A 65-year-old man in Kozhikode dies in his overnight sleep, and the apparent reason is a cardiac arrest. And, there is this talk of his diabetes and the possibility of his blood glucose having plummeted to dangerous level (hypoglycaemia). Did he have a cardiac arrest because of hypoglycaemia?
“Hypoglycaemia-induced risks are immediate, unlike the long-term ones linked to hyperglycaemia (high blood glucose level). When blood glucose dips to very low level, it can cause cardiac arrhythmia,” says Calicut Diabetes Forum secretary S.K. Suresh Kumar. “If a diabetic already has a heart disease, the risk from hypoglycaemia can be fatal,” he says.
Wary of the risk of end-organ damage from high blood glucose level, diabetics would adhere to a strict diet and exercise regimen. “But, do not force this on elders, especially if they are on insulin. They can quickly slip into hypoglycaemia.
Therefore, they should not be forced to achieve the ideal HbA1c (the three-month average) level of 7,” he says.
As for younger diabetics who exercise well and eat less, they must be warned that hypoglycaemia can set in six to seven hours after the exercise. If such persons hit the gym in the evening, they run the risk of a dip in sugar level while asleep past midnight. Hypoglycaemia mimics the effects of drunkenness, says Dr. Suresh Kumar. Dr. Suresh Kumar also warns that frequent bouts of hypoglycaemia will lead to the body adjusting to it and will, therefore, stop providing the warning signs. This is when the stage of ‘hypoglycaemia unawareness’ sets in.
This is a very dangerous stage because the collapsing can happen any moment, and anywhere. It can come in the form of nocturnal hypoglycaemia (while asleep at night) also. The public should be made aware of hypoglycaemia so that they can help a diabetic in distress with quick administration of anything sweet. “We must spread awareness in schools also, because this can happen to children with Type I diabetes,” the diabetologist says.
