by Karen Keller Capuciati
If someone you know has been diagnosed with diabetes, you may be a little lost and wondering how you can help. I felt the same way when my husband, Peter, was diagnosed with type-1 diabetes in 1998. In the 15 years since then, I have found that the most important lesson I can relay to others is to understand and be prepared for episodes of hypoglycemia, which can affect everything from mood to coordination to cognitive function.
Hypoglycemia is when blood-sugar (or blood-glucose) levels drop below a normal range. This can be caused by any number of factors: insulin being injected too soon before a meal; too much insulin being taken; the different rates at which foods metabolize; stress levels; the amount of physical activity. No matter how well someone manages his or her blood sugar, hypoglycemic episodes are common.
Being able to recognize symptoms of hypoglycemia is critical, as episodes can become severe enough to debilitate. Some of the many symptoms are:
- Feeling lousy
- Mood shifts, becoming cranky or irritable
- In severe cases, trouble walking, slurred speech
Hypoglycemia needs to be treated quickly. Here are some guidelines:
- If possible, test the blood-glucose level to confirm that it’s low.
- Give quick-acting sugar like glucose tablets or orange juice
- When in doubt, ingest some sugar and test after
- As a caregiver, don’t ask the person to make decisions at this time. Don’t ask if they want orange juice or a cola. Just give them a glass of juice.
- In severe cases, when the person is unable to eat or drink, use Glucagon, an injectable prescription glucose, or call 911.
Over the years there have been many scary incidents that could have been avoided with proper preparation. Many years ago, Peter’s blood sugar dropped while he was on the highway. He was stuck in bumper-to-bumper traffic, with no available exit, and there was no sugar in the car. He managed to call me but couldn’t tell me where he was — he was clearly not his usual self. I was in a panic and felt completely helpless. He somehow managed to get to the next rest area to get something sugary, but this was a stressful ordeal for both of us, dangerous and entirely avoidable. Other similarly stressful situations over the years have taught me that preparation is essential, and the one area where I can be of genuine assistance.
Here are some useful preparation tips to help avoid unnecessary stress and danger:
- Find your loved one’s preferred form of sugar for relief. It might be anything from glucose tablets to orange juice to candy, but make sure to have it on hand at all times. I have a standing order for a box of Dex4 Fast Acting Glucose 2-ounce drinks that comes every month from DiabetesExpress.com.
- Keep them all over your home so you never find yourself without sugar when you need it. I make sure there are glucose drinks or tablets in the cars, on the bedside table, in my purse, in Peter’s computer bag, etc. I also keep a boxful by the front door to remind us to grab a couple whenever we leave the house.
- I highly recommend a Continuous Glucose Monitor (CGM), which has had a huge impact in preventing low-blood-sugar episodes for Peter. The CGM has an insertion site that automatically tests his blood every five minutes and a remote monitor that fits in the palm of his hand to show his glucose readings at any time. An alarm can also be set to go off when his glucose level drops below normal range. DiabetesNet.com put together a helpful chart to compare different CGM brands. They are all a bit pricey but most are covered by insurance.
- Get a prescription for Glucagon, an emergency last resort. Here is a 4-minute video with information and demonstration on how to use Glucagon.
- Let family and friends know what symptoms to watch out for in your diabetic loved one, and what to do in the event of a hypoglycemic episode when you’re not around.
- If Peter needs sugar when we’re eating out, I have found it best to bypass the waiter and go directly to the bartender and say, “I’m with someone with diabetes who needs a Coke real quick, please.” They usually stop what they’re doing to get me the cola right away.
- Handling these situations quickly, calmly and without a fuss goes a long way to help diffuse what can easily become emotionally charged episodes.
My final note on this topic is to be supportive, compassionate and find the balance so your loved one does not become dependent on you to always be there to help them. Creating a prepared environment allows your loved one to be self-reliant, which is essential for the times when you’re not around.
Let us know of any tips, big or small, that have helped you or your loved one overcome the stress and danger of hypoglycemia.
Karen Keller Capuciati is the Co-Founder of In Care of Dad.