I recently received a question concerning the detection of low blood sugars. This particular person is a Type 1 diabetes patient, and he is having significant difficulty with low sugars. He reports that he feels fine one minute, and then wakes up in an Emergency Department getting treatment. He is very concerned about the effect this is having on his overall health and has requested treatment ideas.
Different folks feel their low sugars at different levels. Some may find symptoms at 100, while others feel fine at 50. Detecting low sugars is a frequent problem for folks with diabetes and seems to be more common as they age. I am not familiar with any medications that can enhance one's ability to detect low sugars, however, I do have a few other ideas that may provide some assistance.
First, frequent blood-sugar testing will assist any patient with symptom identification. The more you test, the more you can pay attention to how you feel at certain levels. I ask the majority of my patients to test four times each day, as well as when they feel odd or symptomatic. These odd feelings may include nausea, fatigue, headache or balance issues. Some patients find that they test eight to 10 times a day, and as a result have much better control. Blood-sugar testing provides your physician with data related to your progress. The more data provided, the easier it is to make safe and effective adjustments to therapy. Likewise, the more you learn how you feel at certain levels, the easier is becomes to detect variations in blood-sugar levels.
Second, continuous glucose-monitoring systems may be an option. These are devices that check body-fluid glucose levels up to 288 times a day. This provides the patient with a constant estimate of their sugar levels and enables them to identify trends as the blood sugar changes. Similarly, these devices have alarms that can predict high or low sugars and assist the patient in the recognition of symptoms. I wear the Medtronic sensor with my pump, and I love it. When I feel funny, I can check the pump and see that the sugar is low or falling rapidly. This provides security, confirmation and helps to train my own low-sugar detection ability.
My third idea and most recent discovery is diabetic alert dogs. The alert dogs have the ability to assist patients with fluctuations in blood-sugar levels. These dogs go through a rigorous training program to enable them to pick up scents that the body gives off whenever the blood sugar changes. Similar to a drug-sniffing dog, when the animals detect these odors, they bark and make every effort to alert the person or, in some cases, the parent. Various groups provide these dogs, and I encourage anyone interested to take the time to speak to the experts and research the differences between the training styles and dogs used. All diabetic alert dogs are service animals and, therefore, through the Americans with Disabilities Act, have access to any place the owner visits.
Other than the ideas presented, there are no easy methods to help patients detect low sugars. Essentially, it becomes an issue of practice with frequent blood testing and acceptance of the fact that your signs and symptoms can change as you age. Likewise, frequent medical visits may be necessary to reduce the frequency of low sugars. Some folks find support groups beneficial to discuss the various symptoms and share the frustration. I hope these ideas are helpful and, as always, thank you for the question.
Dr. Jonathan Beach, who has lived with diabetes himself since age 4, heads the Northeast Center for Diabetes Care and Education at Urgicare of the Northeast in Plattsburgh. Send questions for this column, which runs the second Tuesday of every month, to: Features Editor, P.O. Box 459, Plattsburgh, NY 12901 or email firstname.lastname@example.org.