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    What causes low blood sugar levels?

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Posted on Sat, 28 May 2016 in Diabetes
Question: my blood sugar levels are lower than what you suggest
Average 8 to 10
doctor
Answered by Dr. Shehzad Topiwala 44 minutes later
Brief Answer:
Glucose levels

Detailed Answer:
If you have diabetes and if you are on medication for it, please discuss your glucose goals with your endocrinologist in-person.
This is important because these targets are individualized based on comprehensive assessment.

In general I use fasting and before-meal glucose targets of 4.5 to 7 in many of my patients with an A1c goal of 6.5% to 7%

However this depends on a host of factors for which a thorough evaluation is required.

When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
Free T4
25 hydroxy Vitamin D
None of these tests require any fasting and can be done at any time of the day
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala 3 hours later
DIABETES AND NEUROLOGICAL DISEASES
Have you had any experience with nerves affected by high sugar levels
do they heal and if so how long generally does that take
being more specific 1.cranial nerves and 2 peripheral nerves
As to cranial nerves which are the most commonly affected
doctor
Answered by Dr. Shehzad Topiwala 2 hours later
Brief Answer:
Follow up

Detailed Answer:
1 Yes as an endocrinologist I have seen hundreds of people with diabetes and nerve damage

2 They heal sometimes but not always and not fully, but sometimes they do. It depends on several factors such as

Duration of diabetes

The degree of diabetes control during the years that one has had it

Presence of other conditions that can damage nerves such as poor circulation

In many cases it is irreversible and permanent.

3 Among the cranial nerves the third, fourth and sixth nerves tend to be affected more commonly than others

Among the peripheral nerves, the median nerve in the arm and the peroneal nerve in the leg is more commonly affected than others


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala 2 hours later
As to 4 th cranial nerve,how do you determine if due to closed head injury or diabetic episode?
doctor
Answered by Dr. Shehzad Topiwala 8 hours later
Brief Answer:
Second follow up

Detailed Answer:
In order to determine the most likely cause, an in-person examination followed by further laboratory testing is required.
Fundus related eye changes are less likely due to nerve problems in diabetes.
However, diabetes can directly affect the retina itself causing fundic eye changes to occur
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala 27 minutes later
what lab tests?
an in person examination ,what would you test observe etc
doctor
Answered by Dr. Shehzad Topiwala 12 hours later
Brief Answer:
Third follow up

Detailed Answer:
Nerve conduction studies

Vitamin B12 levels

Folate levels

are example of tests.

On physical examination, the specialist physician will look for pattern of nerve damage. For instance, in diabetes, typically the legs tend to show some signs of loss of protective sensation.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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