Gestational diabetes: Dealing with low blood sugar

Low blood sugar means that the level of sugar in your blood has dropped below what your body needs to function normally.

Most women with gestational diabetes do not have problems with low blood sugar. But if your blood sugar does drop, it can do so quickly (within 10 to 15 minutes). This usually happens 1 to 2 hours after you have had a shot of fast-acting insulin. Low blood sugar can occur if you:

• Skip or delay a meal or snack.
• Exercise too much without eating enough food.
• Drink alcohol, especially on an empty stomach. No amount of alcohol is safe to drink while you are pregnant.
• Take too much insulin.
• Take medications that can affect your blood sugar levels. Talk with your doctor about other medications you are taking, before you take any new medicines (including aspirin and ibuprofen) or nutritional supplements.

Even if your blood sugar level reading is normal, you may have symptoms of low blood sugar if your level is suddenly lower than usual. For example, if your blood sugar level has been more than 200 mg/dL for a week and the level drops suddenly to 70 mg/dL, you may develop symptoms of low blood sugar.

Test Your Knowledge

1. Low blood sugar means that the level of sugar in the blood has dropped below what the body needs to function normally.

   1. True

      This answer is correct.

      Low blood sugar means that the level of sugar in the blood has dropped below what the body needs to function normally.

   2. False

      This answer is incorrect.

      Low blood sugar does mean that the level of sugar in the blood has dropped below what the body needs to function normally.

2. Low blood sugar can develop because I have:

   1. Exercised more than usual, not eaten enough food, or taken too much insulin.

      This answer is correct.

      Low blood sugar can develop because you have exercised more than usual, not eaten enough food, or taken too much insulin. It can also develop if you skip meals, take certain medicines, or drink too much alcohol.

   2. Not slept enough, eaten too much candy, or watched TV all day.

      This answer is incorrect.

      Low blood sugar does not develop from getting too little sleep, eating too much candy, or watching TV all day. The correct answer is a. Low blood sugar can develop because you have exercised more than usual, not eaten enough food, or taken too much insulin. It can also develop if you skip meals, take certain medicines, or drink too much alcohol.

There are three types of low blood sugar: mild, moderate, and severe. If your blood sugar level falls below 55 mg/dL, your body reacts in the same way it does when you feel very afraid, angry, or anxious. These symptoms of mild low blood sugar often last for only a short time if you eat food that contains sugar, which causes the blood sugar level to rise. An emergency is not likely to develop, and you and your baby will not have any long-lasting effects.

Do not drive a car or operate other machinery if you think that your blood sugar is low. You could harm yourself or someone else. Check your blood sugar before driving. Do not drive if your blood sugar level is less than 70 mg/dL.

If your blood sugar continues to drop (below 40 mg/dL), your brain may receive too little sugar to work well. Problems with judgment and muscle coordination are symptoms of moderate low blood sugar.

If your blood sugar drops below 20 mg/dL (severe low blood sugar), you could have a seizure or stop breathing, possibly harming your baby. You could also fall into a coma, have a stroke, or possibly die.

Test Your Knowledge

1. If my blood sugar level drops very low (below 20 mg/dL):

   1. I can fall into a coma and possibly die.

      This answer is correct.

      If your blood sugar level drops to 20 mg/dL or lower, your baby could be harmed if you have a seizure or stop breathing. You could fall into a coma and possibly die.

   2. I will act like I am okay.

      This answer is incorrect.

      If your blood sugar level drops to 20 mg/dL or lower, you will not act like you are okay. You will not be alert enough to eat something that contains sugar to raise your blood sugar level. The correct answer is a. If your blood sugar level drops to 20 mg/dL or lower, your baby could be harmed if you have a seizure or stop breathing. You could fall into a coma and possibly die.

   3. I will be able to eat or drink something to raise it.

      This answer is incorrect.

      If your blood sugar level drops to 20 mg/dL or lower, you will not be able to eat or drink something to raise it. You will not be alert enough to eat or drink something that contains sugar without help. The correct answer is a. If your blood sugar level drops to 20 mg/dL or lower, your baby could be harmed if you have a seizure or stop breathing. You could fall into a coma and possibly die.

Here are some ways you can prevent and manage low blood sugar emergencies.

Be prepared

Although most women with gestational diabetes do not have problems with low blood sugar, you should always be prepared for the possibility.

• Have fat-free milk or quick-sugar foods (such as table sugar, fruit juice, or candy) available. It is best to drink a glass of fat-free milk when your blood sugar is low, because it will raise your blood sugar level 25 mg/dL to 30 mg/dL. If fat-free milk is not available, use quick-sugar foods to raise your blood sugar level about 30 mg/dL within 15 minutes.
• Learn the symptoms of low blood sugar. Carry a copy with you at all times, and post a copy at home and work.
• Wear medical identification in case your blood sugar drops very low and you need help. Medical identification bracelets and necklaces are sold at many local drugstores and pharmacies.
• Keep a copy of instructions on how to check your blood sugar with your blood sugar meter. Tell your family and friends where the instructions are and how to use your meter.
• Post a copy of the emergency care for low blood sugar in a convenient place at home and at work for other people to use if you need help during a low blood sugar episode.
• Do not drive if your blood sugar is less than 70 mg/dL. Your reflexes are slowed, and you could have an accident.

Treat low blood sugar early

Treat low blood sugar levels as soon as the symptoms are noticed, whether by you or by someone else.

• Check your blood sugar often.
• Follow the steps for dealing with low blood sugar when your blood sugar level is below 55 mg/dL.
• Keep track of your symptoms and how you treated them in a low blood sugar level record (What is a PDF document?) .
• Talk with your doctor if you have low blood sugar. If you are taking insulin, your dose may need to be adjusted.

Test Your Knowledge

1. To be prepared for a low blood sugar emergency, I need to carry:

   1. My insulin.

      This answer is incorrect.

      To be prepared for a low blood sugar emergency, you do not need to carry your insulin. An insulin shot would cause your blood sugar level to drop more. The correct answer is b. To be prepared for a low blood sugar emergency, always have some fat-free milk or quick-sugar foods with you. About 8 fl oz (236 mL) of fat-free milk will raise your blood sugar level 25 mg/dL to 30 mg/dL. Quick-sugar foods put sugar into your bloodstream rapidly and will raise your blood sugar level about 30 mg/dL within 15 minutes. Review the list of quick-sugar foods.

   2. Some quick-sugar foods.

      This answer is correct.

      To be prepared for a low blood sugar emergency, have some fat-free milk or quick-sugar foods with you. About 8 fl oz (236 mL) of fat-free milk will raise your blood sugar level 25 mg/dL to 30 mg/dL. Quick-sugar foods put sugar into your bloodstream rapidly and will raise your blood sugar level about 30 mg/dL within 15 minutes. Review the list of quick-sugar foods.

   3. A protein bar.

      This answer is incorrect.

      To be prepared for a low blood sugar emergency, you do not need to carry a protein bar. A protein bar will not get sugar into your bloodstream fast enough. The correct answer is b. To be prepared for a low blood sugar emergency, have some fat-free milk or quick-sugar foods with you. About 8 fl oz (236 mL) of fat-free milk will raise your blood sugar level 25 mg/dL to 30 mg/dL. Quick-sugar foods put sugar into your bloodstream rapidly and will raise your blood sugar level about 30 mg/dL within 15 minutes. Review the list of quick-sugar foods.

2. If my blood sugar level is 50 mg/dL, I need to:

   1. Call my doctor immediately.

      This answer is incorrect.

      If your blood sugar level is 50 mg/dL, you do not need to call your doctor immediately. But you do need to treat the low blood sugar level to prevent an emergency. The correct answer is c. If your blood sugar level is 50 mg/dL, you need to follow the steps for dealing with low blood sugar.

   2. Go to sleep and rest.

      This answer is incorrect.

      If your blood sugar level is 50 mg/dL, you should not go to sleep and rest. You need to treat the low blood sugar to prevent an emergency. The correct answer is c. If your blood sugar level is 50 mg/dL, you need to follow the steps for dealing with low blood sugar.

   3. Follow the steps for dealing with low blood sugar.

      This answer is correct.

      If your blood sugar level is 50 mg/dL, you need to follow the steps for dealing with low blood sugar.

Now that you have read this information, you are ready to prevent and treat low blood sugar levels effectively.

Talk with your doctor. If you have questions about this information, take it with you when you visit your doctor.