For Veterans - Quality, Safety & Value
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Hypoglycemia (Low Blood Sugar) 

What is hypoglycemia? Hypoglycemia is the medical term for “low blood sugar.” This can be something you feel or something you measure. The feelings of hypoglycemia may include weakness, shakiness, hunger, sweating, lightheadedness, or just a feeling of “not being right.” It can be very vague. The measure of your blood sugar may be a value less than 70 but many patients feel poorly even at blood sugar values above this. Symptoms should prompt you to check your blood sugar and, if it is less than 70, treat the low sugar according to the “15-15 rule”. In addition, if low blood sugars occur, consider a discussion with your health care team about lowering your risk for hypoglycemia, which may include adjusting your A1C target and/or changes in medication.

Is hypoglycemia (low blood sugar) really that dangerous for me? Studies show that all hypoglycemia should be avoided. Even one episode of hypoglycemia can stress your heart and may cause dizziness, falls, or accidents. You may not always feel symptoms of hypoglycemia, which can lead to even more dangerous situations. Always tell your health care team about low readings, whether or not they cause symptoms, so you can discuss the causes and possible changes in your diabetes treatment. 

Ways to Lower the Risk of Low Blood Sugars

What should I do to treat hypoglycemia (low blood sugar)? Treat hypoglycemia with fast-acting sugar, such as 3-4 glucose tablets or 4 ounces of fruit juice. Discuss the “15-15 rule” for treating hypoglycemia with your health care team.

You are encouraged to talk with your health care team to avoid hypoglycemia (low blood sugar). Learn more here.

 A1C Test and Targets

I have heard about the A1C test and would like more information to help me understand it. Click here for a document explaining what the A1C test means and how it may vary from test to test.
What is my A1C goal? An individualized approach where you discuss with your health care team the benefits and potential risks of various A1C goals and together select one that considers your medical conditions, health status, lifestyle, and the things that are important to you is recommended. Your target A1C goal will likely change over time. Talk with your health care team about what A1C goal fits you.

We Want You and Your Provider to Discuss and Choose a Safe A1C Goal.

Medication Safety

Am I taking my diabetes medicines at the right time? Should they be taken with or without a meal?
Some medications used to treat diabetes can cause hypoglycemia (low blood sugar), especially if taken at the wrong time. Take them as directed on your medicine label and discuss any concerns with your health care team.

Ways to Lower the Risk of Low Blood Sugars

Food Insecurity

Food insecurity is the state of being without reliable access to a sufficient quantity of affordable, nutritious food. Having a lack of food, or not eating consistently, can increase your risk of hypoglycemia (low blood sugars). Here are some resources to help you select healthy food choices and lower your risk of hypoglycemia.

Visit the VHA Nutrition and Food Services diabetes information site for other resources.

Shared Decision-Making

Shared decision-making is a process in which you work together with your health care team to make decisions and select tests, treatments, and care plans based on clinical evidence that balances risks and expected outcomes with your preferences and values.

VHA strongly encourages Veterans to take charge of their care and recommends shared decision-making as the best way to get a plan that sets patients on the right course. VHA’s Choosing Wisely Hypoglycemia Safety Initiative (CW-HSI) promotes patient-centric care through shared decision-making and urges patients with diabetes to avoid low blood sugar. Read more here.

Additional Resources