hypoglycemia low blood sugar
FAQs with Dr. Kajal Shah: Hypoglycemia

According to the American Diabetes Association, hypoglycemia, or low blood sugar, occurs when your blood glucose levels have fallen low enough that you need to take action to bring them back to your target range. This is usually when your blood glucose is less than 70 mg/dl in people with diabetes and less than 55 mg/dl in people without diabetes. It’s important to be aware of the risks of hypoglycemia because it can cause complications and in some cases, a trip to the emergency room

We asked endocrinologist Dr. Kajal Shah for her expert insight on hypoglycemia.

Who is most affected by hypoglycemia?  What causes low blood sugar? 

Hypoglycemia mostly occurs in people with diabetes. It usually occurs due to medications that increase the insulin levels in the body and the defective counter regulatory hormones that prevent hypoglycemia. Hypoglycemia is rare in adults without diabetes and could be from medications, chronic illnesses affecting kidneys or liver, severe infections, some hormone deficiencies, or tumors in the pancreas making excess insulin. There are some children who may be born with disorders causing hypoglycemia, which are evident after a period of fasting.

Is hypoglycemia a condition you are born with or something that develops over time? 

​Hypoglycemia may be a condition that some children are born with. In adults, it usually occurs over time or incidentally.

What are the symptoms of low blood sugar? 

The symptoms of low blood sugar are either adrenergic or neuroglycopenic. Adrenergic symptoms are from the release of epinephrine and include excessive sweating, hunger, palpitations, feeling nervous, or having tremors. Neuroglycopenic symptoms are from the lack of glucose in brain and could include headache, dizziness, drowsiness, confusion, and in very severe cases, coma.

Who is at a risk of having low blood sugar? 

In persons with diabetes, if they are on insulin or medications that increase insulin levels in the body, they are at risk of having hypoglycemia. Diabetes also causes hypoglycemic unawareness where one will not have these classic symptoms of hypoglycemia despite having low blood sugar. 

In people without diabetes, some of the risks for low blood sugar include uncontrolled liver disease, kidney disease, prolonged fasting, severe infections, and excess alcohol intake. Certain antibiotics and anti-inflammatory medications can also result in low blood sugar. Some individuals also have hypoglycemia following gastric bypass surgery for weight loss.

Can these risks be mitigated with proper treatment? 

For people with diabetes, the risk can be reduced by checking finger stick glucose at regular intervals, especially before meals and bedtime, eating meals at regular intervals, and correcting a low blood sugar episode with glucose intake. The American Diabetes Association recommends the Rule of 15 – correcting a hypoglycemic episode with 15 grams of carbohydrates which could be achieved through 4 glucose tablets, 4 ounces of juice or 1 tablespoon of sugar and rechecking the blood glucose in 15 minutes to make sure it has improved. 

For people without diabetes, the risk can be mitigated by addressing the underlying problem.

When should someone see a healthcare provider for low blood sugar?

If a person has symptoms suggestive of hypoglycemia and a fingerstick glucose value of less than 70 mg/dl, they should see a healthcare provider. If they are unable to check their fingerstick glucose, they should still see their healthcare provider to determine if their symptoms are in fact related to low blood sugar.

Dr. Shah is a board certified endocrinologist with special interest in thyroid and adrenal gland disorders. She sees patients at our Central Austin location.

If you’d like to learn more about our full range of diabetes services, please call Texas Diabetes and Endocrinology at (512) 458-8400 or request an appointment online

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

blood sugar spikes
FAQs with Dr. Jean Chen: Blood Sugar Spikes

A blood sugar spike occurs when there is a rapid rise in blood sugar in a short amount of time. While the body’s response to foods that are high in carbohydrates or sugar is one of the most common reasons for these spikes, there can be various causes – and some may even surprise you – like a sunburn, dehydration, and losing sleep.

We asked board certified endocrinologist Dr. Jean Chen to answer some common patient questions about blood sugar spikes. Read on to learn about her expert insights on the topic.

Why do blood sugar spikes happen?

There are numerous reasons why a blood sugar spike can occur. It can occur if a person is acutely stressed, ill, or on certain medications, like steroids. However, the most common reason is due to the body’s response to foods that are high in carbohydrates/sugar. Small spikes in blood sugar after eating carbohydrates can be normal, but if someone also has insulin resistance, then blood sugar levels can be significantly higher. When we intake food that is high in carbohydrates or sugar, our body must produce insulin to signal to our muscles and organs to absorb that sugar from the bloodstream. When there is insulin resistance, the body does not respond to insulin as quickly as it should. Sugar remains in circulation longer, leading to elevations in blood sugar.

Why do regular blood sugar spikes matter? What is the impact on your health? 

​Everyone needs a certain amount of sugar to produce enough energy for our body to work appropriately. However, if blood sugars elevate too high or stay elevated for prolonged periods of time, it has the reverse effect and can cause dysregulation in our body. This can lead to several complications, such as obesity, cardiovascular disease, high cholesterol, and kidney disease.

Are there symptoms of a blood sugar spike? If so, what are they? 

Sometimes there are no symptoms or signs when blood sugars spike. If blood sugars reach a severe level and stay elevated, then people can have fatigue, increased thirst, increased urination, and even weight loss.

Why does a blood sugar crash follow a spike? Are there signs associated with this subsequent blood sugar crash? 

If blood sugar starts to drop after a spike, it is most likely due to high amounts of insulin the body has released in response to either insulin resistance or foods that are high in sugar. Therefore, people tend to feel these drops more after a large meal that is high in carbohydrates, especially carbohydrates that are low in fiber. People can start feeling more sluggish or tired. If blood sugars reach a critically low level, then symptoms of sweating, tremors, nervousness, fast heart rate, and hunger may occur.

About Dr. Chen

Dr. Jean Chen is a board certified endocrinologist with special interest in reproductive endocrinology, thyroid disease and pituitary disorders. She sees patients at our South Austin location.

If you’d like to learn more about our full range of diabetes services, please call Texas Diabetes and Endocrinology at (512) 458-8400 or request an appointment online

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

ozempic weight loss
Impact of the Ozempic Shortage

At Texas Diabetes & Endocrinology, we treat people who have Type 1, Type 2, and gestational diabetes. Our entire team is up to date with the latest treatment options available including nutrition, lifestyle, and other alternatives in addition to conventional treatments.

There is growing concern in the health care community about the continued misuse of the diabetes drug Ozempic and resulting shortage.

The drug Semaglutide (brand name Ozempic) was introduced in the market in 2017. It is one of the first line medications to treat patients with Type 2 diabetes. Ozempic slows down the absorption of food, causes the body to produce insulin and suppresses appetite. As a result, weight loss is common when taking the drug. However, the FDA has not approved it for this use. Furthermore, when patients get off the medication, weight is often regained because there has been no change in lifestyle habits such as diet or exercise and reversal of above stated mechanisms occur.

Over the last year, Ozempic has gained a lot of popularity because of its effect on weight loss, which has led to it’s misuse for short term gains. 

Obesity is a chronic disease and hence a medication used to treat it should always be considered for the long term and as an adjunct to lifestyle interventions of modified diet and exercise. Semaglutide was approved under the brand name of Wegovy for patients with clinical obesity, however, the dose strength and titrations are different from Ozempic and most importantly, patients regain weight when they stop the medication. 

There are also several negative side effects of these medications which need to be considered which include: 

  • Nausea
  • Vomiting
  • Abdominal pain
  • Fatigue
  • Inflammation of the pancreas (especially if mixed with alcohol or if someone has high triglyceride levels)
  • Gallbladder disease
  • Some association with thyroid cancer in animal studies

We have continued our efforts in working with our patients to get them their Ozempic prescriptions, but many a times patients have had to reduce their dose or even go without if they can’t find it.  Ozempic also comes in different doses and should be taken only with the guidance of a medical care provider.

Watch Dr. Kajal Shah discuss the Ozempic shortage on KVUE News Austin.

Personalized Diabetes Treatment

Our team of board certified endocrinologists and certified diabetes care and education specialists are dedicated to making diabetes easier to manage on a day to day basis. We offer a full range of diabetes services including:

  • NextStepMD weight management program
  • Insulin pumps
  • Continuous glucose monitoring
  • Participation in clinical research trials for diabetes treatment

If you’d like to learn more about our full range of diabetes services, please call Texas Diabetes and Endocrinology at (512) 458-8400 or request an appointment online

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you with helpful wellness and health information.

eat better resolution
Tips to Keep your ‘Eat Better’ New Year’s Resolution

As we get further into 2023, it can become increasingly difficult to stick with the New Year’s resolutions you made. Priorities constantly shift to keep up with busy schedules and new commitments, and – despite your best intentions – the goals you made can quickly be forgotten.

If ‘eat better’ was on your list of New Year’s resolutions, we’re here to not only help you achieve that goal but also make it an ongoing habit. Here are some tips to help you eat better throughout the year.

Approach your Resolution as a Lifestyle Change

Think of your resolution to eat better as a lifestyle change, not just a box on a list of goals to check off. To help you eat better more consistently, consider making little changes at first. For example, try to add a fruit a day into your meal plan. Then, gradually add more fruits and vegetables while eliminating processed foods. Dr. Keta Pandit recently shared her expertise on healthy weight management with Medical News Today. She says, “lifestyle habits, such as increased exercise and eating a well-balanced meal high in protein and fiber, are crucial to maintaining weight loss.” While taking steps to eat better, she recommends thinking about the larger health picture rather than a temporary life obstacle. Envisioning an achievable and realistic goal in a set amount of time is an important exercise to build a change in lifestyle because it allows people to focus on the goal with a purpose. Making some small changes by building small habits to achieve this goal is how most people can make successful changes. It also helps to find a system to track those habits in order to build a lifestyle change that is sustainable.

Make a Realistic Plan

Changing your diet can be an overwhelming process and it likely won’t happen overnight. When you can, set smaller goals for yourself throughout each week to ensure you’re moving at a pace that you can maintain. If eating better is part of a larger goal to lose weight, consider joining a program to help build a realistic plan that fits your needs. Our NextStepMD Weight Loss Program is designed to help you lose weight, maintain weight loss, and gain better control of your health. We offer one-on-one sessions and work closely with our patients to recommend the methods that offer the greatest opportunities of success. We’ll educate, motivate and support you through your weight loss journey, which includes establishing new eating habits.

Remember that Setbacks are Temporary 

With any lifestyle change, there are going to be days when you fall off course and don’t meet your goal. When this happens, the key is to remember that these setbacks don’t have to be permanent. Don’t give up – each day is a new opportunity to make any needed adjustments, move forward, and take a step closer to your goals!

Schedule a Free Health Coach Consultation 

Our knowledgeable health coaches are dedicated to helping you start your journey to a healthier, more energetic lifestyle. Contact us today to learn more about how our one-on-one coaching session can support you and your long-term goals. 

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

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