Hypoglycemia is defined as a blood glucose level of less than 60 mg/dl. Many type 2s, however, may be well above this level but still say they feel “low.” A common mistake for type 2s is to eat sweets because you feel low, only to later find they have a very high blood sugar.
New research is now helping us to better understand this phenomenon. Findings released in the December 9, 2000 issue of The Lancet explain why type 2s frequently report feeling low when measured BG values are within the normal range.
Researchers at the School of Postgraduate Medicine and Health Sciences in Exeter, United Kingdom, report that hormonal counter-regulation occurs at normal glucose levels in people with type 2 diabetes. It has to do with the counter-regulatory release of epinephrine, norepinephrine and cortisol. This release occurs at significantly higher BG readings in type 2s. The release of these hormones causes the individual to feel shaky, nervous, confused or have other symptoms of a low blood sugar.
Researchers investigated the effect of BG levels on symptoms, cognitive function and counter-regulatory hormone concentration in seven well-controlled people with type 2 diabetes and seven healthy matched subjects. Study participants experienced a release of epinephrine when their blood glucose levels got as low as 68.4 mg/dl in the diabetic group, compared with 46.8 mg/dl or lower in the healthy subjects.
For type 2s, it is always advisable to test before you treat a low blood sugar. If you test and you are not really low, do not treat with quick-acting simple sugar as you would a true low blood sugar. A low sugar snack such as a carrot might be more appropriate.