Hypoglycemia

Overview

Hypoglycemia is a condition characterized by abnormally low blood sugar levels. Glucose, a primary source of energy for the body and brain, is affected when blood sugar levels become too low. This can occur in people with or without diabetes and may be caused by various factors, including medications, certain health conditions, or hormonal imbalances. Symptoms of hypoglycemia include paleness, shakiness, sweating, and difficulty concentrating. Treatment involves quickly raising blood sugar levels through the consumption of high-sugar foods or drinks, or in severe cases, medication.

Understanding the disease

Symptoms

Symptoms of hypoglycemia include: looking pale, shakiness, sweating, headache, hunger or nausea, an irregular or fast heartbeat, fatigue, irritability or anxiety, difficulty concentrating, dizziness or lightheadedness, tingling or numbness of the lips, tongue, or cheek. As hypoglycemia worsens, signs and symptoms can include confusion, unusual behavior or both, loss of coordination, slurred speech, blurry vision or tunnel vision, nightmares, and severe cases may cause unresponsiveness, seizures, or even death in rare instances.

Risk Factors

The risk factors for developing hypoglycemia include:

1. Excessive alcohol drinking
2. Some critical illnesses (severe liver illnesses, severe infection, kidney disease, and advanced heart disease)
3. Long-term starvation, such as from an eating disorder like anorexia nervosa
4. An illness, trauma, or surgery
5. Poorly managed diabetes, including not monitoring blood sugar levels or taking medications as directed
6. Deliberately skipping meals or insulin doses, which can occur in people with eating disorders
7. Drinking alcohol, as it can have unpredictable effects on blood sugar levels It is essential to consult a healthcare provider for personalized guidance on blood sugar levels and appropriate treatment measures.

Development

Hypoglycemia can develop due to several reasons, including:

1. Insulin overdose or excess insulin production: Insulin is a hormone that regulates blood sugar levels by allowing glucose to enter the cells. When there is too much insulin in the body, it can cause blood sugar levels to drop too low, leading to hypoglycemia.
2. Delayed or missed meals: Skipping meals or delaying meals can cause blood sugar levels to drop, leading to hypoglycemia.
3. Exercise: Intensive physical activity can lower blood sugar levels, especially if you have diabetes and are taking medications that increase insulin sensitivity.
4. Alcohol consumption: Drinking alcohol, especially without eating, can lower blood sugar levels by interfering with the liver's ability to release stored glucose into the bloodstream.
5. Medications: Some medications used to treat diabetes, such as insulin or sulfonylureas, can cause hypoglycemia if the dosage is too high or if they are taken without food.
6. Critical illnesses or disorders: Severe liver disease, kidney disease, advanced heart disease, and certain other conditions can interfere with the body's ability to regulate blood sugar levels, leading to hypoglycemia.
7. Starvation or malnutrition: Long-term starvation or malnutrition can deplete the body's glycogen stores, leading to hypoglycemia. An eating disorder like anorexia nervosa is an example of a condition that can cause hypoglycemia due to long-term starvation. It is essential to identify the underlying cause of hypoglycemia and to seek medical advice to determine the appropriate treatment plan.

Assessment and Diagnosis

Triage

Seek medical help immediately if you experience symptoms of hypoglycemia and you don't have diabetes or if hypoglycemia isn't responding to treatment in someone with diabetes.

Diagnosis

To diagnose hypoglycemia, you should check your blood sugar level with a blood glucose meter. If your blood sugar level drops below 70 mg/dL (3.9 mmol/L), you have hypoglycemia. If you don't have access to a blood glucose meter, assume that your blood sugar is low and treat for hypoglycemia. In addition to checking your blood sugar, your healthcare provider may ask about your signs and symptoms, medical history, and any medications you are using. They may also request a blood test to analyze your blood sugar levels during symptomatic episodes.

Management and Treatment

Complications

Complications of hypoglycemia can include seizures, coma, death, dizziness, falls, injuries, a greater risk of dementia in older adults, and a reduced awareness of low blood sugar levels (hypoglycemia unawareness). Over time, repeated episodes of hypoglycemia can lead to hypoglycemia unawareness, which increases the risk of severe, life-threatening hypoglycemia. If you have diabetes and experience recurring hypoglycemia or hypoglycemia unawareness, your healthcare provider might modify your treatment, raise your blood sugar level goals, and recommend blood glucose awareness training. A continuous glucose monitor (CGM) is an option for some people with hypoglycemia unawareness.

Prevention

hypoglycemia can be prevented by following certain measures. Here are some ways to help prevent hypoglycemia:

1. Monitor your blood sugar: Regularly check and record your blood sugar levels as recommended by your health care provider.
2. Be consistent with meals and snacks: Maintain a consistent eating schedule, and don't skip or delay meals or snacks if you take insulin or oral diabetes medication.
3. Measure medication carefully: Take your diabetes medication as advised by your health care provider, and ensure that you accurately measure and administer it on time.
4. Always carry fast-acting carbohydrates: Keep juice, hard candy, or glucose tablets with you to treat low blood sugar levels before they become dangerously low.
5. Adjust medication and eating habits: Make adjustments to your medication or eat additional snacks based on your blood sugar test results, physical activity level, and medications.
6. Eat a meal or snack with alcohol: If you choose to drink alcohol, always have a meal or snack with it to prevent hypoglycemia.
7. Record low glucose reactions: Keep a record of your low blood sugar episodes to help you and your health care team identify patterns and find ways to prevent them.
8. Carry diabetes identification: Use a medical identification necklace, bracelet, or wallet card to inform others of your diabetes in case of an emergency. Remember to consult with your health care provider for personalized advice and target blood sugar ranges based on your specific condition and treatment plan.

Home Remedies

Home remedies for hypoglycemia include:

1. Eating or drinking something containing sugar: Quickly consume 15-20 grams of sugar, such as a small fruit juice, candy, or sweetened tea. This can help raise your blood sugar levels quickly.
2. Eating a balanced meal: Eating a well-balanced meal with a combination of carbohydrates, protein, and fat can help stabilize blood sugar levels and provide sustained energy.
3. Drinking a glass of non-diet soda or fruit juice: These beverages contain sugar and can help raise blood sugar levels quickly.
4. Including protein in snacks: Snacking on protein-rich foods like nuts, seeds, or cheese can help prevent hypoglycemia by slowing the absorption of carbohydrates in the body.
5. Wearing medical identification: Wearing a medical identification bracelet or necklace can help others recognize and respond appropriately in case of hypoglycemia-related emergencies. It's important to remember that if hypoglycemia occurs frequently or becomes severe, it's crucial to consult with a healthcare provider to determine the underlying cause and develop an appropriate treatment plan.

Treatment

The treatments for hypoglycemia involve quickly raising the blood sugar level back to the standard range. This can be done with high-sugar food or drink, or with medication. Long-term treatment requires identifying and treating the cause of hypoglycemia. The specific treatment approach depends on the individual case and the health care provider's guidance.

Preparing for medical consultation

To prepare for an appointment related to hypoglycemia, follow these steps:

1. Make a list of your symptoms: Document the symptoms you're experiencing, including when they started and how often they occur.
2. Record key personal information: Write down any major stresses or recent life changes that may be relevant. If you're monitoring your glucose values at home, bring a record of the glucose results, detailing the dates and times of testing.
3. List your medications and supplements: Provide a list of all medications, vitamins, and supplements you're taking, including doses.
4. Gather your diabetes treatment information: If you have diabetes, include the timing and results of recent blood sugar tests, as well as the schedule on which you've been taking your medications, if any.
5. Prepare a list of questions: Compile a list of questions to ask your health care provider during the appointment. Some questions to consider include:
   • Are my symptoms due to hypoglycemia?
   • What do you think is triggering my hypoglycemia?
   • Do I need to adjust my treatment plan? Remember to inquire about any pre-appointment restrictions, such as dietary limitations, when scheduling your appointment. Follow your health care provider's instructions regarding any necessary preparations before the appointment.