Hypoglycemia – a condition where blood glucose levels fall below the recommended limit – can result from several factors like alcohol consumption, skipping meals and intense workouts. Dr Muthu Kumaran Jayapaul, senior consultant endocrinology & diabetes, Fortis Hospitals, Chennai, says ideal blood sugar levels for people with diabetes may vary based on factors like age, lifestyle and duration of the condition.
The lifestyle factors causing hypoglycemia are mainly dietary, including the type of foods consumed and meal intervals. Dr Harish Kumar, clinical professor and head, centre for endocrinology and diabetes, Amrita Hospital, Kochi, points out that hypoglycemia, mainly characterised by dizziness, hunger and weakness, poses a greater immediate risk compared to hyperglycemia (high blood sugar levels).
Common causes of hypoglycemia
According to experts, the primary reasons for low blood sugar levels include:
1. Missed or delayed meals
Dr Jayapaul says skipping or delaying meals due to busy schedules or work commitments can cause a sudden drop in blood sugar levels in people with diabetes. “Missed or delayed meals can lower the body’s carbohydrate reserve, leading to a dip in blood sugar levels,” he adds.
It is vital to stick to your regular meal schedule and ensure adequate carbohydrate intake as prescribed by your doctor.
2. Alcohol consumption
Alcohol consumption (except for beer and wine) can cause a sudden dip in blood glucose levels. Once alcohol is consumed, the liver, responsible for detoxifying it from the blood as well as releasing glucose for energy, will focus only on the former, causing a dip in blood glucose levels.
Dr Jayapaul says, “Binge drinking or drinking on an empty stomach can plummet blood sugar levels.” In addition, sugar levels can drop even four or five hours after drinking. So, it’s essential to monitor blood glucose levels during that time.
Having snacks like toast or oats before drinking as well as eating something afterwards would help prevent hypoglycemia, explains Dr Jayapaul.
3. Physical activity and exercise
Physical activity or high-intensity workouts can increase insulin secretion, leading to a dip in blood glucose levels. It is always advisable to consult your doctor before starting intense workouts.
Dr Jayapaul says blood sugar levels may drop either during a workout session or even five to eight hours afterwards.
“For instance, those who do intense workouts in the morning tend to experience low blood sugar levels in the evening, while those who exercise in the evening could experience the same later at night or the next morning,” he adds.
One should always carry a banana or some fruit in their gym bag. In addition, it’s vital to inform your personal trainer or gym staff about your condition so that they can respond effectively in case of an emergency.
4. Improper diet
Just like skipping meals, eating the wrong type of food can also disrupt blood sugar levels, especially if you are on insulin. A balanced diet created by your doctor or nutritionist is vital to ensure that blood sugar levels remain stable. A healthy diet should contain an adequate amount of protein, fibre and complex carbohydrates.
5. Menstruation
Women can experience a dip in blood sugar levels during their periods. This can result from fluctuations in progesterone hormone, which increase insulin resistance.
“Women with diabetes often experience low mood swings during their periods, which can alter their dietary intake,” says Dr Jayapaul. In such cases, if the carbohydrate intake is insufficient, they will be at an increased risk of hypoglycemia, he adds.
Hence, menstruating women should incorporate protein and fibre-rich carbohydrates into their daily diet.
6. Insulin dosage
People with diabetes should be extra careful while altering their insulin dosage, as doing so without supervision can disrupt their eating patterns, says Dr Jayapaul. Several factors like bodyweight, blood sugar levels and pre-existing health conditions are considered while prescribing an appropriate insulin dosage for an individual. Hence, one must always stick to the prescribed dosage until the doctor says otherwise.
7. High altitudes
High altitude and blood glucose levels do not go together. Highlands (hypoxia) have low oxygen levels, and the body ends up using more glucose to compensate for this deficit. In addition, people indulging in adventure sports like mountain climbing or trekking might experience a low appetite and end up not eating properly, worsening the situation.
Hence, people with diabetes travelling to high altitudes or participating in such activities are advised to monitor their blood sugar levels and consume complex carbohydrates on a regular basis. Mountaineers with diabetes should always carry their glucometer and keep extra insulin vials and syringes in case of emergencies.
8. Other medical conditions
According to Dr Jayapaul, certain medical conditions can also lead to hypoglycemia. For instance, people with pancreatic tumors may experience low blood sugar levels, especially early in the morning or during the night.
In addition, those who are suffering from renal failure or have undergone bariatric surgeries are also at a higher risk of hypoglycemia.
