What is Hypoglycemia? What you can do about it
Hypoglycemia is when glucose in your blood circulation drops below 70 mg/dl. The side effects of hypoglycemia may vary from person to person as some individuals may react differently to low blood sugar. Symptoms of hypoglycemia typically appear at levels below 60 mg/dL. Some people may feel symptoms above this level. Levels below 50 mg/dL affect brain function and can lead to coma. Because each person might react differently is important to know signs and symptoms. The best however is to have a glucometer handy and perform frequent blood reading.
Hypoglycemia is a serious adverse event and if not addressed immediately can cause serious consequences. Not acting can lead to coma or even death. Hypoglycemia is commonly associated with diabetes and are most likely caused by too much insulin, not enough food, or too much exercise or energy expenditure.
A combination of these three factors can affect your blood sugar levels. Hypoglycemia can also be found in non diabetics.
Glucose the primary source of energy for the brain, muscles, and other essential cells. The brain is one of the most metabolically active organs in the body. Together with the heart, liver, and kidneys, it consumes about 60% of the body’s energy requirements. – by the actions of different hormones. These hormones include insulin (which lowers the blood sugar level) and other chemicals which raise blood sugar (such as glucagon, growth hormone, and epinephrine).
Everyone can have hypoglycemic events. If you spend too much energy without replenishing your body well your blood sugar can drop. Some people are more prone to have low blood sugar episodes while others may have a better glycemic control.
This may be related to diet and body type. Hypoglycemia is not a disease, it is just an indicator of a health problem. A diet rich in simple carbohydrates can lead to mild hypoglycemia because it creates quick sugar spikes which are followed by low blood sugar levels as glucose drops rapidly.
A diet rich in fats and protein and complex carbohydrates tend to provide a better gycemic control. Muscle building may also help build a more robust glycemic control because muscle act as a buffer releasing insulin slower and keeping blood sugar levels more balanced.
Immediate treatment of hypoglycemia involves quick steps to get your blood sugar levels back into a normal range — about 70 to 100 milligrams per deciliter or mg/dL (3.9 to 5.6 millimoles per liter or mmol/L) — either with high-sugar foods such as juice or cookies or medications such as glucagon. Long-term treatment requires identifying and treating the underlying cause of hypoglycemia.
Hypoglycemia is diagnosed by the presence of three key features known as Whipple’s triad.
- symptoms consistent with hypoglycemia,
- a low plasma glucose concentration, and
- relief of symptoms after the plasma glucose level is raised.
Signs and Symptoms
- Nervousness or anxiety
- Sweating, chills and clamminess
- Irritability or impatience
- Confusion, including delirium
- Rapid/fast heartbeat
- Lightheadedness or dizziness
- Hunger and nausea
- Blurred/impaired vision
- Tingling or numbness in the lips or tongue
- Weakness or fatigue
- Anger, stubbornness, or sadness
- Lack of coordination
- Nightmares or crying out during sleep
Possible associations and causes
The patient’s medical and/or social history may reveal the following:
- Diabetes mellitus, renal insufficiency/failure, alcoholism, hepatic cirrhosis/failure, other endocrine diseases, or recent surgery
- Central nervous system: Headache, confusion, personality changes
- Ethanol intake and nutritional deficiency
- Weight reduction, nausea and vomiting
- Fatigue, somnolence
Neurogenic or neuroglycopenic symptoms of hypoglycemia may be categorized as follows:
- Neurogenic (adrenergic) (sympathoadrenal activation) symptoms: Sweating, shakiness, tachycardia, anxiety, and a sensation of hunger
- Neuroglycopenic symptoms: Weakness, tiredness, or dizziness; inappropriate behavior (sometimes mistaken for inebriation), difficulty with concentration; confusion; blurred vision; and, in extreme cases, coma and death
Reactive hypoglycemic include the following features:
- More common in overweight and obese people who are insulin-resistant
- May be a frequent precursor to type 2 diabetes
- Possible higher risk in patients with a family history of type 2 diabetes or insulin-resistance syndrome
True loss of consciousness is highly suggestive of an etiology other than reactive hypoglycemia.
Gestational hypoglycemia may have the following features :
- More frequent in women younger than 25 years
- More frequent in women with a preexisting medical condition
- Less frequent in women whose prepregnancy body mass index was ≥30 kg/m2
- Greater risk of preeclampsia/eclampsia in affected women
- Consume 15-20 grams of glucose or simple carbohydrates
- Recheck your blood glucose after 15 minutes
- If hypoglycemia continues, repeat.
- Once blood glucose returns to normal, eat a small snack if your next planned meal or snack is more than an hour or two away.
15 grams of simple carbohydrates commonly used:
- glucose tablets (follow package instructions)
- gel tube (follow package instructions)
- 2 tablespoons of raisins
- 4 ounces (1/2 cup) of juice or regular soda (not diet)
- 1 tablespoon sugar, honey, or corn syrup
- 8 ounces of nonfat or 1% milk
- hard candies, jellybeans, or gumdrops (see package to determine how many to consume)
How to tell if they are high or low:
“warm and dry sugar high, cold and clammy give them candy”
Hypoglycemia occurs when the body’s blood sugar or blood glucose level drops below normal. Hypoglycemia is also known as low blood sugar or low blood glucose, or an insulin reaction. Glucose comes from the food we eat and is used by the body as a source of energy. So when people have low glucose in their bloodstream, they are “low” on energy. That is, they feel dizzy, weak, hungry and a host of other symptoms that vary from person to person.
Signs/Symptoms of Hypoglycemia and Hyperglycemia
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