rubyroselee
New member
I finally got some solid evidence of hypoglycemia in CF. I found that one of my old dieticians had some great articles to share with me. So I thought I'd pass them along to you all since many of you deal with the same issues with hypoglycemia. If anyone wants additional information on hypoglycemia or the CFRD pamphlet I received (with GREAT info!), please contact me privately and I'll be happy to share.
<hr>
<u><b>Hypoglycemia and CF </u>
In-Depth Education > Diabetes and Cystic Fibrosis</b>
<i>Carol M. Brunzell, RD, CDE</i>
<i><b>Hypoglycemia </b>is a condition of low blood glucose levels (lower than 70 mg/dL or 3.9 mmol/L). Hypo means low, and glycemia refers to the level of glucose (sugar) in your blood. Hypoglycemia can occur as a complication of diabetes, as a condition in itself, or in association with other disorders. This article discusses hypoglycemia in people who have cystic fibrosis (CF) but who do NOT have diabetes and do NOT take insulin. If you develop hypoglycemia, be sure to treat it immediately and appropriately.
<b>When and Why Does Hypoglycemia Occur? </b>Hypoglycemia can develop quickly. The two main kinds of hypoglycemia in people with CF who do not take insulin are:
1. <b>Fasting hypoglycemia</b>. This type of low blood glucose occurs first thing in the morning before breakfast. Normally, the body stores glucose during the day and releases it slowly overnight to protect you from low blood glucose while you sleep, in addition to providing your body with a needed source of energy while you fast. If your blood glucose stores are depleted, you can "run out" overnight and have a low blood glucose in the morning. This is especially common in children and in adults with CF who are underweight.
2. <b>Reactive hypoglycemia</b>. Normally there is a very tight balance maintained between your blood glucose level and your blood insulin level. When the blood glucose starts to rise, such as after eating or drinking, the body's pancreas should immediately secrete the right amount of insulin to bring the blood glucose down to normal. When the blood glucose starts to drop, insulin secretion should stop.
In people with CF, the pancreas is damaged and does not work efficiently. When blood glucose levels start to rise, the pancreas does not immediately "kick in" to secrete insulin and blood glucose levels become too high. When the pancreas does finally respond, it overreacts to the high blood glucose level and secretes too much insulin, causing a low blood glucose. Typically this occurs about 2 hours after a carbohydrate-rich meal, and it is especially common after breakfast.
<b>What Are the Symptoms of Hypoglycemia?</b>Hypoglycemia in people who do not have diabetes is often mild, is not dangerous, and is easily treated with food. Normal blood glucose levels range from 60 mg/dL (3.3 mmol/L) to 120 mg/dL (6.6 mmol/L). People with hypoglycemia typically have a blood glucose reading of less than 60 mg/dL (3.3 mmol/L).
Mild low blood glucose can cause the following symptoms. You may experience only some of these symptoms, and the symptoms can vary greatly from one person to another.
. Shakiness
. Weakness
. Sweating
. Dizziness
. Rapid heartbeat
. Sudden urge to eat
. Headache
. Nausea (upset stomach)
. Pale color
. Drowsiness or tiredness
. Anxiety or behavior changes
. Numbness or tingling in the lips or fingertips
. Irritability
<b>How Do I Treat a Hypoglycemic Episode?</b>
A mild low blood glucose usually resolves quickly with the proper treatment. The goal is to bring your glucose level up. One way to increase the glucose in your blood is to eat a food that contains carbohydrate (sugars and starches).
Carbohydrate is the body's main dietary source of glucose, so always carry some form of carbohydrate with you wherever you go. Foods that contain carbohydrate include:
. Starches, such as breads, grains, and cereal
. Starchy vegetables, such as potatoes, green peas, and corn
. Legumes, such as lentils
. Milk and yogurt
. Fruit and fruit juices
. Foods and beverages made with sugar
<b>The American Association of Diabetes Educators recommends treatment of hypoglycemia as follows: </b>
. If possible, check your blood glucose. You are experiencing low blood glucose if the test results are less than 60 mg/dL (3.3 mmol/L) or you have symptoms but are unable to test your blood glucose.
. Eat or drink something containing 10 to 15 grams of carbohydrate. Examples of 15 grams of carbohydrate are 3 to 4 glucose tablets, 1/2 cup (4 ounces) of regular (not diet) soda, juice, Kool-Aide, lemonade, or fruit punch, 1 cup (8 ounces) of milk, 1 medium piece fresh fruit, 2 tablespoons raisins, 4 teaspoons sugar, 7 to 8 LifeSavers.
. Wait at least 15 minutes before you eat again and recheck your blood glucose. If the level is greater than 60 g/dL (3.3 mmol/L) and your symptoms have improved,you have treated your low blood glucose appropriately. If the level is still less than 60 mg/dL (3.3 mmol/L), eat another 15 grams of carbohdyrate every 15 minutes until your blood glucose is over 60 mg/dL (3.3mmol/L) and your symptoms subside.
. If you will not be eating a meal within the next 1 to 2 hours, you may need a snack with an additional 15 to 30 grams of carbohydrate to avoid another drop in blood glucose.
<b>How Do I Prevent Hypoglycemia?</b>
To prevent hypoglycemia:
. Eat three or more meals per day in addition to several small snacks throughout the day.
. Try not to wait longer than 2 to 3 hours to have a meal or snack.
. Include some form of carbohydrate with each meal. Eating carbohydrate-containing foods throughout the day may prevent low blood glucose from occurring.
. Try to avoid eating a large quantity of food that contains simple carbohydrate at one time. For example, try to limit eating or drinking large amounts of sweetened beverages (soda or juice), syrups, or simple sugars found in desserts, candy, Jell-O, jams, and jellies at a single meal or snack. These may cause your blood glucose to drop quickly. Try to eat more complex carbohydrates (breads, starches, cereals, pasta) or whole fruits instead of fruit juice.
. Try eating different kinds of foods at meals and snacks. You may find some combinations of foods works better than others in preventing low blood glucose.
. Limit or avoid drinking alcoholic beverages on an empty stomach. Drinking alcohol on an empty stomach can lower blood glucose. Always drink alcohol with a meal or snack that contains carbohydrate (for example, popcorn, crackers, pretzels).
. Avoid beverages and foods that contain caffeine. Caffeine can produce the same symptoms as hypoglycemia.
. Eat carbohydrate when you exercise. Try to eat 15 grams of carbohydrate (see above) before, during, or after you exercise for every 30-to 60-minute session.
If you have fasting hypoglycemia, be sure to eat a good bedtime snack and work on maintaining a normal body weight.
<b>Speak With Your Healthcare Team</b>
Speak with members of your healthcare team, especially your clinic dietitian. Your dietitian can help you choose carbohydrate-containing foods and develop a meal pattern, so you can prevent hypoglycemia episodes.
This article was written by Carol M. Brunzell, RD, CDE, a registered dietitian and a certified diabetes educator. It was reviewed by Antoinette Moran, MD.</i>
<hr>
<u><b>Low Blood Sugar (Hypoglycemia) </b></u>
<b>What Is Hypoglycemia? </b>
Hypoglycemia is low blood sugar. Levels less than 0 mg/dL or .9 mmol/L are too low and can be dangerous.
Blood sugars this low don't often occur unless a person is taking insulin. People who are taking insulin shots can
have VERY low blood sugar levels. Blood sugar levels can drop fast and must be treated fast! Early treatment prevents worse symptoms. When you are newly diagnosed, you and the people you live and work around must learn the symptoms of hypoglycemia and how to treat it.
<b>Low Blood sugar symptoms </b>
The body gives a warning when blood sugars are getting low. WARNINGS VARY FROM PERSON TO PERSON. Others may see these symptoms in you before you do.
If your blood sugar is low and you don't treat it, you may pass out, have a seizure, or have convulsions. If you are taking insulin, it is very important that you treat your low blood sugar right away so that symptoms don't worsen. Symptoms often occur when blood sugar levels are not yet low enough for you to pass out. The early signs of low blood sugar are caused by the release of a hormone called adrenaline. Adrenaline is also called the "fight or flight" hormone because most people release it when they are excited or scared. Among other things, it dilates the pupils, raises the heart rate, and makes people feel shaky and sweaty. If you feel these symptoms, check your
blood sugar. If it is less than 0 mg/dL or .9 mmol/L, you need to treat it quickly by eating or drinking foods
that contain carbohydrates.
<b>Common symptoms of low blood sugar: </b>
. Sudden hunger
. Upset stomach (nausea)
. Shaky feeling hands or body
. More sweat than normal (often a "cold" sweat)
. A pale face color
. Weakness
. Headache
. Confusion (you may feel or look "spaced out" or "dazed")
. Blurred vision or double vision
. A change in the way you act or feel (crying, feeling
nervous, acting "drunk" or angry, etc.)
. Fast heartbeat
. Tingling or numbness in your lips and mouth
<b>Low Blood Sugar Causes </b>
When your body doesn't have enough sugar to burn for
fuel, your blood sugar level drops. The drop in blood
sugar triggers the release of counter-regulatory hormones,
which help your body correct low blood sugar.
These hormones cause the symptoms of low blood
sugar. Very low blood sugar levels often only occur if
people are taking insulin. Low blood sugar tied to insulin
use is often called an insulin reaction or a reaction.
<b>Low Blood Sugar in CF Without Diabetes </b>
People with CF who are not taking insulin may have
slightly low blood sugar levels and feel the warning
symptoms listed above. These symptoms occur because
your body's own insulin secretion isn't well timed to
when you eat your meals. Although slightly low blood
sugar can feel bad, it is not a danger. Your blood sugar
should never drop really low unless you are taking insulin.
People not taking insulin who feel low blood sugar
symptoms can stop or prevent them by eating small
meals every 2 to 3 hours. These meals should contain
carbohydrates. Although eating prevents low blood sugar, you can also try products that contain uncooked starch.
This can be found in stores in cookie-like bars (like Nite Bite Barstm or Extend Bars). These bars should not
be used to treat blood sugars less than 70 mg/dL or 3.9 mmol/L because they will not raise blood sugar quickly.
Always treat very low blood sugar with simple sugars that do not require enzymes. Ask your dietitian to help you
with a meal plan if you have low blood sugars.
<b>Low blood sugar with insulin use is often caused by:</b>
. Late or missed meals and snacks
. Extra exercise that burns more sugar
. An insulin dose that is too high
. Absorbing the insulin too fast, which can happen with exercise or if the shot is given in the muscle instead of just under the skin
. Lack of low blood sugar warning symptoms (for example, when you are asleep)
. Getting too much insulin or wrongly mixed insulin types
. Drinking alcohol on an empty stomach when taking insulin
<b>Low Blood Sugar Treatment </b>
The best treatment for very low blood sugar is to eat or drink a simple sugar source that does not require enzymes
for digestion. If your blood sugar is less than 70 mg/dL or 3.9 mmol/L, you should take 15 grams of carbohydrates (such as in 3 or 4 glucose tablets; ½ cup of regular soda, juice, or lemonade; 1 cup of skim milk; 1 tablespoon of sugar or honey; or 1 piece of medium-sized fruit). If your blood sugar is less than 50 mg/dL or 2.75 mmol/L, you should take 30 grams of carbohydrates (a double serving of the above). If you are taking insulin, you should always carry glucose tablets with you. Use them when you feel "low" but don't have time to test or when you have no other sugar source. It is not safe to feed a person who has passed out because they will likely choke. If your blood sugar is so low that you pass out or can't drink, someone else needs to give you a glucagon shot. Glucagon is a hormone that "squeezes" extra sugar out of the liver and raises the blood sugar level. You should have glucagon with you. Those who live with you should know how to give it. Glucagon can cause nausea and throwing up for up to 6 hours. Even if the package is not opened, glucagon expires after 1 year. Check your glucagon now and then to see when it expires. Replace it when needed. Always wear an ID bracelet or necklace stating that you have diabetes and CF. This is the first thing that rescue workers look for. It tells them that you might need glucagon or intravenous (IV) sugar if your blood sugar is low.
<b>To treat low blood sugar, eat or drink:</b>
. 3 or 4 glucose tablets
. ½ cup of regular soda, juice or lemonade
. 1 cup of skim milk
. 1 Tbsp of sugar or honey
. 1 piece of medium-sized fruit
<b>Driving and Low Blood Sugar</b>
People with diabetes can still drive. If taking insulin, though, they should do all they can to prevent low blood
sugar while driving.
. Check your blood sugar before you drive. NEVER drive if your blood sugar is less than 100 mg/dL or 5.5
mmol/L.
. Eat a snack with carbohydrates before you drive.
. Pack plenty of snacks with carbohydrates for long trips.
. Pull over and check your blood sugar if you feel shaky. If it is low, eat a snack.
. Don't take insulin on an empty stomach before driving to a restaurant. Take insulin when you get your food.
. Keep glucose tablets in your car.
<b>Exercise and Low Blood Sugar</b>
Routine exercise is good for many reasons. It can help control your blood sugars by making your body respond better to insulin. Exercise can strengthen your lungs and help you feel better. Exercise can help with depression. Exercise may also cause low blood sugar (hypoglycemia) because muscles use sugar for fuel. People with CFRD can work out safely as long as they understand the following:
You may need to adjust your insulin dose to match your activity level. Even if your blood sugar is more than 100 mg/dL or 5.5 mmol/L, eating an extra carbohydrate snack before starting is wise. You may need an extra 15 to 30 grams or more of carbohydrates for each hour of intense or lengthy exercise. The blood sugar lowering effect of a workout can last as long as 12 to 24 hours, so you may need to eat an extra bedtime snack with carbohydrates on the days you've exercised really hard. Record exercise in the "comments" section of your blood sugar records so that your doctor will know if exercise caused low blood sugar.
<b>Tips for exercising:</b>
. Avoid giving insulin shots in the parts of the
body you will work out
. Check your blood sugar before, during, and after
your workout so you can watch your blood sugar
patterns
. Eat a snack with carbohydrates before you begin
if your blood sugar is less than 100 mg/dL or 5.5
mmol/L
. Have a source of carbohydrates with you (such
as glucose tablets)
<hr>
<u><b>Hypoglycemia and CF </u>
In-Depth Education > Diabetes and Cystic Fibrosis</b>
<i>Carol M. Brunzell, RD, CDE</i>
<i><b>Hypoglycemia </b>is a condition of low blood glucose levels (lower than 70 mg/dL or 3.9 mmol/L). Hypo means low, and glycemia refers to the level of glucose (sugar) in your blood. Hypoglycemia can occur as a complication of diabetes, as a condition in itself, or in association with other disorders. This article discusses hypoglycemia in people who have cystic fibrosis (CF) but who do NOT have diabetes and do NOT take insulin. If you develop hypoglycemia, be sure to treat it immediately and appropriately.
<b>When and Why Does Hypoglycemia Occur? </b>Hypoglycemia can develop quickly. The two main kinds of hypoglycemia in people with CF who do not take insulin are:
1. <b>Fasting hypoglycemia</b>. This type of low blood glucose occurs first thing in the morning before breakfast. Normally, the body stores glucose during the day and releases it slowly overnight to protect you from low blood glucose while you sleep, in addition to providing your body with a needed source of energy while you fast. If your blood glucose stores are depleted, you can "run out" overnight and have a low blood glucose in the morning. This is especially common in children and in adults with CF who are underweight.
2. <b>Reactive hypoglycemia</b>. Normally there is a very tight balance maintained between your blood glucose level and your blood insulin level. When the blood glucose starts to rise, such as after eating or drinking, the body's pancreas should immediately secrete the right amount of insulin to bring the blood glucose down to normal. When the blood glucose starts to drop, insulin secretion should stop.
In people with CF, the pancreas is damaged and does not work efficiently. When blood glucose levels start to rise, the pancreas does not immediately "kick in" to secrete insulin and blood glucose levels become too high. When the pancreas does finally respond, it overreacts to the high blood glucose level and secretes too much insulin, causing a low blood glucose. Typically this occurs about 2 hours after a carbohydrate-rich meal, and it is especially common after breakfast.
<b>What Are the Symptoms of Hypoglycemia?</b>Hypoglycemia in people who do not have diabetes is often mild, is not dangerous, and is easily treated with food. Normal blood glucose levels range from 60 mg/dL (3.3 mmol/L) to 120 mg/dL (6.6 mmol/L). People with hypoglycemia typically have a blood glucose reading of less than 60 mg/dL (3.3 mmol/L).
Mild low blood glucose can cause the following symptoms. You may experience only some of these symptoms, and the symptoms can vary greatly from one person to another.
. Shakiness
. Weakness
. Sweating
. Dizziness
. Rapid heartbeat
. Sudden urge to eat
. Headache
. Nausea (upset stomach)
. Pale color
. Drowsiness or tiredness
. Anxiety or behavior changes
. Numbness or tingling in the lips or fingertips
. Irritability
<b>How Do I Treat a Hypoglycemic Episode?</b>
A mild low blood glucose usually resolves quickly with the proper treatment. The goal is to bring your glucose level up. One way to increase the glucose in your blood is to eat a food that contains carbohydrate (sugars and starches).
Carbohydrate is the body's main dietary source of glucose, so always carry some form of carbohydrate with you wherever you go. Foods that contain carbohydrate include:
. Starches, such as breads, grains, and cereal
. Starchy vegetables, such as potatoes, green peas, and corn
. Legumes, such as lentils
. Milk and yogurt
. Fruit and fruit juices
. Foods and beverages made with sugar
<b>The American Association of Diabetes Educators recommends treatment of hypoglycemia as follows: </b>
. If possible, check your blood glucose. You are experiencing low blood glucose if the test results are less than 60 mg/dL (3.3 mmol/L) or you have symptoms but are unable to test your blood glucose.
. Eat or drink something containing 10 to 15 grams of carbohydrate. Examples of 15 grams of carbohydrate are 3 to 4 glucose tablets, 1/2 cup (4 ounces) of regular (not diet) soda, juice, Kool-Aide, lemonade, or fruit punch, 1 cup (8 ounces) of milk, 1 medium piece fresh fruit, 2 tablespoons raisins, 4 teaspoons sugar, 7 to 8 LifeSavers.
. Wait at least 15 minutes before you eat again and recheck your blood glucose. If the level is greater than 60 g/dL (3.3 mmol/L) and your symptoms have improved,you have treated your low blood glucose appropriately. If the level is still less than 60 mg/dL (3.3 mmol/L), eat another 15 grams of carbohdyrate every 15 minutes until your blood glucose is over 60 mg/dL (3.3mmol/L) and your symptoms subside.
. If you will not be eating a meal within the next 1 to 2 hours, you may need a snack with an additional 15 to 30 grams of carbohydrate to avoid another drop in blood glucose.
<b>How Do I Prevent Hypoglycemia?</b>
To prevent hypoglycemia:
. Eat three or more meals per day in addition to several small snacks throughout the day.
. Try not to wait longer than 2 to 3 hours to have a meal or snack.
. Include some form of carbohydrate with each meal. Eating carbohydrate-containing foods throughout the day may prevent low blood glucose from occurring.
. Try to avoid eating a large quantity of food that contains simple carbohydrate at one time. For example, try to limit eating or drinking large amounts of sweetened beverages (soda or juice), syrups, or simple sugars found in desserts, candy, Jell-O, jams, and jellies at a single meal or snack. These may cause your blood glucose to drop quickly. Try to eat more complex carbohydrates (breads, starches, cereals, pasta) or whole fruits instead of fruit juice.
. Try eating different kinds of foods at meals and snacks. You may find some combinations of foods works better than others in preventing low blood glucose.
. Limit or avoid drinking alcoholic beverages on an empty stomach. Drinking alcohol on an empty stomach can lower blood glucose. Always drink alcohol with a meal or snack that contains carbohydrate (for example, popcorn, crackers, pretzels).
. Avoid beverages and foods that contain caffeine. Caffeine can produce the same symptoms as hypoglycemia.
. Eat carbohydrate when you exercise. Try to eat 15 grams of carbohydrate (see above) before, during, or after you exercise for every 30-to 60-minute session.
If you have fasting hypoglycemia, be sure to eat a good bedtime snack and work on maintaining a normal body weight.
<b>Speak With Your Healthcare Team</b>
Speak with members of your healthcare team, especially your clinic dietitian. Your dietitian can help you choose carbohydrate-containing foods and develop a meal pattern, so you can prevent hypoglycemia episodes.
This article was written by Carol M. Brunzell, RD, CDE, a registered dietitian and a certified diabetes educator. It was reviewed by Antoinette Moran, MD.</i>
<hr>
<u><b>Low Blood Sugar (Hypoglycemia) </b></u>
<b>What Is Hypoglycemia? </b>
Hypoglycemia is low blood sugar. Levels less than 0 mg/dL or .9 mmol/L are too low and can be dangerous.
Blood sugars this low don't often occur unless a person is taking insulin. People who are taking insulin shots can
have VERY low blood sugar levels. Blood sugar levels can drop fast and must be treated fast! Early treatment prevents worse symptoms. When you are newly diagnosed, you and the people you live and work around must learn the symptoms of hypoglycemia and how to treat it.
<b>Low Blood sugar symptoms </b>
The body gives a warning when blood sugars are getting low. WARNINGS VARY FROM PERSON TO PERSON. Others may see these symptoms in you before you do.
If your blood sugar is low and you don't treat it, you may pass out, have a seizure, or have convulsions. If you are taking insulin, it is very important that you treat your low blood sugar right away so that symptoms don't worsen. Symptoms often occur when blood sugar levels are not yet low enough for you to pass out. The early signs of low blood sugar are caused by the release of a hormone called adrenaline. Adrenaline is also called the "fight or flight" hormone because most people release it when they are excited or scared. Among other things, it dilates the pupils, raises the heart rate, and makes people feel shaky and sweaty. If you feel these symptoms, check your
blood sugar. If it is less than 0 mg/dL or .9 mmol/L, you need to treat it quickly by eating or drinking foods
that contain carbohydrates.
<b>Common symptoms of low blood sugar: </b>
. Sudden hunger
. Upset stomach (nausea)
. Shaky feeling hands or body
. More sweat than normal (often a "cold" sweat)
. A pale face color
. Weakness
. Headache
. Confusion (you may feel or look "spaced out" or "dazed")
. Blurred vision or double vision
. A change in the way you act or feel (crying, feeling
nervous, acting "drunk" or angry, etc.)
. Fast heartbeat
. Tingling or numbness in your lips and mouth
<b>Low Blood Sugar Causes </b>
When your body doesn't have enough sugar to burn for
fuel, your blood sugar level drops. The drop in blood
sugar triggers the release of counter-regulatory hormones,
which help your body correct low blood sugar.
These hormones cause the symptoms of low blood
sugar. Very low blood sugar levels often only occur if
people are taking insulin. Low blood sugar tied to insulin
use is often called an insulin reaction or a reaction.
<b>Low Blood Sugar in CF Without Diabetes </b>
People with CF who are not taking insulin may have
slightly low blood sugar levels and feel the warning
symptoms listed above. These symptoms occur because
your body's own insulin secretion isn't well timed to
when you eat your meals. Although slightly low blood
sugar can feel bad, it is not a danger. Your blood sugar
should never drop really low unless you are taking insulin.
People not taking insulin who feel low blood sugar
symptoms can stop or prevent them by eating small
meals every 2 to 3 hours. These meals should contain
carbohydrates. Although eating prevents low blood sugar, you can also try products that contain uncooked starch.
This can be found in stores in cookie-like bars (like Nite Bite Barstm or Extend Bars). These bars should not
be used to treat blood sugars less than 70 mg/dL or 3.9 mmol/L because they will not raise blood sugar quickly.
Always treat very low blood sugar with simple sugars that do not require enzymes. Ask your dietitian to help you
with a meal plan if you have low blood sugars.
<b>Low blood sugar with insulin use is often caused by:</b>
. Late or missed meals and snacks
. Extra exercise that burns more sugar
. An insulin dose that is too high
. Absorbing the insulin too fast, which can happen with exercise or if the shot is given in the muscle instead of just under the skin
. Lack of low blood sugar warning symptoms (for example, when you are asleep)
. Getting too much insulin or wrongly mixed insulin types
. Drinking alcohol on an empty stomach when taking insulin
<b>Low Blood Sugar Treatment </b>
The best treatment for very low blood sugar is to eat or drink a simple sugar source that does not require enzymes
for digestion. If your blood sugar is less than 70 mg/dL or 3.9 mmol/L, you should take 15 grams of carbohydrates (such as in 3 or 4 glucose tablets; ½ cup of regular soda, juice, or lemonade; 1 cup of skim milk; 1 tablespoon of sugar or honey; or 1 piece of medium-sized fruit). If your blood sugar is less than 50 mg/dL or 2.75 mmol/L, you should take 30 grams of carbohydrates (a double serving of the above). If you are taking insulin, you should always carry glucose tablets with you. Use them when you feel "low" but don't have time to test or when you have no other sugar source. It is not safe to feed a person who has passed out because they will likely choke. If your blood sugar is so low that you pass out or can't drink, someone else needs to give you a glucagon shot. Glucagon is a hormone that "squeezes" extra sugar out of the liver and raises the blood sugar level. You should have glucagon with you. Those who live with you should know how to give it. Glucagon can cause nausea and throwing up for up to 6 hours. Even if the package is not opened, glucagon expires after 1 year. Check your glucagon now and then to see when it expires. Replace it when needed. Always wear an ID bracelet or necklace stating that you have diabetes and CF. This is the first thing that rescue workers look for. It tells them that you might need glucagon or intravenous (IV) sugar if your blood sugar is low.
<b>To treat low blood sugar, eat or drink:</b>
. 3 or 4 glucose tablets
. ½ cup of regular soda, juice or lemonade
. 1 cup of skim milk
. 1 Tbsp of sugar or honey
. 1 piece of medium-sized fruit
<b>Driving and Low Blood Sugar</b>
People with diabetes can still drive. If taking insulin, though, they should do all they can to prevent low blood
sugar while driving.
. Check your blood sugar before you drive. NEVER drive if your blood sugar is less than 100 mg/dL or 5.5
mmol/L.
. Eat a snack with carbohydrates before you drive.
. Pack plenty of snacks with carbohydrates for long trips.
. Pull over and check your blood sugar if you feel shaky. If it is low, eat a snack.
. Don't take insulin on an empty stomach before driving to a restaurant. Take insulin when you get your food.
. Keep glucose tablets in your car.
<b>Exercise and Low Blood Sugar</b>
Routine exercise is good for many reasons. It can help control your blood sugars by making your body respond better to insulin. Exercise can strengthen your lungs and help you feel better. Exercise can help with depression. Exercise may also cause low blood sugar (hypoglycemia) because muscles use sugar for fuel. People with CFRD can work out safely as long as they understand the following:
You may need to adjust your insulin dose to match your activity level. Even if your blood sugar is more than 100 mg/dL or 5.5 mmol/L, eating an extra carbohydrate snack before starting is wise. You may need an extra 15 to 30 grams or more of carbohydrates for each hour of intense or lengthy exercise. The blood sugar lowering effect of a workout can last as long as 12 to 24 hours, so you may need to eat an extra bedtime snack with carbohydrates on the days you've exercised really hard. Record exercise in the "comments" section of your blood sugar records so that your doctor will know if exercise caused low blood sugar.
<b>Tips for exercising:</b>
. Avoid giving insulin shots in the parts of the
body you will work out
. Check your blood sugar before, during, and after
your workout so you can watch your blood sugar
patterns
. Eat a snack with carbohydrates before you begin
if your blood sugar is less than 100 mg/dL or 5.5
mmol/L
. Have a source of carbohydrates with you (such
as glucose tablets)