Sweating, trembling, fatigue, hunger, palpitations, headaches, anxiety… These are all very unpleasant symptoms that occur when blood sugar levels drop rapidly and fall below a certain threshold (usually 4.0 mmol/L). This is called hypoglycemia.
When you have low blood sugar, resisting the urge to eat everything in sight can be a real challenge! The intense feeling of hunger combined with the urgency of the situation, the unpleasant symptoms, the feeling of panic, or the fear of hypoglycemia, can lead you to eat more carbs than recommended.
What happens if you give in? Are there any strategies to avoid eating everything?
The blood sugar rollercoaster
If you sometimes let hunger overtake you and eat more than needed to correct your low blood sugar, you may end up with the opposite problem: hyperglycemia. This phenomenon is quite common. A 2016 study reported that 73% of participants with type 1 diabetes (T1D) tended to eat too many carbs to treat hypoglycemia.
In addition to the feelings of guilt and frustration that sometimes arise from giving in to temptation, overtreating hypoglycemia can lead to a chain reaction that can be difficult to stop. You may end up with hyperglycemia, which you may impulsively want to correct with too much insulin, leading to another hypoglycemic episode, and so on. You then get caught up in the blood sugar rollercoaster, which can affect your energy level, weight, mood, etc.
Breaking the cycle
Here are some strategies to help you get off that (hellish) rollercoaster and break the cycle:
- Hunger is a symptom! While the intense feeling of hunger that comes with hypoglycemia is real, remember that it is due to your low blood sugar and does not necessarily signal physiological hunger. This feeling will disappear once you treat the hypoglycemia.
- Choose well to avoid giving in. Identify in advance some carbs that you don’t particularly like and won’t overeat to treat your hypoglycemia (e.g., glucose tablets, sugar cubes, honey).
- Go for fast sugars. Fast-acting carbs like glucose tablets are an excellent choice for treating hypoglycemia. You won’t be tempted to take too much, and they will bring your blood sugar back up much faster than a compound food like a chocolate bar or ice cream! That’s because fat- and protein-free fast-acting carbs help your blood sugar rise faster, which means you’ll feel better, faster!
- Be prepared! Carry these carbs with you at all times (e.g., in your bedroom, in your school bag, in your car) to help you avoid the temptation of facing your pantry or the grocery shelves to find something to eat in case of low blood sugar. Preparing a serving equivalent to 15-30 g of carbohydrates in advance can also be a good idea.
- Create a diversion. It’s not easy to wait at least 15 minutes for your blood sugar to come back up! Find a way to distract yourself during this time (e.g., listening to music, chewing gum, calling a friend) to avoid the urge to eat more and give your carbs time to do their job. You may want to set an alarm after 15 minutes, so you don’t forget to test your blood sugar again.
- Double-check with a capillary blood sugar meter. If you use a continuous glucose monitor (e.g., Dexcom, Freestyle Libre, Guardian) and tend to eat too many carbs to treat hypoglycemia, it may be better to use a capillary blood sugar meter to confirm that your blood sugar is rising. There’s a delay (video in French only) before blood sugar fluctuations are picked up by the CGM, since it measures glucose in the interstitial fluid and not in the blood. So, it may take longer to see the blood sugar rise on the CGM following a hypo.
- Reduce temptation. If there are certain foods that you obsessively crave when you have low blood sugar (e.g., ice cream, cookies, potato chips), try to identify them and make them part of your diet. If you eat them more regularly, they will become less tempting.
Note: Studies are currently underway to assess the amount of carbs needed to treat hypoglycemia. Preliminary results seem to show that the recommendations of taking 15 grams of carbohydrate and waiting 15 minutes do not work for everyone or in all situations.
Time and experience sometimes shape the way we deal with hypoglycemia, and habits can develop without us being aware of them. Taking the time to reflect on and evaluate these habits and their potential impact on well-being and quality of life seems to be essential if you want to make a change. Remember that it’s always possible to change even the oldest habits!
- Adapté du module Tout sur l’hypoglycémie, à paraître dans la plateforme Support.
- Beyond Type 1, «3 tips: getting off the blood sugar roller coaster», consulté le 11 octobre 2022, https://beyondtype1.org/blood-sugar-roller-coaster/
- Diabetestrong, «How to Stop Binge-Eating During Low Blood Sugars», consulté le 11 octobre 2022, https://diabetesstrong.com/binge-eating-low-blood-sugars/
- Savard, Valérie et al. “Treatment of Hypoglycemia in Adult Patients with Type 1 Diabetes: An Observational Study.” Canadian journal of diabetes vol. 40,4 (2016): 318-23. doi:10.1016/j.jcjd.2016.05.008
Written by: Sarah Haag RN. BSc.
- Amélie Roy-Fleming Dt.P., EAD, M.Sc.
- Rémi Rabasa-Lhoret, MD, PhD
- Jacques Pelletier, Claude Laforest, Marie-Christine Payette, Sonia Fontaine, Eve Poirier, Michel Dostie, patient-partners of the BETTER project
Linguistic revision by: Marie-Christine Payette
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