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HomeDiabetes CareWhat Is a ‘Low Hangover’? Plus How To Get Through It

What Is a ‘Low Hangover’? Plus How To Get Through It

This content originally appeared on diaTribe. Republished with permission.

By Amelia Harnish

Feeling shaky, drained, and irritable after a nighttime low? For individuals with diabetes, this phenomenon is referred to as a “low hangover.” Here’s the right way to manage.

While a lucky few can have only heard stories about it, many individuals with diabetes have experienced the dreaded “low hangover” firsthand.

Low hangover describes the constellation of symptoms that may come following an episode of hypoglycemia (low blood sugar). These can include headache, nausea, brain fog, and fatigue – all of which make “hangover” a fairly apt descriptor.

“The brain requires glucose as its fuel and rapidly malfunctions when deprived of it,” explained Dr. Brian Frier, a professor on the University of Edinburgh, Scotland, who makes a speciality of diabetes. “This causes cognitive impairment and generates symptoms.”

Discussions of low hangover and what to do about it abound in patient circles and support forums. However it’s not necessarily something your doctor will concentrate on, which could also be since it’s not a medical term or official diagnosis.

“I actually have heard this term a couple of times from patients. It isn’t something we frequently discuss but possibly we should always discuss it more,” said Dr. Katherine Kutney, a pediatric endocrinologist at Rainbow Babies and Children’s Hospital in Cleveland, Ohio.

Considering that individuals with diabetes may experience low blood sugar as often as a couple of times per week, the chance for a low hangover is pretty high. Here’s what to find out about this little-discussed phenomenon.

Why do ‘low hangovers’ occur?

The “low” in low hangover refers to hypoglycemia.

For most individuals with diabetes who take insulin, that is defined as a blood sugar under 70 mg/dL. For people without diabetes or who aren’t taking insulin, blood sugars all the way down to 60 mg/dL might be normal.

Most frequently for individuals with diabetes, hypoglycemia happens when there’s a mismatch between the insulin dose they’re taking and what their body needs.

“An excessive amount of insulin makes blood sugar drop. The tricky part is that insulin sensitivity can change for a lot of reasons,” Kutney said.

For instance, your insulin dose could also be too high, or possibly you didn’t quite eat enough to match the dose. Other reasons include having a very energetic day or not eating as much fat or protein as usual.

Many individuals with diabetes experience hypoglycemia at night while they sleep. Research finds that roughly 50% of severe hypoglycemic episodes occur at night.

These low sugar spells may result in more symptoms (especially fogginess) as hypoglycemia while sleeping can affect memory consolidation and cognitive function. Nocturnal hypoglycemia is commonly brought on by being energetic near bedtime or taking an excessive amount of insulin.

“Although blood glucose can rise quickly after hypoglycemia is treated and be restored to a standard level, the recovery of the brain lags behind. So, cognitive function can take as much as 30-60 minutes to recuperate, and mood changes can persist for for much longer,” Frier explained.

What does a ‘low hangover’ feel like?

Symptoms range, but much like an alcohol hangover, individuals with diabetes recovering from a hypoglycemic episode often feel drained and usually unwell following treatment.

“Hypoglycemia has a negative effect on mood, which is stressful and unsightly,” Frier added. “Mood changes include what’s called ‘tense-tiredness,’ feelings of unhappiness, irritability, and sometimes anger and a negative appraisal of situations. These mood changes are common, might be profound, and are continuously neglected by clinicians.”

Whenever you experience low blood sugar, your body tries to counteract the low by releasing hormones like epinephrine (also referred to as adrenaline) and cortisol. These hormones, especially epinephrine, cause the shakiness, nervousness, and sweating which can be common symptoms of low blood sugar.

“The adrenaline doesn’t necessarily shut off instantly once blood sugar is over 70 mg/dL, which could lead on to this low hangover feeling,” Kutney said. “Cortisol normally makes people feel more energized, but could leave you feeling ‘worn out’ on account of fluctuations in the degrees.”

The phenomenon of a “low hangover” is normally observed within the morning after an episode of nocturnal hypoglycemia. How long symptoms last also rely on the duration and severity of hypoglycemia.

How long does it take for symptoms to go away?

Once your blood sugar levels return to normal, symptoms can linger for hours but normally go away without additional treatment.

While symptoms typically resolve inside a day, repeated hypoglycemia can begin to affect your health and well-being. Nobody likes to feel fatigued, foggy, and nauseous. These symptoms can result in needing a time without work, which if repeated, often can impact work or school schedules.

Some research suggests that repeated episodes of hypoglycemia can impact cognitive function over time. Repeated lows are also related to hypoglycemia unawareness, which implies you don’t notice the signs of low blood sugar; this might be dangerous and even deadly.

Are there any tricks for treating hypoglycemia at night?

Sadly, like hangovers from excess alcohol consumption the night before, there aren’t any proven quick fixes for a low hangover.

“Treating it with rapid-acting carbs like glucose tablets, fruit juice, Skittles, or SweetTarts will help blood sugar recuperate quicker,” said Kutney. “Nevertheless, this won’t necessarily avoid the low hangover feeling.”

One of the best method to avoid a low hangover is to stop hypoglycemia. Remember this is less complicated said than done because many low episodes are sometimes out of an individual’s control. Nevertheless, technologies like continuous glucose monitors (CGM) are worthwhile tools for hypoglycemia prevention and managing blood sugar levels on the whole.

“Automated insulin delivery systems (pumps that communicate with the CGM to regulate the insulin) can often prevent a low from occurring,” Kutney added.

One other thing to look at out for is overtreating low blood sugar.

“Most individuals need about 15 grams of rapid-acting carbs to treat a low, but this could vary. In the event you overdo it, this could cause high blood sugars later which could contribute to a sluggish feeling after lows,” Kutney said.

Otherwise, the perfect advice for coping with a low hangover is to take it easy and rest. Frier added that you need to also avoid doing anything that might be potentially dangerous on this state, like driving or making vital decisions.

“The message for individuals who experience low blood sugar is to understand that the aftermath of treated hypoglycemia might be prolonged. Attempt to be patient and permit time for a full recovery to happen,” he said.

Learn more about the right way to handle lows here:

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