profusely: Cold, clammy sweat is a common symptom, even when the environment isn't warm.
• Rapid Heartbeat: The body releases adrenaline in an attempt to raise blood sugar, leading to a racing pulse.
• Muscle Weakness: A general feeling of weakness, making it difficult to stand or move.
• Inability to Swallow: Which is particularly dangerous if someone attempts to give them food or drink while unconscious.

It's important to recognize that a person experiencing a severe hypoglycemia episode may not realize what's happening to them. This makes it crucial for family members, friends, and colleagues to be aware of their condition and know how to respond.

What Should You Do During a Severe Hypoglycemia Attack?

If you encounter someone experiencing a severe hypoglycemic episode, follow these steps:

1. Check for Responsiveness: Try to rouse the person by calling their name or gently shaking them.
2. Do NOT Give Food or Drink if Unconscious: This is extremely important. An unconscious person could choke if you try to force them to eat or drink.
3. Administer Glucagon (if available): Glucagon is a hormone that raises blood sugar levels. If the person has a glucagon emergency kit, administer it according to the instructions provided. It's usually an injection or nasal spray. Know where the kit is kept if possible.
4. Call for Emergency Medical Assistance (911): Even if glucagon is administered, call emergency services immediately. The person needs professional medical attention.
5. Position the Person on Their Side (Recovery Position): If the person is breathing but unconscious, place them in the recovery position to prevent choking if they vomit.
6. Stay with the Person: Remain with them until medical help arrives. Monitor their breathing and pulse.

Prevention is Key: Managing Hypoglycemia Risk

While knowing how to respond to a severe episode is crucial, prevention is even more important. Here are some steps individuals with diabetes can take to minimize their risk of severe hypoglycemia:

• Regular Blood Sugar Monitoring: Check blood glucose levels frequently, especially before meals, before bed, and after exercise.
• Consistent Meal Schedules: Eat regular meals and snacks to maintain stable blood sugar levels.
• Medication Management: Work closely with your doctor to adjust insulin or other diabetes medication dosages as needed.
• Carbohydrate Counting: Learn how to accurately count carbohydrates to match insulin doses appropriately.
• Awareness of Hypoglycemia Symptoms: Know your individual warning signs of low blood sugar and act quickly when they appear.
• Educate Family and Friends: Inform those around you about your condition, the signs of hypoglycemia, and how to administer glucagon.
• Wear a Medical Alert Bracelet or Necklace: This will inform first responders about your diabetes in case you're unable to communicate.
• Carry Fast-Acting Carbohydrates: Always have a readily available source of quick-acting carbohydrates (glucose tablets, juice, or regular soda) to treat mild to moderate hypoglycemia.

Advanced Strategies

• Continuous Glucose Monitoring (CGM): A CGM can provide real-time blood sugar readings and alert you to potential lows before they become severe. Many CGMs can now communicate directly with insulin pumps to automatically adjust basal rates and prevent low blood sugar.
• Insulin Pump Therapy: Insulin pumps deliver a continuous basal rate of insulin, which can be programmed and adjusted more precisely than multiple daily injections. This can help to reduce the risk of both hypoglycemia and hyperglycemia.
• Diabetes Education: Ongoing diabetes education from a certified diabetes care and education specialist (CDCES) can help you stay up-to-date on the latest management techniques and technologies.
• Review Medications: Certain medications (not directly related to diabetes) can affect blood sugar levels. Discuss all medications with your healthcare provider.

Who is most at risk?

Several factors can increase the risk of severe hypoglycemia attack. Those include:

• Elderly individuals with diabetes
• Individuals with impaired kidney function
• People with a history of frequent hypoglycemic episodes
• Those who are unaware of their hypoglycemia symptoms (hypoglycemia unawareness)
• Individuals who take insulin and have difficulty adjusting their doses

Impact of Hypoglycemia on Quality of Life

Frequent hypoglycemia, even mild episodes, can significantly impact a person's quality of life. It can lead to: How To Prevent Blood Sugar Spikes After Meals 5 Proven Tips

• Fear of Hypoglycemia: Constant worry about low blood sugar can cause anxiety and limit activities.
• Impaired Cognitive Function: Repeated hypoglycemia can affect cognitive function, particularly in older adults.
• Reduced Driving Safety: Low blood sugar can impair reaction time and judgment, making driving dangerous.
• Relationship Strain: Hypoglycemia can be stressful for both the individual with diabetes and their loved ones.

Symptom Category	Specific Symptoms During Severe Hypoglycemia	Importance
Neurological	Loss of consciousness, seizures, confusion, slurred speech, combativeness.	Critical indicators; necessitates immediate glucagon and medical intervention.
Physical	Profuse sweating, rapid heartbeat, muscle weakness, inability to swallow.	Provides additional clues; ensures appropriate care (avoid oral intake if unable to swallow).
Cognitive	Disorientation, inability to answer simple questions, unawareness of surroundings.	Highlights impaired brain function; emphasizes need for external assistance.

Conclusion

A severe hypoglycemia attack is a serious medical condition that requires prompt recognition and immediate intervention. By understanding the symptoms, knowing how to respond, and focusing on prevention strategies, you can help reduce the risk of these potentially life-threatening episodes and improve the overall well-being of individuals with diabetes. It's essential for people with diabetes, their families, and caregivers to be well-informed and prepared to manage this challenging condition effectively. Early recognition and decisive action are paramount in ensuring a positive outcome during a severe hypoglycemic event. Remember always consult with healthcare professionals for guidance tailored to individual health needs. ```

By Aoife M. Egan, M.B., B.Ch., Ph.D.