Warning Signs: When to Check Your Blood Sugar Levels STAT—Lifesaving Indicators You Can't Ignore

Throughout their blood sugar management journey, diabetic patients may encounter instances of uncontrolled glucose levels, such as hypoglycemia or severe hyperglycemia. It is crucial for them to promptly identify these anomalies to avert potential risks.

Heavy Sleep: Asymptomatic Hypoglycemia

Asymptomatic hypoglycemia is a particularly concerning complication for diabetics, characterized by the absence of typical hypoglycemia symptoms. According to the "China Guidelines for the Prevention and Treatment of Type 2 Diabetes (Popular Science Edition)," this phenomenon can arise from two main mechanisms:

1. Repeated hypoglycemic episodes can damage the high-level autonomic nervous center, diminishing the body's capacity to recognize and respond to low blood sugar. In such cases, consulting a healthcare professional to adjust the type or dosage of antidiabetic medication is essential to minimize hypoglycemic occurrences. Gradual reduction in both frequency and severity of hypoglycemia may help restore the perception and response to low glucose levels.
2. Long-term diabetic patients with comorbid autonomic neuropathy or pituitary microvascular disease may exhibit a blunted hormonal response during hypoglycemia. Regular blood sugar monitoring is vital for these individuals to promptly detect asymptomatic hypoglycemia.

Asymptomatic hypoglycemia lacks the telltale signs like palpitations, anxiety, sweating, and hunger. Some patients may even experience sudden hypoglycemic coma without any preceding symptoms. Thus, when a diabetic experiences unusually deep sleep, they should be wary of asymptomatic hypoglycemia. Family members should also be vigilant and measure the patient's blood sugar promptly to prevent potential dangers.

Nightmares, Sweating: Nighttime Hypoglycemia

An ill-suited blood sugar lowering plan can lead to nocturnal hypoglycemia, particularly in insulin-treated patients. For instance, using intermediate-acting insulin as basal insulin may result in nocturnal hypoglycemia due to its peak effect. If diabetics suspect nocturnal hypoglycemia, they should ask themselves the following questions:

1. Have you noticed damp pajamas or mattress upon waking up?
2. Do you experience restless sleep or nightmares?
3. Do you wake up with a headache or persistent fatigue?

If affirmative responses are given, nocturnal hypoglycemia might be the cause. To confirm, measure blood sugar levels at 2 to 3 AM for two consecutive nights. If hypoglycemia is detected, inform your doctor immediately to adjust your blood sugar management plan accordingly.

While night sweats can be indicative of low blood sugar, they can also result from yin deficiency. Characterized by sweating during sleep, yin deficiency may also present with hot palms and soles, irritability, facial flushing, and oral or throat issues. Given their dryness and other distinct features, diabetics should differentiate night sweats caused by hypoglycemia from those stemming from yin deficiency.

Irritability: Hypoglycemia

In addition to physical symptoms like palpitations, sweating, and hunger, hypoglycemia can also elicit emotional changes such as irritability, impatience, anger, anxiety, and more. Hence, when a diabetic displays uncharacteristic temper, it could signal an underlying hypoglycemic episode. Timely blood sugar checks are necessary to avert any potential risks, especially for those prone to emotional challenges. Severe iatrogenic hypoglycemia or cardiovascular events triggered by it can offset the lifelong benefits of maintaining normal blood sugar levels.

Emotional Disturbances Can Also Elevate Blood Sugar

It is worth noting that a negative mood can also cause blood sugar to rise. Emotional fluctuations can disrupt hormone secretion in the body, leading to increased production of glucagon-like hormones such as epinephrine and glucagon. Therefore, diabetics must learn to manage their emotions, as they serve as a 'barometer' for blood sugar control, signaling not only potential hypoglycemia but also potential hyperglycemia.

Dizziness: Hypoglycemia

For diabetics with liver dysfunction, heavy alcohol consumption can easily precipitate hypoglycemia after drinking. Alcohol inhibits gluconeogenesis and hepatic glycogen breakdown in the body. Gluconeogenesis is the process where, in response to low blood glucose concentrations, fatty acids and amino acids are converted into glucose via gluconeogenesis pathways to supply energy. Glycogen serves as an 'energy reserve,' stored in muscles and liver and converted into glucose when blood sugar levels are insufficient to meet physiological demands. If a diabetic consumes large amounts of alcohol, especially on an empty stomach, rapid ethanol absorption in the liver hampers the conversion of liver glycogen into glucose and its release into the bloodstream. Gluconeogenesis is also hindered, increasing the likelihood of hypoglycemia.

Some hypoglycemia symptoms closely mimic those of intoxication, such as unsteady gait, slowed reactions, and drowsiness. Misinterpreting these as drunkenness can result in delayed intervention, severe and prolonged hypoglycemia, and even life-threatening situations in severe cases. Regardless of alcohol intake or apparent intoxication, diabetics should measure their blood sugar to promptly detect hypoglycemia.

Fatigue and Drowsiness: High Blood Sugar

Diabetics experiencing fatigue, exhaustion, or excessive sleepiness may be experiencing high blood sugar. When blood glucose levels rise, insulin becomes less effective, preventing glucose from entering cells for energy. Instead, some glucose is excreted in urine, leaving cells energy-depleted and causing fatigue. In the early stages of diabetic ketoacidosis, symptoms include increased urination, thirst, and fatigue. As the condition worsens, patients may also experience loss of appetite, irritability, and lethargy.

Diabetics must discern fatigue and drowsiness caused by hypoglycemia and hyperglycemia. While hypoglycemic episodes can also produce mental changes and cognitive impairment, they are accompanied by typical hypoglycemia symptoms like palpitations, anxiety, and sweating, allowing differentiation from hyperglycemia symptoms.

Rotten Apple Smell: Ketoacidosis

In diabetic ketoacidosis, the breath develops a distinctive 'rotten apple' odor due to the presence of acetone. This hallmark characteristic can serve as an early indicator of the condition. When a diabetic detects this scent in their breath, they should not dismiss it lightly and should immediately monitor their condition to timely detect and treat ketoacidosis.