Hypoglycemia with Gestational Diabetes

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Hypoglycemia with Gestational Diabetes is a concerning event. It is not common, but you need to know how to handle it when it happens.  Hypoglycemia is when your blood glucose level drops too low.  For me, this is when my blood glucose level drops below 4.0 according to my endocrinologist.  For the most part, hypos are only a concern when you are on insulin, but it can happen to those not on insulin as well.  If you are not on insulin you only need to worry if you do not feel well with low blood glucose numbers.  I have been fortunate and only had a hypo once.  Hypos can occur when you do not eat enough carbs, or take too much insulin for your blood glucose level and the carbs you are eating, or if you exercise without sufficient carbs.  The last one is what happened to me.  I did not eat sufficient carbs before a hike and went hypoglycemic on the trail.  Luckily I had a hypo kit with me and knew what to do. 


Hypo Kit- these are the tools you will need if your blood glucose levels drop too low. The first piece is your testing kit since you need to be able to test your levels to know if they are too low and if they are being corrected.  Next, you need a fast-acting carb and then last a slow-acting carb.  I have glucose jelly beans for my fast-acting carb and a protein bar for my slow-acting carbs.  


Symptoms of Hypoglycemia

Feeling shaky

Being confused

Being irritable

Being clumsy 

Sweating or chills and clamminess

Feeling dizzy

Slurred speech

Headaches

If you feel drunk, or someone asks if you have been drinking, check your levels! 


Here is the process:

  1. You start to feel symptoms, or it is time for a test anyway, so you test and discover you are hypo.

  2. IMMEDIATELY. Sit down and eat 15g of fast-acting carbs. I eat 5 jellybeans.

  3. Wait 15 minutes, sitting down

  4. Test again. If your BGL is the same or lower than before, go back to step 2.

  5. If BGL has gone up, eat 15g of slow-acting carbs. I eat a protein bar.  If you are not driving you can stop here, just take it easy. 

  6. Wait 15 more minutes

  7. Test again. If your BGL is above your hypo threshold, you can get back to whatever you were doing before, otherwise, keep waiting and eating as you feel you need to. Do not drive until your levels are above 4 at a minimum.  

 

Going hypoglycemic while driving can be very dangerous.  I had to test my glucose levels the other day while at the hospital for CTG monitoring and had a 4.2.  (Again, 4.0 is normally my danger threshold.) Because I had driven there, they would not let me leave without eating something or having a glass of juice because they were worried that my levels would drop further while driving.  


My hypo experience was interesting.  I definitely felt the effects of the hypoglycemia before I tested, but was stubborn and didn’t test until it was time after my meal. My husband also noticed the difference and probably realized something was wrong before I did.  We went on a challenging hike while I was 31 weeks pregnant.  We planned to go by KFC on the way, but it was too early and it was closed so we went to Mcdonalds instead.  I got just chicken nuggets and forgot to order chips to go with it.  So we ate at the trailhead like we normally do. As we hiked it was getting steeper and steeper, but I was getting more and more stubborn about pushing through it and not stopping. For me, that is always a sign that something is wrong. After two hours, we stopped so I could test my blood glucose levels. And it was really low.  So I have my 5 glucose jelly beans and sat on a log for 15 minutes.  After that, my number was still very low, but going up, so we had our lunch of bagels with peanut butter and kept hiking.  That was probably a mistake, I felt very shaky for quite a while.  We hiked for about 40 more minutes, before deciding that we would not reach the top and it wasn’t worth it.  We then turned around.  On the way back down, I slipped twice and landed on my butt both times.  After the second time, I admitted I still felt shaky. It had been an hour and my blood glucose was in range, but lower than expected for the amount of carbs I ate. At that point, I had a snack every hour on the hour for the remainder of the hike and eventually felt normal again.  Hypos are no joke and can leave you feeling awful for hours even after being corrected.  I did call the hospital about the fall but did not need to go in for monitoring since I fell a very short distance and did not bruise or hurt myself in any way and I could feel the baby moving like normal. Just wanted to end on that note to remind you that it is very important to treat hypos promptly and to take it easy afterward. 



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