MONDAY JUNE 9, 2008 (foodconsumer.org) -- A new study presented today at the American Diabetes Association conference suggests that a recent episode of hypoglycemia in type 2 diabetes patients can be a major predictor of heart attack, stroke and death.

The study led by William Duckworth and colleagues at the VA Medical Center in Phoenix under the Department of Veterans Affairs showed patients who had become severely hypoglycemic in the previous three months were 2 to 3 times more likely to have a heart attack, stroke or die.

The finding apparently explains the high mortality rate observed among diabetics who received intensive treatment to lower their blood sugar to nearly normal as another trial known as ACCORD showed.

Both ACCORD and another Australian trial called ADVANCE show that lowering glucose levels to or below the normal levels did not reduce the risk of diabetics dying from cardiovascular events such as heart attack and stroke although the latter indicated that it might help protect diabetics' eyes, kidneys and nerves.

Diabetes patients’ blood sugar tends to be high and they are at a high risk of cardiovascular disease which kills an estimated 70 percent of the patients.   The trials tried to determine if low glucose levels would benefit diabetics.

ACCORD showed that lowering glycated hemoglobin levels to normal (6 percent) for 3.5 years actually drastically increased the odds of patients dying from cardiac events .

Low blood sugar or hypoglycemia is risky and diabetics should prevent it from occurring. The condition occurs when your blood glucose (blood sugar) level drops too low to provide enough energy for your body's activities.   It can result from other medications or diseases, hormone or enzyme deficiencies, or tumors.

Usually the condition is mild and can readily be treated by eating or drinking something with carbohydrate. But left untreated, however, hypoglycemia can lead to loss of consciousness.

Symptoms of hypoglycemia include hunger, nervousness and shakiness, perspiration, dizziness or light-headedness, sleepiness, confusion, difficulty speaking, feeling anxious or weak.  

Here is how to prevent hypoglycemia recommended by National Diabetes Information Clearinghouse:

Your diabetes medications:  Some medications can cause hypoglycemia. Ask your health care provider if yours can. Also, always take medications and insulin in the recommended doses and at the recommended times.

Your meal plan:  Meet with a registered dietitian and agree on a meal plan that fits your preferences and lifestyle. Do your best to follow this meal plan most of the time. Eat regular meals, have enough food at each meal, and try not to skip meals or snacks.

Your daily activity: Talk to your health care team about whether you should have a snack or adjust your medication before sports or exercise. If you know that you will be more active than usual or will be doing something that is not part of your normal routine—shoveling snow, for example—consider having a snack first.

Alcoholic beverages:  Drinking, especially on an empty stomach, can cause hypoglycemia, even a day or two later. If you drink an alcoholic beverage, always have a snack or meal at the same time.

Your diabetes management plan. Intensive diabetes management—keeping your blood glucose as close to the normal range as possible to prevent long-term complications—can increase the risk of hypoglycemia. If your goal is tight control, talk to your health care team about ways to prevent hypoglycemia and how best to treat it if it does occur.

When hypoglycemia occurs, you may do the following:

If you think your blood glucose is too low, use a blood glucose meter to check your level. If it is 70 mg/dL or below, have one of these "quick fix" foods right away to raise your blood glucose:

2 or 3 glucose tablets

1/2 cup (4 ounces) of any fruit juice

1/2 cup (4 ounces) of a regular (not diet) soft drink

1 cup (8 ounces) of milk

5 or 6 pieces of hard candy

1 or 2 teaspoons of sugar or honey

After 15 minutes, check your blood glucose again to make sure that it is no longer too low. If it is still too low, have another serving. Repeat these steps until your blood glucose is at least 70. Then, if it will be an hour or more before your next meal, have a snack.

If you take insulin or a diabetes medication that can cause hypoglycemia, always carry one of the quick-fix foods with you. Wearing a medical identification bracelet or necklace is also a good idea.

Exercise can also cause hypoglycemia. Check your blood glucose before you exercise.