reactive hypoglycemia and not eating before medical procedures

I don't know why I have not had this question before.  I have had medical procedures since surgery that you can't eat before.  I never really thought about the reactive hypoglycemia in relation to that, but the RH seems worse lately than it used to be.

I am scheduled for an epidural steroid injection in about a week and I will be sedated for it and am not supposed to eat after midnight the night before.  The injection is scheduled for 11 am.  What should I do if my blood sugar gets really low?  I am not supposed to eat or drink.  I know glucose tablets are not the best way to deal with low blood sugar, but would it be a reasonable option in this case?

I recently had to deal with this for a chemical stress test;  my doctor's office didn't have any
advice for me!! 

I was told that the actual hours pre-procedure were 7 hours w/NPO;  could you get the procedure
moved up to the first thing in the am???

If not, then I'm thinking that the glucose tabs are your only recourse.

Good luck! 

Unfortunately, moving it up is not an option.  I guess I'll pick up some glucose tablets.  thanks!

I've had epidural steroid injections with only a 2-3hr no solid restriction, but each facility is different.  Do you actually check your blood glucose level on a glucometer to document your hypoglycemic reactions?  

It seems glucose tablets or hard candy even would be reasonable. (Some glucose tablets actually have less simple sugars per tablet than regular Life Savers or other hard candy so whereas you might need to take 4 glucose tablets you can get the same effect from 1 hard candy.  Check the carb/sugar content per tablet on the label.  Besides the hard candies often taste MUCH better)

Again, check with the facility/physician as generally the standard is to either move a patient ot the fist case of the day if they are diabetic/history of hypoglycemia OR change the NPO deadline from midnight to later in the morning so there is not a 11 hour period of NPO.  Sometimes the change is no solid food after midnight, but clear fluids (including apple juice) can be taken until 6 hrs before the procedure. Again check with your healthcare provider to determine what their preferred protocol is.

Pre-procedure be sure to advise the nursing staff that you have hypoglycemic reactions. The anesthesiologist/pain management physician/facility often have treatment protocols for diabetic/hypoglycemic patients.   Usually it is monitoring the patient's blood glucose levels frequently (even hourly or with any change or appearance of hypoglycemic symptoms). The staff treats accordingly depending on the glucose level.

Make certain the nursing and medical staff is aware of your reactive hypoglycemia as corticosteroids (even epidurally) have the potential to cause hyperglycemic reactions. So you may need some extra monitoring post procedure.  As always YMMV.

Best of luck to you.

Thank you for all the info and suggestions.

I do check my blood sugar with a glucometer, yes.  I don't check it every time I feel my blood sugar get too low anymore, but I do sometimes.  I can always tell it's low by how I feel.  I've never had that feeling and then checked it and it wasn't low.

Can you dissolve a glucose tablet in your mouth?  That's a good question.

Why couldn't you dissolve one?

I don't know anything about those tabs - if they can be chewed without drinking water, etc.  My endocrinologist suggested I keep some on me at all times.  I guess I don't understand your question.

My question was what would be the best way to treat my  hypoglycemia when I cannot eat or drink.  Normally I treat it by eating something with protein.  That works better than something like sugar, such as glucose tablets.  Eating sugar would get my blood sugar up fast, yes, but it would be likely to crash again shortly after.  In addition, I dump on too much sugar and would prefer to avoid that.

My question was, even though I normally would not use glucose tablets for low blood sugar, if that would be the best way to deal with it when I cannot eat or drink anything.

I think hard candy or the glucose tablets on standby in the event you feel a crash coming on would be ok - I would do it.  I guess the thing is to have an empty stomach in the event that the strong pain meds they give you make you vomit while sedated.  That would serve the purpose of an empty stomach and help you if your blood sugar crashes.  Eat really well for the week prior - like high protein and very low carb.  With me, the more carbs I eat the more crashes I have.  but my issue may not be as severe as yours...