Nurse Teaching on Common Causes of Hypoglycemia in Diabetic Individuals

Nurse educated the patient and caregiver regarding common causes of hypoglycemia in diabetic individuals as follows:

  1. Irregular eating habits: Appropriate eating habits at regular intervals is very important to maintain the blood sugar levels in a healthy range. Individuals practicing intermittent fasting or those with irregular eating habits can often miss a meal and consequently, stand the risk for presentation with low blood sugars.
  2. Advanced age: Senior citizens can often present with low appetite or reduced sensitivity to hunger and consequently, skip a meal. This can put them at risk for presentation with low blood sugar levels. Compliance with intake of anti-diabetic medications despite skipping the meal can put them at increased risk for hypoglycemia.
  3. Individuals with history of poorly controlled diabetes: Diabetic individuals can be on various medications, such as, short-acting insulins, long-acting insulins, and oral anti-diabetic medications for blood sugar regulation. Dose of these medications could frequently change in individuals with poorly regulated blood sugar numbers. Also, some individuals could be on a sliding scale insulin, which is varied dose of insulin based on the blood glucose level. Due to the complexity of situation with multiple medications involved, poorly managed diabetics can be at increased risk for presentation with hypoglycemic episodes. Noncompliance with mealtimes by these individuals can further the risk for hypoglycemia.
  4. Poor knowledge of balanced diet: Proper balanced diet is essential to ensure the requirements of carbohydrates, proteins, fats, vitamins, minerals, and other alternative nutrients are all appropriately met. Carbohydrates are broken down to sugars and usually are the first & readily available source for sugars. Diets that are poor on carbohydrates can yield very little glucose and individuals following this diet can be at increased risk for presentation with hypoglycemia.
  5. Poor knowledge of insulin dose: Diabetic individuals with poor knowledge of their insulin dose can often stand the risk of administering high dose of insulin that recommended. This can result in acute drop in the blood sugar levels and increased risk for presentation with hypoglycemic symptoms.
  6. Poor knowledge of insulin action and use: Diabetic individuals can be on various insulin regimen, such as, short-acting insulins, long-acting insulins, ultra-long-acting insulins. The peak and duration of all these insulins vary significantly. Absolute compliance with eating schedule with thorough knowledge of the insulin peak and duration of action is very important to avoid precipitating a hypoglycemic episode. Noncompliance with eating schedule after intake of the insulin dose can trigger the risk for presentation with hypoglycemia.
  7. Overperformance on physical exercise regimen: A healthy balance between physical exercise and calorie intake in diabetic individuals is important to maintain the blood sugars in the desired range. Overperformance on physical exercise regimen coupled either with compliance on calorie intake recommendation or undernutrition can tip off the balance, burn extra calories, lower the blood sugar levels – sometimes dangerously, which can result in increased risk for hypoglycemia.
  8. Excess alcohol intake: Insulin helps to shift the sugar from the blood into the cells, thus lowering/controlling blood sugar levels. Alcohol intake can lead to increased insulin secretion, which can result in increased transport of sugar from the blood into the cells, thus dropping the blood sugars. This can increase the risk of the individual for presentation with hypoglycemia.