Emergencies
If you have been around someone and know them well , any sign that they are confused , displaying strange or bizarre behaviour , are shaking , having fits ( seizures ) or not walking up ( coma ), chances are you could be dealing with hypoglycaemia . Some people might start with complaining of hunger , sweating , heart beating fast , being weak , feeling anxious , faint or complaining of headache . If these symptoms started after they missed a meal or haven ' t eaten , you should be worried . In an ideal situation , you should check their sugar with a glucometer ( sugarreading portable machine ) then take action .
Mild Hypoglycaemia
The patient is still awake , aware of what they are feeling , symptoms ( hunger , headache , sweating etc .). They should take a sugary drink immediately ( 2 to 4 teaspoons of sugar with water ). This should be followed by bread and milk . These are what we call slowly digestible foods and will maintain the glucose within normal ranges .
Severe Hypoglycaemia
In this case , another person is needed to assist with immediate treatment . The above measures can be tried starting , with a sugary drink . If you have a relative or loved one that experiences these severe bouts of hypoglycaemia , speak to your family doctor about getting a glucagon kit that is used to increase glucose in someone that is either unconscious or unable to take oral feeds for any other reasons . In instances where calling the ambulance will take too long and the patient is unconscious and unable to swallow a sugary drink , try rubbing honey or syrup on the patient ' s gums .
Any patient that gets a severe hypoglycaemic episode should be admitted for further care and management at the hospital . This will also include identification of risk factors , medication adjustment if necessary , collection of bloods for renal ( kidney ) and hepatic ( liver ) functions and more education for the patient and family .
What if someone keeps having hypoglycaemic episodes ? It should not be considered ' normal ' having a relative that always gets these episodes . Inappropriate dosages , alcohol intake and patient ' s understanding and medication usage should be investigated . This will include a detailed dietary history by ideally a dietician . Some patients may be suffering from renal impairment . The kidneys may not be excreting the medication well , causing a build-up in the body . Hepatic impairment affects the glucose storage and processing to maintain an average blood glucose . Some patients may be victims of abuse , whereby the caregiver injects them more insulin ( used to lower glucose ) to get attention from hospital personnel . Sometimes this is done as a form of punishment to the patient . Some patients may also inject themselves to lower their glucose , either for attention seeking behaviour or as a cry for help . Such cases will need psychological review . One cannot easily say , without professional assistance , why these odd behaviours occur .
Hypoglycaemia is a preventable , silent killer . Please speak to your GP and dietician about how you can keep your glucose controlled or help a loved one deal with this complication . Please visit www . diabetessa . org . za for more , reliable and relevant information on living with diabetes in South Africa .
Dr T . G . Matoro MBChB , UCT Clinical Advisor
Reference 1 . The 2012 SEMDSA Guideline for the Management of Type 2 Diabetes . www . diabetessa . org . za 2 . Retrieved 12 September 2016 .
BDM TALENT ISSUE # 04 12