Lows on Sulfonylurea Treatment
Reviewed by CDE Mehandi Sharma · Updated
The same feature that makes HNF1A and HNF4A-MODY so treatable — marked sensitivity to sulfonylureas — is what makes low blood sugar a real risk. Low doses are used deliberately for this reason.
A low is generally a reading below 70 mg/dL. The symptoms are shakiness, sudden hunger, sweating, a fast heartbeat, dizziness, headache, tiredness or trouble seeing clearly, and often a sense of feeling abruptly and strangely unwell.
The 15-15 rule
- Take 15 to 20 grams of fast-acting glucose immediately.
- Wait 15 minutes.
- Check your blood sugar again.
- If it is still below 70 mg/dL, repeat.
Fifteen grams is roughly three or four glucose tablets, three teaspoons of sugar in water, or half a cup of regular juice. Not chocolate or biscuits — the fat slows absorption when you need speed.
The usual triggers are a meal skipped or delayed after taking the tablet, more activity than usual, alcohol on an empty stomach, illness, and fasting.
Report lows to your doctor even when you handled them. In these subtypes, repeated lows usually mean the dose is too high for your sensitivity — which is a correctable problem, and hiding it means it stays uncorrected.