It is true no-one wants to receive a diagnosis of type 2 diabetes but if there was ever a time to be told you have this problem, this is it. Fortunately, enough is known about diabetes nowadays to make a reasonably normal life possible… but sometimes things can go out of control. This can be frustrating, but it doesn’t mean its time to throw in the towel. Type 2 diabetes is defined and diagnosed according to abnormally high blood sugar levels but for diabetics low blood sugars can be equally problematic.

Your diabetes can go out of control for a number of reasons. Hypoglycemia, or low blood sugar, is defined as a blood glucose level of below 70 mg/dL (4 mmol/L).

Reasons for hypoglycemia include:

• problems with diet, exercise, or medications
• skipping meals or snacks
• eating later than usual
• eating too much sugar or carbohydrate can trigger hypoglycemia. This may sound paradoxical but your blood glucose level may actually go down below normal because your pancreas, sensing a high level, can over-react and produce too much insulin, which can bring your blood glucose down to below the normal level. This is particularly true for type 2 diabetics who are being treated with insulin injections and who still have some pancreatic function.

Despite the obvious benefits to your blood sugar control through exercise, too much of a good thing can cause trouble. Check with your health care provider first so he can review your exercise program. Most providers will recommend:

• measuring blood sugar levels before sport or other strenuous exercise
• having a snack before beginning exercise if your blood glucose level is below 100 mg/dL (5.5 mmol/L)
• it is a good idea to check blood glucose levels after your exercise as well.

Sometimes medications may be adjusted if unusual activity is planned.

Anti-diabetic medications can also be responsible for hypoglycemia:

• a higher dose of insulin than is needed can lower your blood sugars far too much
• oral hypoglycemic agents, which stimulate your pancreas to produce insulin, can be one of the culprits… Diabinese, Tolinase, and Orinase can cause your blood sugars to drop too far
• it is important to take the right dose at the same time every day

Various drugs that can cause hypoglycemia include:

• coumadin, or warfarin, given to prevent blood clots
• arthritis drugs Zyloprim (allopurinol), Benemid and Probalan (probenecid).
• aspirin
• alcohol

These can all lead to hypoglycemia when combined with anti-diabetic medications.

Did you know that when reversing hypoglycemia, it is more difficult to reverse low blood sugars caused by taking a large dose of insulin than it is to reverse hypoglycemia caused from missing a meal?

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