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Dr. Bill's Commentaries

Lack Of Knowledge About Hypoglycemia, and a New Resource to Help   (April 17, 2011)

The American College of Endocrinology recently conducted an on-line survey about hypoglycemia (low blood sugar), involving 2530 people with type 2 diabetes (T2DM). The results (discussed on-line in a press release) disturbed me, as I would expect that people who are willing to take the time to answer on-line surveys are probably pretty motivated and fairly well educated, compared to the average disinterested non-poll-taker.

In the survey, many of the patients were unable to name the leading causes of hypoglycemia. 46% didn't know that excessive exercise may bring on hypoglycemia; 35% did not know that diabetic medications may enhance the risk for hypoglycemia; and 27% did not know that the skipping meals could cause hypos.

Symptoms of hypoglycemia were known to most, but by no means all, of the respondents: 39% thought that thirst was the primary symptom of hypoglycemia (wrong!). And some folks did not know that the most common symptoms are dizziness (22%) and shakiness (17%).

Which brings up an interesting point: why is there this knowledge gap? Is it due to busy physicians who don't take the time to educate? Or to refer their patients to diabetes educators who have the time? Or simple forgetfulness on the part of patients -- every now and then, it would be good to have reinforcement of the concepts involved in hypoglycemia, especially in people with T2DM who may not have episodes of hypoglycemia terribly often.

Another thought: since people with diabetes can become confused when their blood sugar level is low, it would be a good idea for friends and family members to be educated, and to understand what causes low sugars, what the symptoms are, and how to treat hypoglycemia.

One way to educate is the Internet, and the American College of Endocrinology's parent organization, the American Association of Clinical Endocrinologists, have set up a website to teach websurfers about "Blood Sugar Basics." It's at, and it reviews the fundamentals of both low and high blood sugars. It contains checklists such as "Checklist for Controlling Low Blood Sugar" and "Checklist for Controlling High Blood Sugar" as well as a brief interactive Blood Sugar Basics quiz. I do have a few gripes about the website, and hope that some of my thoughts can be incorporated into improving the website. The level of language isn't very basic: for example, "Extreme fatigue and irritability" would have been more basic if replaced by "Very tired and grouchy." It also would be nice to have the entire website replicated in other languages: currently, it's English-only. Also, the "Resources" section of the website doesn't hyperlink to other websites that could provide additional information. And I have no idea why a website targeted at patients has a section for "Media."

But the basic information is there. Be sure to review the Blood Sugar Basics website, and review your own knowledge about hypo- and hyperglycemia. And have your friends and family review the information also.

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Dr. Bill Quick began writing at HealthCentral's diabetes website in November, 2006. These essays are reproduced at D-is-for-Diabetes with the permission of HealthCentral.

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