Very low blood sugar can lead to coma
By Paul G. Donohue, M.D.
DEAR DR. DONOHUE: Last year I was diagnosed with type 2 diabetes. I take half a diabetes tablet and test my blood three times a week. The monograph I received with the tablets plus everything else I've read all say the same thing: If blood sugar is very low, the patient should drink a regular soft drink or eat table sugar, honey or candy. Nowhere does it say what to do when blood sugar spikes.
Not long ago, my blood sugar tested at 88 (4.9), a little low for me. I began to feel really bad. I ate breakfast and tested again. My reading was 244 (13.5). I took the other half-tablet, and in time I felt better. What will take blood sugar down in a hurry? S.H.
ANSWER: Insulin takes blood sugar down rapidly.
Most of the time, a high blood sugar doesn't have to be lowered quickly. When a type 2 diabetic has a sugar even in the 300s (16.7), emergency lowering of blood sugar isn't necessary. You can do exactly as you did and check the sugar later.
When blood sugar remains very high for a more than a couple of days, people with type 2 diabetes can get into trouble. Frequent urination, thirst, nausea and weakness are indications that blood sugar is high. If it stays high, then people with type 2 diabetes can develop what's called hyperosmotic hyperglycemia, something that can make them lethargic and produce a coma.
That almost never happens, and it takes time for it to develop. It's a condition that has to be treated in the hospital. Infections, emotional stress, prolonged and high doses of cortisone drugs, stopping diabetes medicines, heart attacks and strokes are some of the things that can raise blood sugar. So long as you're checking your sugar, so long as it doesn't stay at 300 to 500 for a matter of more than a day or two, and so long as you have no symptoms, there is no urgency to rapidly lower the sugar.
Low blood sugar, on the other hand, can quickly put a person into a coma if blood sugar is not raised rapidly. The brain needs constant sugar to function. If blood sugar dips much lower than 50 (2.8), palpitations, sweating and trembling are signs that you need to take action. Very low sugar levels can produce coma, brain damage and death. The methods you suggest to raise sugar are fine.
People with type 1 diabetes can get diabetic ketoacidosis from high blood sugar. This doesn't usually happen to those with type 2 diabetes. It's a subject for another day.
The diabetes booklet provides background on this common illness. Readers can obtain a copy by writing: Dr. Donohue -- No. 402W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6.75
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2007 North America Synd., Inc. All Rights Reserved
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