Hypoglycema

Question 1

Why shouldn’t protein be consumed to treat hypoglycemia?

Answer 1

In T2DM, ingestion of protein appears to increase insulin response without increasing plasma glucose concentrations. Therefore carbohydrate sources high in protein should not be used to treat or prevent hypoglycemia.

Protein’s effect on blood glucose levels in T1DM is less clear.

Question 2

Preferred treatment for hypoglycemia (conscious patient)

Answer 2

• Treat with 15 -20 grams of Glucose
• Note that glycemic response correlates better with the glucose content of the food rather than the carbohydrate content
• Recheck SMBG in 15 min
• Retreat if still hypoglycemic
• Eat a snack or meal after resolution to prevent recurrence

Question 3

Patients on insulin who experience hypoglycemia unawareness or severe hypoglycemia should be advised to do what?

Answer 3

• Advise patients to increase their glycemic targets for at least several weeks in order to partially reverse hypoglycemia unawareness and reduce risk of future episodes (allows time for autonomic re-set of counterregulatory hormones)