Low blood glucose level after injecting insulin

[Kanav]

Hi, my mother is a 43-year-old female who is on insulin. She has been using insulin for 3 months, and her blood glucose level has significantly improved. Her blood glucose level is typically in the range of 80 to 120 mg/dL. She states that it occasionally goes below 60 mg/dL and she starts feeling shaky. This first began when she started taking insulin, and it usually happens when she does not eat her normal meals. She says when she feels shaky and lightheaded, she usually eats a sandwich or something with carbohydrates to increase her blood glucose level. What counseling points would I give to my mother regarding low blood glucose level, can anyone suggest?

[Gunjan]

@kanav Your mother's shakiness and lightheadedness are clear symptoms of hypoglycemia. Typically, signs of hypoglycemia are shakiness, sweating, chills, confusion, lightheadedness, dizziness, and blurred vision. Because she also has a blood glucose level below 60 mg/dL, it is important that she treats her hypoglycemia appropriately. Typically, eating a sandwich would not provide enough simple sugars to treat hypoglycemia. She needs to have 15 to 20 g of simple carbohydrates. Fifteen grams of carbohydrates can be obtained from any of the following: 3 or 4 glucose tablets (follow package instructions), a gel tube (follow package instructions), 2 table spoon of raisins, 4 oz of juice or regular soda, 1 table spoon of sugar, or 8 oz of milk. After taking 15 to 20 g of carbohydrates, she should wait 15 minutes and then recheck her blood glucose. If hypoglycemia continues, she should consume an additional 15 to 20 g of carbohydrates. Once her blood glucose level returns to normal, she should be encouraged to eat a small snack if the next meal is 1 to 2 hours away. To avoid hypoglycemia, she should also be educated on eating proper meals and told not to skip meals. She should also be encouraged to follow up with her physician to discuss management of insulin on days when she is going to skip meals.