If you have diabetes type 2, you can be at risk for hypoglycemia if you are using insulin. However, a recent survey indicates that 50 percent of people with diabetes type 2 are not aware they have such a risk. And as you probably know, hypoglycemia can have serious consequences.

What is hypoglycemia?

Hypoglycemia means low blood sugar (hypo means low and glycemia means sugar). Hypoglycemia symptoms are one of the most common, and most dangerous, side effects of any medication for lowering blood glucose.

If you are diabetic, your goal of treatment is to lower blood glucose levels to as close to normal as possible. If the treatment plan includes insulin and/or one of the insulin-stimulating medications (a sulfonylurea or glitinide) then you are at risk for hypoglycemia.

The normal range for blood glucose is 70 to 99 mg/dl. If your blood glucose falls below this level, you are in trouble. Your brain and nervous system depend solely on glucose for energy. When this happens, the brains sends out emergency signals in an attempt to raise the glucose level; as a result, your alpha cells, located in your pancreas, release glucagon, which signals your liver and muscles to release the glucose stored in those organs (glycogen).

Meanwhile, the body releases the hormone epinephrine which increases your hunger and causes a resistance to insulin. Other hormones, cortisol among them, are also released to counteract insulin and raise your blood glucose levels.

Symptoms of hypoglycemia

As a result of all this commotion in your body, you have some external symptoms. Early symptoms caused by the release of epinephrine are dizziness, irritability, hunger, sweating, rapid heartbeat, fatigue or weakness, nervousness or anxiety, and shakiness.

Here is the information on the survey as posted by DiabetesHealth on Oct 11, 2011

Hypoglycemia in Type 2 Diabetes

Hypoglycemia can catch many type 2s unaware.

Hypoglycemia, or low blood sugar, is commonly perceived as a concern for people with type 1, not type 2, diabetes. However, hypos are a potential risk for anyone using insulin, and approximately 50 percent of people with type 2 diabetes are insulin-dependent. Recent research suggests that many of these patients are unaware of the risks and symptoms of hypoglycemia.

According to new survey data released at the American Association of Clinical Endocrinologists (AACE) 20th Annual Meeting and Clinical Congress, more than half (55 percent) of Americans with type 2 diabetes report they have experienced hypoglycemia. What’s more, many experienced it during typical daily activities such as working (42 percent), exercising (26 percent), and driving (19 percent).

Recognizing symptoms like nervousness, sweating, or shakiness before engaging in common activities is important to help reduce the risk of serious consequences, such as fainting or loss of consciousness.

“While most people with diabetes recognize the importance of avoiding high blood sugar, they may not know the risks of extremely low blood sugar,” says Farhad Zangeneh, MD, FACP, FACE, the medical director and endocrinology consultant at the Endocrine, Diabetes and Osteoporosis Clinic (EDOC) and member of the American Association of Clinical Endocrinologists (AACE) Board of Directors.

“Skipping meals, drinking too much alcohol, and changing exercise routines can all contribute to low blood sugar; patients may also need to adjust their medications and should talk with their doctor about any episodes of low blood sugar.”

The online survey of more than 2,500 adults living with type 2 diabetes was designed by the American College of Endocrinology (ACE) and supported by Merck. Its results indicated the following:

· 27 percent of type 2s were unable to name the leading cause of hypoglycemia

· 35 percent did not know the diabetes medications that can cause hypos

· 46 percent were not aware that unusual increased exercise can cause hypos

· 52 percent were concerned about repeat episodes of hypoglycemia, but did not know that the most common symptoms are dizziness (22 percent) and shakiness (17 percent), and 39 percent incorrectly thought that thirst was the primary symptom of hypoglycemia.

· 6 percent of patients who responded to the online survey had been treated for hypoglycemia in the emergency room.

Kelly Love Johnson, who has lived with type 2 diabetes for six years, says, “I had to do my own research to find out that it’s crucial to have a blood glucose that fluctuates less than 50 to 60 mg/dL (my ideal blood glucose range is 70 to 110 mg/dL), and it’s the wide fluctuations (or highs and lows) that we need to worry about.” Dr. Zangeneh agrees, saying, “Low is bad and high is bad. What we want is for our patients to have a nice flight from the East coast to the West coast with no turbulence.”

The endocrinologists in the American College of Endocrinology are very concerned about the lack of knowledge that type 2s have about hypoglycemia. They are addressing the issue by launching a program called “Blood Sugar Basics,” an educational program with an interactive website.

The website includes fact pages that help people with diabetes, their families, and their loved ones learn about the importance of understanding and managing low and high blood sugar. Dr. Zangeneh, who is on the Blood Sugar Basics board of directors, reports that the website is user-friendly and will empower patients with knowledge. “Education, education, education,” he says. “The best way to treat a low is to avoid it. You need to be an ongoing student when you have diabetes.”

Final word

If you have diabetes type 2 and you are taking insulin, get as much information as you can from your doctor or diabetes educator about how to prevent hypoglycemia.


I am Andy Carpenter and I would start by saying that I have a Bachelor Degree in Nutrition Science conferred by California State University, Los Angeles and that I am certified as a Registered Dietitian.

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