There are many signs of hypoglycemia and some of the most common are sometimes overlooked.  The following are 3 of  those:

1.      Hunger:  This is the most common early symptom.  A truly well-controlled, well-nourished diabetic should not be unduly hungry – unless he’s hypoglycemic.  This symptom, although frequently ignored, should not be.  On the other hand, hunger is also very often a sign of tension or anxiety.  One cannot assume that it automatically signals hypoglycemia.  Perhaps half of so-called insulin reactions may merely reflect hunger pangs provoked by mealtime, emotional factors, or even high blood sugars.  When blood sugars are high, the cells of the body are actually being deprived of glucose, and you may feel hungry.  Thus, hunger is very common in poorly controlled diabetics.  IF YOU FEEL HUNGRY, MEASURE YOUR BLOOD SUGAR.

2.     Elevated Pulse Rate:  Always carry a watch with a sweep second hand.  Know your maximum resting pulse rate.  When possible symptoms of hypoglycemia appear and you have no handy means of testing your blood sugar, measure your resting pulse.  Many people find it more convenient to measure the temporal pulse (at the temple, on the side of the head between eyebrow and hairline) or carotid pulse (on the side of the neck near lower edge of jaw about 1-2 inches forward of the ear) than the radial, or wrist, pulse.  If resting pulse exceeds your maximum testing value by more than one-third, assume hypoglycemia.  This measurement may be normally elevated if you’ve been waiting about during the prior 10minutes.  Teaching your patients how to check their pulse can help prevent severe hypoglycemia, even when they don’t have a meter to check.

3.     Nystagmus:  This symptom may be demonstrated by slowly moving your eyes from side to side while keeping your head immobile.  If another person is asked to watch your eyes, she will notice – when your blood sugar is low – that they may jerk briefly in the reverse direction, or “ratchet,” instead of moving smoothly.  You can observe the effect of this by looking at the sweep second hand of your watch.  If it seems occasionally to jump ahead, you are experiencing nystagmus (actually, as your eyes jumped to the side for brief instants, you missed seeing bits of motion of the second hand).

For Information on Dr. Bernstein’s book “The Diabetes Solution” go to www.rx4betterhealth.com

Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S.