This content material initially appeared on diaTribe. Republished with permission.
By Amelia Harnish
Feeling shaky, drained, and irritable after a nighttime low? For folks with diabetes, this phenomenon is called a “low hangover.” Right here’s tips on how to handle.
Whereas a fortunate few might have solely heard tales about it, many individuals with diabetes have skilled the dreaded “low hangover” firsthand.
Low hangover describes the constellation of signs that may come following an episode of hypoglycemia (low blood sugar). These can embody headache, nausea, mind fog, and fatigue – all of which make “hangover” a fairly apt descriptor.
“The mind requires glucose as its gas and quickly malfunctions when disadvantaged of it,” defined Dr. Brian Frier, a professor on the College of Edinburgh, Scotland, who makes a speciality of diabetes. “This causes cognitive impairment and generates signs.”
Discussions of low hangover and what to do about it abound in affected person circles and assist boards. But it surely’s not essentially one thing your physician will deal with, which can be as a result of it’s not a medical time period or official prognosis.
“I’ve heard this time period a couple of times from sufferers. It isn’t one thing we recurrently talk about however perhaps we must always talk about it extra,” stated Dr. Katherine Kutney, a pediatric endocrinologist at Rainbow Infants and Kids’s Hospital in Cleveland, Ohio.
Contemplating that individuals with diabetes might expertise low blood sugar as typically as a couple of times every week, the danger for a low hangover is fairly excessive. Right here’s what to find out about this little-discussed phenomenon.
Why do ‘low hangovers’ occur?
The “low” in low hangover refers to hypoglycemia.
For most individuals with diabetes who take insulin, that is outlined as a blood sugar beneath 70 mg/dL. For folks with out diabetes or who aren’t taking insulin, blood sugars right down to 60 mg/dL might be regular.
Most frequently for folks with diabetes, hypoglycemia occurs when there’s a mismatch between the insulin dose they’re taking and what their physique wants.
“An excessive amount of insulin makes blood sugar drop. The difficult half is that insulin sensitivity can change for a lot of causes,” Kutney stated.
For instance, your insulin dose could also be too excessive, or perhaps you didn’t fairly eat sufficient to match the dose. Different causes embody having a very energetic day or not consuming as a lot fats or protein as standard.
Many individuals with diabetes expertise hypoglycemia at night time whereas they sleep. Analysis finds that roughly 50% of extreme hypoglycemic episodes occur at night time.
These low sugar spells might result in extra signs (particularly fogginess) as hypoglycemia whereas sleeping can have an effect on reminiscence consolidation and cognitive perform. Nocturnal hypoglycemia is usually attributable to being energetic near bedtime or taking an excessive amount of insulin.
“Though blood glucose can rise rapidly after hypoglycemia is handled and be restored to a standard degree, the restoration of the mind lags behind. So, cognitive perform can take as much as 30-60 minutes to get well, and temper modifications can persist for for much longer,” Frier defined.
What does a ‘low hangover’ really feel like?
Signs vary, however just like an alcohol hangover, folks with diabetes recovering from a hypoglycemic episode typically really feel drained and customarily unwell following therapy.
“Hypoglycemia has a destructive impact on temper, which is irritating and ugly,” Frier added. “Temper modifications embody what’s referred to as ‘tense-tiredness,’ emotions of unhappiness, irritability, and typically anger and a destructive appraisal of conditions. These temper modifications are widespread, might be profound, and are often neglected by clinicians.”
Whenever you expertise low blood sugar, your physique tries to counteract the low by releasing hormones like epinephrine (often known as adrenaline) and cortisol. These hormones, particularly epinephrine, trigger the shakiness, nervousness, and sweating which are widespread signs of low blood sugar.
“The adrenaline doesn’t essentially shut off straight away as soon as blood sugar is over 70 mg/dL, which might result in this low hangover feeling,” Kutney stated. “Cortisol often makes folks really feel extra energized, however might go away you feeling ‘worn out’ as a consequence of fluctuations within the ranges.”
The phenomenon of a “low hangover” is often noticed within the morning after an episode of nocturnal hypoglycemia. How lengthy signs final additionally rely upon the length and severity of hypoglycemia.
How lengthy does it take for signs to go away?
As soon as your blood sugar ranges return to regular, signs can linger for hours however often go away with out further therapy.
Whereas signs usually resolve inside a day, repeated hypoglycemia can start to impression your well being and well-being. Nobody likes to really feel fatigued, foggy, and nauseous. These signs can result in needing a day without work, which if repeated, typically can impression work or college schedules.
Some analysis suggests that repeated episodes of hypoglycemia can impression cognitive perform over time. Repeated lows are additionally related to hypoglycemia unawareness, which suggests you don’t discover the indicators of low blood sugar; this may be harmful and even lethal.
Are there any methods for treating hypoglycemia at night time?
Sadly, like hangovers from extra alcohol consumption the night time earlier than, there aren’t any confirmed fast fixes for a low hangover.
“Treating it with rapid-acting carbs like glucose tablets, fruit juice, Skittles, or SweetTarts will assist blood sugar get well faster,” stated Kutney. “Nonetheless, this received’t essentially keep away from the low hangover feeling.”
One of the simplest ways to keep away from a low hangover is to forestall hypoglycemia. Take note that is simpler stated than completed as a result of many low episodes are sometimes out of an individual’s management. Nonetheless, applied sciences like steady glucose screens (CGM) are worthwhile instruments for hypoglycemia prevention and managing blood sugar ranges on the whole.
“Automated insulin supply techniques (pumps that talk with the CGM to regulate the insulin) can typically forestall a low from occurring,” Kutney added.
One other factor to be careful for is overtreating low blood sugar.
“Most individuals want about 15 grams of rapid-acting carbs to deal with a low, however this could differ. Should you overdo it, this could trigger excessive blood sugars later which might contribute to a sluggish feeling after lows,” Kutney stated.
In any other case, one of the best recommendation for coping with a low hangover is to take it simple and relaxation. Frier added that you simply must also keep away from doing something that might be doubtlessly dangerous on this state, like driving or making essential choices.
“The message for individuals who expertise low blood sugar is to understand that the aftermath of handled hypoglycemia might be extended. Attempt to be affected person and permit time for a full restoration to happen,” he stated.