Hypoglycemia

Hypoglycemia

Hypoglycemia is a condition where there is not enough glucose, or sugar, in the blood.

Levels of blood sugar are below 4 mmol/L (72mg/dL).

Hypoglycemia is often related to the treatment of diabetes. However, a variety of conditions — many rare — can cause low blood sugar in people without diabetes. Like fever, hypoglycemia isn't a disease itself — it's an indicator of a health problem.

Immediate treatment of hypoglycemia is necessary when blood sugar levels are at 70 milligrams per deciliter (mg/dL) or 3.9 millimoles per liter (mmol/L) or below. Treatment involves quick steps to get your blood sugar level back into a normal range either with high-sugar foods or drinks or with medications. Long-term treatment requires identifying and treating the underlying cause of hypoglycemia.

Although people usually think about the long-term complications when it
comes to diabetes, short-term or acute problems can also occur. Both low
blood sugar levels (hypoglycemia) and high blood sugar levels (hyperglycemia)
are acute problems.

Here are some key points about hypoglycemia.

·      Hypoglycemia is not a disease but a symptom of another condition.

·      Early symptoms include hunger, sweating, and trembling.

·      A common cause is diabetes.

·      Alcohol abuse and kidney disorders can also lower blood sugar levels.

What is a low blood sugar?

Usually, a blood sugar level of less than 70 mg/dL is considered too low and
needs to be treated. Low blood sugar is also called hypoglycemia.
Anything that lowers your blood sugar can cause hypoglycemia. Too much
insulin, the wrong kind or dose of your diabetes pills, too much exercise, or too
little food can cause your blood sugar to go too low.

Symptoms of Hypoglycemia

When the blood sugar is too low, you will feel certain symptoms. This is called a
reaction. You might feel:

• sweaty • a fast heartbeat • nervous • anxious
• irritated • weak • headache • hungry
• confused • numb around your nose or mouth

Sometimes other people notice you are having a reaction before you do. They
might notice you are:

• irritable • not thinking clearly • confused
• slurring your words • acting groggy or sleepy
• not sleeping well or having nightmares

Some people experience low blood sugar during the night.

Signs include:

·         nightmares

·         crying out in the night

·         feeling tired or irritable when waking

·         sweating more than usual during the night

If a child shows signs of confusion, dizziness, headache, irritability, sudden mood changes, or clumsy or jerky movements, they should see a doctor as soon as possible.

Hypoglycemia in children

Hypoglycemia can affect children as well as adults, especially if they have diabetes. It may happen after taking too much insulin, exercising strenuously for some time, or not eating enough.

In children without diabetes, recurrent hypoglycemia may result from:

·         ketotic hypoglycemia, especially between the ages of 1 and 5 years

·         some medications

·         a health condition that is present from birth, such as hyperpituitarism or hyperinsulinism

Ketotic hypoglycemia is a potentially life-threatening condition that involves hypoglycemia and high levels of ketones bodies. The cause is unknown.

Complications

If a person does not take action when symptoms of hypoglycemia appear, it can lead to:

·         seizures

·         loss of consciousness

·         coma

A person who regularly experiences hypoglycemia may become unaware that it is happening. They will not notice the warning signs, and this can lead to severe and possibly fatal complications.

Hypoglycemia is often a sign of diabetes, or poorly managed diabetes. Ignoring the signs of hypoglycemia can enable diabetes to become more severe.

Causes of Hypoglycemia

Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this may happen, the most common is a side effect of drugs used to treat diabetes.

Causes of hypoglycemia may include:

  ·         Excessive exercise, or lack of food intake

  ·         Certain forms of alcohol may cause low blood sugar levels

  ·         Certain kinds of tumors, affecting the pancreas (insulinomas)

  ·         After stomach surgery

  ·         People with kidney failure, who are on dialysis, may experience hypoglycemia.

  ·         If you have liver disease, you may be at risk for hypoglycemia.

  ·         You may have problems with your thyroid, adrenal, or pituitary glands.

  ·         You may not be absorbing food that you eat very well, thus resulting in hypoglycemia.

Prevention

  If you have diabetes, carefully follow the diabetes management plan you and your doctor have developed. If you're taking new medications, changing your eating or medication schedules, or adding new exercise, talk to your doctor about how these changes might affect your diabetes management and your risk of low blood sugar.

A continuous glucose monitor (CGM) is an option for some people, particularly those with hypoglycemia unawareness. These devices insert a tiny wire under the skin that can send blood glucose readings to a receiver.

If blood sugar levels are dropping too low, some models of CGM will alert you with an alarm. Some insulin pumps are now integrated with CGMs and can shut off insulin delivery when blood sugar levels are dropping too quickly to help prevent hypoglycemia.

Be sure to always have a fast-acting carbohydrate with you, such as juice or glucose tablets so that you can treat a falling blood sugar before it dips dangerously low.

·         If you don't have diabetes but have recurring episodes of hypoglycemia, eating frequent small meals throughout the day is a stopgap measure to help prevent your blood sugar levels from getting too low. However, this approach isn't an advisable long-term strategy. Work with your doctor to identity and treat the underlying cause of hypoglycemia.