Dr. P. D. Pahwa

Hypoglycemia, commonly referred to as low blood sugar is the condition of the body, when the level of blood sugar falls down below the normal level. This accounts for clumsiness, feeling shaky, feeling confused, losing consciousness, serious seizure. Severe lowering of blood sugar may cause death. You are likely to feel exhausted and very hungry. The symptoms usually show quite quickly.

Hypoglycemia is commonly caused due to diabetes medicine like insulin, sulfonylureas or biguanides. Starving for long hours, over straining the body or extreme alcohol consumption may lead to hypoglycemia. Failure of the kidneys, liver diseases, metabolism disorders also lead to hyperglycemia.

Fall in the the blood sugar level must be taken very seriously and never be ignored. If you feel the symptoms of lowered blood sugar, it is advised that you immediately take a sugar test. You must also indulge in high calorie food items such as sweets or chocolates. You need to increase the glucose intake, so that the blood-sugar level rises up.

Here are some steps you should follow to control hyperglycemia:

1. Keep away from the practices, which lead to hyperglycemia: The best way of keeping away from hyperglycemia is by taking all measures, which would avoid the condition to develop. The medical schedule of diabetic patients should be closely monitored and optimized by the patient's caregivers. Their lifestyle should be kept under check. It should be ensured that the patients do not skip meals. Insulin should be avoided as much possible.
2. Discuss problems with the patient: Patients and their guardians must be properly educated about the disease and what important steps they should take, in spite of all kinds of prevention treatments they take. Teach them about the symptoms and the steps to be taken in case of any emergency. Use of glucose tablets should be encouraged. They must know that the process is ongoing. Every patient is different from another and hyperglycemia differs from person to person.
3. Use glucagon: Glucagon is basically a hormone, which stimulates the liver to release pre-stored glucose all over your bloodstream in case your blood-sugar level falls down steadily. Glucagon is usually injected, and kits are available. Prescribed by doctors, glucagon can be used to treat a person who has fallen unconscious after a fatal reaction due to insulin. You should consult an expert before buying a glucagon kit.

Hypoglycemia is a serious problem. Lowering or fall in your blood sugar level must never be ignored, and measures must be taken to regain your sugar balance immediately.

If you are diabetic, know that high blood sugar level can take a severe toll on your eyes in the form of blurry vision, cataract, glaucoma and retinopathy, if left unchecked. It can even lead to partial/complete blindness in young adults. Nonetheless, a strict control over your blood sugar count would prove effective in preventing such eye complications in the long run.

How does diabetes affect the eyes?

1. Blurry Vision: Diabetes can cause swelling of the eye and damage to your vision. In case you are already using glasses, it might bring about fluctuations in your optical power. Once your blood sugar count gets back to the normal level; that is within the range of 70 to 130 milligrams per deciliter, your vision would be normal again; though this might take some time (about 3 months).

2. Cataract: Eye lens works just like a camera, helping you to focus on a particular object. Cataract is a condition wherein this lens gets clouded with debris. Nevertheless, diabetic patients are more vulnerable to cataracts as compared to others. It has to be removed with a surgery wherein an artificial lens replaces the blurry eye lens.

3. Glaucoma: Pressure starts building up within the eyes when fluids do not get drained out normally. This damages the nerves and blood vessels, thereby causing vision loss, blurred vision, watery eyes and headaches. Generally, glaucoma can be cured with laser, surgery, eye drops or medicines. Medications do help in alleviating eye pressure, reducing excessive fluid production and facilitating drainage. Having said that, diabetics are likely to develop neovascular glaucoma, a rare complication wherein new blood vessels form on the iris (the ring-shaped colored region in the eye), obstructing the normal fluid flow and further increasing the eye pressure.

4. Diabetic Retinopathy: The retina is a cluster of cells behind the eyes that absorb light and converts them into images which are then transmitted to the brain through the optic nerve. High blood sugar levels damage the tiny blood vessels of the retina, leading to a condition called Diabetic retinopathy.

The stages of diabetic retinopathy

The retina requires a constant blood supply via a network of small blood vessels. In due course of time, a high blood sugar count might damage those blood vessels; primarily across three stages:

1. Background Retinopathy: This is a condition wherein tiny lumps develop in your blood vessels, causing slight bleeding that usually does not affect your eye sight.

2. Pre-proliferative Retinopathy: This is a condition characterized by significant bleeding from the eyes as a result of the blood vessels being severely affected.

3. Proliferative Retinopathy: Proliferative retinopathy is a condition wherein new blood vessels and scar tissues that bleed easily develop on the retina, leading to vision loss.

Are you at risk?

The risks of Diabetic retinopathy increase if one is suffering from diabetes. Apart from this, certain other factors could also aggravate the chances of this disorder:

1. Rise or fall in blood sugar

2. Rise in the blood pressure level

3. High cholesterol

4. Pregnancy

5. Excessive consumption of tobacco

When should you call a doctor?

1. When you experience spots in your vision

2. In case of blurred and fluctuating vision

3. Impaired color vision

4. Sudden loss of vision

5. Redness and pain in the eyes

These signs serve as an early wake up call. However, it’s not mandatory for these signs to indicate towards diabetic retinopathy.

How to protect your eyes from diabetes and keep them healthy?

1. Get your eyes checked periodically and try and maintain a steady blood sugar count.

2. Take the prescribed medicines on time.

3. Try to achieve and then maintain optimal weight levels.

4. Avoid a sedentary lifestyle and engage in some sort of physical activity.

5. Control your cholesterol levels by picking the right kind of foods.

6. Abstain from smoking and limit alcohol consumption.

7. Opt for a healthy diet comprising of green and leafy vegetables, oily fish, tuna, salmon; protein rich foods such as beans, nuts and eggs; citrus fruits such as oranges; pork and oysters. 

   If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.