Understanding Your Hypoglycemia Risk in Type 2 Diabetes

It’s a common misconception that if you have type 2 diabetes, you're automatically at risk for low blood sugars (hypoglycemia). However, diabetes medications are typically the biggest contributors to your hypoglycemia risk. In short, not everyone with type 2 diabetes needs to worry about hypoglycemia. Here’s a quick rundown on determining your hypoglycemia risk and why low blood sugars are a big deal.

Knowing your risk for hypoglycemia

In type 2 diabetes, you’re more at risk for hypoglycemia if you take one or more of the following medications:

• Insulin (any type)
• Glyburide (Diabeta, Micronase)
• Micronized glyburide (Glynase Prestabs)
• Glipizide (Glucotrol)
• >Glipizide extended release (Glucotrol XL)
• Glimepiride (Amaryl)
• Repaglinide (Prandin)
• Nateglinide (Starlix)

It's possible to have low blood sugars on other diabetes medications too, but those are more rare.

A few tips on the medications above: most need to be taken with food, most cause low blood sugars if you're more active than usual, skip meals, are sick, or use them with alcohol, for example.

If you do use some of these diabetes medications, your low blood sugar risk is even higher if you:

• take more than one of the medications on the list
• have had diabetes a long period of time
• have other medical conditions like heart and kidney disease
• and are older in age

3 reasons why you should understand your hypoglycemia risk

Beyond making you feel miserable, here are 3 big reasons why you should understand your hypoglycemia risk and its impact on your world.

1. The short term impact on your body

When you are having a low blood sugar your body has little to no fuel source. This includes your brain, one of the most critical organs in your body. This leads to signs and symptoms of low blood sugars, and can make your recovery from a low blood sugar exhausting! Think of your body like an empty pantry that needs to be restocked. It takes time to get back to feeling fully functional.

2. The long term impact on your body

You may have heard of the dangers of high blood sugars and what they can do to your body over time. But what happens long term when blood sugars are too low?

Low blood sugars can cause complications such as heart attacks, loss of vision, and brain impairment with dementia-like symptoms. Over time, with enough low blood sugars, you can develop hypoglycemia unawareness. This is one of the most common side effects of frequent low blood sugars that I see as a certified diabetes educator (CDE).

3. The everyday impact on your life

Low blood sugars can significantly impact your diabetes burden. If you've ever experienced a low blood sugar before, you realize how exhausting and time consuming it is to manage it. If you have them often enough, they can greatly affect your work, sleep, recreational fun, driving, and more.

Final thoughts on hypoglycemia

Low blood sugars are a big deal, but not everyone with type 2 diabetes has to worry about them. If you are at risk, minimizing the number and severity is key to living healthy with type 2 diabetes.

Working with a CDE (or diabetes care and education specialist) can help you identify the causes of your hypoglycemia and work towards eliminating them. A CDE can also help you develop a plan for preventing frequent hypoglycemia in the future.