Hypoglycemia or low blood sugar occurs when blood glucose drops to a point where the patient becomes confused and disoriented. This low level varies from person to person, however some health professionals say any blood sugar level below 70 mg/dl is low. Still, others put the "trigger level" at 60mg/dl.

Hypoglycemia can affect insulin-dependent and noninsulin-dependent diabetics. Type 1 is more at risk and safety is vitally important. To keep safe, patients should talk with their doctors about where their sugar levels should be.

Prevention is the best treatment for hypoglycemic reactions. Although levels vary, if sugar levels stay around 80 to 120mg/dl, low blood sugar reactions won't happen.

"Frequent blood glucose monitoring is the best way to prevent symptoms of low blood sugar," says Dr. Evelyn Crayton, a foods and nutrition specialist with the Alabama Cooperative Extension System.

Another way is to know your body. By observing your low blood sugar patterns, and learning how much medication and food your body needs, you can make the necessary changes to prevent a reaction.

"It's not wise to wait for symptoms of low sugar to appear to occur. Too often, these reactions occur with little or no warning," she says.

Almost every diabetic, especially those who use insulin, occasionally experience a low blood sugar reaction. Common causes include straying from a prescribed diet, skipping meals, taking too much insulin or oral medication, and not eating enough. Alcohol and certain drugs, such as sedatives and beta blockers, also can bring on a reaction.

Symptoms of low blood sugar can be divided into two stages. The first stage usually includes shakiness, sweating, nervousness, a fast pulse, dizziness, headache and

pale skin color. The second stage includes sudden mood or behavior changes, confusion, poor coordination, difficulty in speaking and sometimes unconsciousness.

Unfortunately, some diabetics have hypoglycemia unawareness and cannot sense when a reaction is coming or if a reaction is in progress. By the time symptoms manifest, these individuals may be too disoriented to help themselves. A diabetic in this condition, while still conscious and able to swallow, needs a concentrated, refined sugar product immediately.

There are a variety of products available. Many diabetics carry sugar cubes or glucose tablets with them. Four small sugar cubes equal about 16 grams of sugar. These products and even cake icing all act quickly, but they burn off quickly too. One inexpensive and tasty way to prevent a hypoglycemia low is to eat Lifesavers. Six of the candies add up to 15 grams of sugar and provide the same dose as four glucose tablets

"Never use diet drinks, insulin or sugar-free candy to combat low blood glucose levels, says Crayton. "They provide no benefit and anything containing aspertame actually slows the absorption of sugar. Candy bars with chocolate or nuts also should not be used because they work too slowly. Their high fat content slows absorption of sugars in the blood."

Once sugar products have been taken and low blood sugar symptoms have cleared, eat food containing complex carbohydrates, such as milk, fruit, crackers or a peanut butter sandwich. "Milk is particularly good," says Crayton, "because it contains a simple sugar, lactose and proteins. These foods help prevent hypoglycemia from reoccuring."

Complex carbohydrates enter the blood more slowly than refined sugar, but their effects last longer, helping reestablish normal blood sugar levels. Don't overeat! You don't want to drive your blood sugar above 300mg/dl. If a blood glucose monitor is available, recheck blood sugars 15 to 30 minutes after treatment.

Occasionally type 2 diabetics experience a hypoglycemic low. If an individual is taking oral medication alone or in conjunction with a sulfonylurea, oral glucose tablets or milk are recommended. Table sugar is not an effective treatment.

A hypoglycemic reaction is an emergency situation. Educate your family members, coworkers and friends as to what to do when you cannot help yourself. Discuss the symptoms and make sure someone always knows where you keep the sugar snacks.

Diabetics walk a thin line between high and low blood sugar. To keep diabetes under control, diabetics must follow a recommended diet and exercise plan and take the proper dosage of medication, on time.

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