Description

Hypoglycemia is a condition in which blood sugar (glucose) is lower than the standard range. Glucose is your body's main source of energy.

Hypoglycemia is often related to the treatment of diabetes. But other drugs and a variety of conditions — rare — can cause low blood sugar in people who do not have diabetes.

Hypoglycemia needs immediate treatment. For many people, a fasting blood sugar of 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L), or below should serve as a warning of hypoglycemia. But your numbers may be different. Ask your health care provider.

The treatment consists in obtaining quickly the sugar in the blood within the standard range with a high sugar in the food, beverage, or medication. The long-term treatment requires the identification and treatment of the cause of the hypoglycemia.

Symptoms

If the blood sugar levels are too low, hypoglycemia signs and symptoms may include:

  • Paleness of the skin
  • Tremors
  • 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, the signs and symptoms may include:

  • Confusion, unusual behavior, or both, such as the inability to complete routine tasks
  • Loss of coordination
  • Speech difficulty
  • Blurred vision or tunnel vision
  • Nightmares, if he's sleeping

Severe hypoglycemia can cause:

  • The lack of response (loss of consciousness)
  • Seizures

When to see a doctor

Seek immediate medical help if:

  • You have what could be the symptoms of hypoglycemia and who do not have diabetes
  • You have diabetes and hypoglycemia is not responding to treatment, such as the consumption of juice or regular (non-diet) soft drinks, sweets, or taking glucose tablets

Seek emergency help for a person with diabetes or a history of hypoglycemia that have symptoms of severe hypoglycemia or loses consciousness.

Causes

Hypoglycemia occurs when blood sugar (glucose) level falls too low for bodily functions to continue. There are several reasons why this can happen. The most common reason for a low sugar in the blood is a side effect of the medications used to treat diabetes.

The regulation of sugar in the blood

When you eat, your body breaks down the food into glucose. Glucose, the main energy source for the body, it enters cells with the help of insulin, a hormone produced by the pancreas. Insulin allows glucose to enter the cells and provide the fuel your cells need. Excess glucose is stored in the liver and muscles in the form of glycogen.

When you have not eaten for several hours and your blood sugar level drops, it stops producing insulin. Another hormone from your pancreas called glucagon signals your liver to break down stored glycogen and release glucose into the bloodstream. This keeps the blood sugar within a standard range up to eat again.

Your body also has the ability to make glucose. This process occurs mainly in the liver, but also in the kidneys. With prolonged fasting, the body can break down fat deposits and the use of the products of the decomposition of the fat as an alternative fuel.

Possible causes diabetes

If you have diabetes, you might not make it to the insulin (type 1 diabetes) or can be less sensitive to it (type 2 diabetes). As a result, glucose accumulates in the bloodstream and can reach dangerously high levels. To correct this problem, you can take insulin or other medications to lower blood sugar levels.

But an excess of insulin or other diabetes medications may cause your blood sugar level to drop too low, causing hypoglycemia. Hypoglycemia also can occur if you eat less than usual after you take your regular dose of diabetes medication, or if you exercise more than usual.

Possible causes without diabetes

Hypoglycemia in people without diabetes is much less common. The causes may include:

  • Drugs. Take someone oral medication for diabetes, accidentally, it is a possible cause of the hypoglycemia. Other medications that can cause hypoglycemia, especially in children or in people with kidney failure. An example is quinine (Qualaquin), used to treat malaria.
  • The excessive consumption of alcohol. Drink a lot without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia.
  • Some critical illnesses. Serious liver diseases such as severe hepatitis or cirrhosis of the liver, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. Kidney disorders can also prevent your body from properly excretion of the drug. This can affect the glucose levels due to an accumulation of medications which decrease levels of sugar in the blood.
  • Long-term starvation. Hypoglycemia can occur with malnutrition and hunger, when they do not receive enough food, and the glycogen stores in your body needs to create glucose are used. An eating disorder called anorexia nervosa is an example of a condition that can cause hypoglycemia and outcome in the long term, the hunger.
  • The overproduction of insulin. A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. Other tumors may also be the result of excessive production of insulin-like substances. Unusual cells in the pancreas that produce insulin can result in excessive release of insulin, causing hypoglycemia.
  • Hormonal deficiencies. Certain adrenal glands and the pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism. The children may have hypoglycemia if you have very little growth hormone.

Hypoglycemia after meals

Hypoglycemia usually occurs when you have not eaten, but not always. Sometimes the symptoms of hypoglycemia occur after certain meals, but exactly why this happens is uncertain.

This type of hypoglycemia, it is called reactive hypoglycemia or hypoglycemia, postprandial, can occur in people who have had surgeries that interfere with the normal function of the stomach. The surgery that is most commonly associated with this is the stomach bypass surgery, but it can also occur in people who have had other surgeries.

Complications

Untreated hypoglycemia can lead to:

  • Seizures
  • Comma
  • Death

Hypoglycemia can also cause:

  • The dizziness and weakness
  • Falls
  • Injuries
  • Motor vehicle accidents
  • Increased risk of dementia in older adults

Hypoglycemia unawareness

Over time, repeated episodes of hypoglycemia can cause hypoglycemia unawareness. The body and the brain can no longer produce signs and symptoms that warn of a low blood sugar, such as shakiness or irregular heartbeats (palpitations). When this happens, the risk of severe, life-threatening hypoglycemia increases.

If you have diabetes, recurrent episodes of hypoglycemia and hypoglycemia unawareness, your health care provider. you may modify your treatment, raise your blood sugar level goals and recommend blood glucose awareness training.

A continuous glucose monitoring (CGM) is an option for some people with hypoglycemia unawareness. The device can alert you when your blood sugar is too low.

Undertreated diabetes

If you have diabetes, episodes of low blood sugar is uncomfortable and can be frightening. The fear of hypoglycemia can cause you to take less insulin to make sure that your blood sugar does not drop too low. This can lead to uncontrolled diabetes. Talk with your health care provider about your fear, and do not change the dose of your diabetes medicine without discussing the change with your health care provider.

Prevention

If you have diabetes

Follow the plan of management of diabetes to you and your health care provider have been developed. If you are taking any new medications, change your way of eating or medication schedules, or the addition of a new exercise, talk to your health care provider about how these changes may affect your control of the diabetes and the risk of low levels of sugar in the blood.

Know the signs and symptoms you experience with low blood sugar. This can help to identify and treat hypoglycemia before it's too low. Frequently check your blood sugar level lets you know when your blood sugar is low.

A continuous glucose monitoring (CGM) is a good option for some people. A CGM is a small wire that is inserted under the skin that can send blood glucose readings to a receiver. If the blood sugar levels are dropping too low, some models CGM will alert you with an alarm.

Some of the insulin pumps are now integrated with CGMs and can be shut off insulin delivery when blood sugar levels are dropping too fast for you to help prevent hypoglycemia.

Make sure you always have a fast-acting carbohydrate with you such as fruit juice, hard candy or glucose tablets, so that you can treat a drop in the level of sugar in the blood before dipping dangerously low.

If you do not have diabetes

For recurrent episodes of hypoglycemia, eating frequent small meals throughout the day is a stopgap measure to help prevent the levels of sugar in the blood to drop too low. However, this approach is not recommended as a long-term strategy. Work with your health care provider to identify and treat the cause of the hypoglycemia.

Diagnosis

If you have symptoms of hypoglycemia, your doctor will likely conduct a physical exam and review your medical history.

If you use insulin or other medicines for diabetes to lower blood sugar, and you have signs and symptoms of low blood sugar, test your blood sugar levels with a blood glucose meter. If the result shows low levels of blood sugar (under 70 mg/dL ), the treatment according to your plan of treatment of diabetes.

Keep a log of your blood sugar test results and how to treat low blood sugar levels so your health care provider can review the information to help you adjust to your plan of treatment of diabetes.

If you do not use medications known to cause hypoglycemia, your health care provider will want to know:

  • What were your signs and symptoms? If you don't have signs and symptoms of hypoglycemia during his first visit with the doctor, he or she might have to fast during the night or longer. This will allow the low blood sugar symptoms occur, so that a diagnosis can be made. It is also possible that you will need to do an extended fast — up to 72 hours in a hospital.
  • What is your blood sugar level when you are having symptoms? Your health care provider will draw a blood sample to be analyzed in the laboratory. If your symptoms occur after a meal, blood sugar tests may be done after eating.
  • Make your symptoms disappear when the blood sugar levels increase?

Treatment

Immediate treatment of hypoglycemia

If you have symptoms of hypoglycemia, do the following:

  • Eat or drink 15 to 20 grams of fast-acting carbohydrates. These are sugary foods or drinks with no protein or fat that are easily converted to sugar in the body. Try to glucose tablets or gel, fruit juice, regular (not diet) soda, honey or sweet.
  • Re-check the levels of blood sugar 15 minutes after treatment. If the blood sugar levels are still below 70 mg/dL (3.9 mmol/L ), eat or drink another 15 to 20 grams of fast-acting carbohydrates, and re-check your blood sugar again in 15 minutes. Repeat these steps until your blood sugar is above 70 mg/dL (3.9 mmol/L ).
  • Have a snack or meal. Once your blood sugar is back in the standard range, eating a healthy snack or meal can help prevent another drop of blood sugar and fill your body of glycogen stores.

The immediate treatment of severe hypoglycemia

Hypoglycemia is considered severe if you need the help of someone to recover. For example, if you cannot eat, you might need an injection of glucagon or intravenous glucose.

In general, people with diabetes treated with insulin should have a kit of glucagon for emergency situations. The family and friends I need to know where to find the kit and how to use it in case of emergency.

If you are helping someone who is unconscious, do not try to give the person food or drink. If there is a kit available glucagon or do not know how to use it, call for emergency medical help.

The treatment of an underlying condition

Preventing recurrent hypoglycemia requires your health care provider to identify the condition causing the hypoglycemia and treatment. Depending on the cause, treatment may include:

  • Nutrition counseling. A review of dietary habits and food of planning with a nutritionist can help reduce hypoglycemia.
  • Drugs. If a medication is the cause of the hypoglycemia, your doctor will probably suggest to add, change, or discontinue the drug or dosage adjustment.
  • The treatment of the Tumor. A tumor in the pancreas is usually treated by surgical removal of the tumor. In some cases, medication for the control of the hypoglycemia or partial removal of the pancreas is necessary.

Preparing for your appointment

If you have diabetes and are having repeated episodes of hypoglycemia, or if your blood sugar levels are dropping significantly, talk with your health care provider to find out how you can be you need to change your treatment plan for diabetes.

If you have not been diagnosed with diabetes, make an appointment with your primary care provider to determine the cause of hypoglycemia and appropriate treatment.

Here's some information to help you prepare for your appointment. Have a friend or family member, if possible. Someone who accompanies you can help you remember the information they give you.

What you can do

Before your appointment:

  • Make a list of your symptoms, including when they started and how often they occur.
  • The list of your key medical information, including other conditions for which you are being treated, and the names of all the medications, vitamins, or other supplements that you take, including over-dose.
  • Provide treatment of diabetes with the information if you have diabetes. Indicate the date and results of the latest tests of sugar in the blood, as well as the time in which you have been taking your medications, if any.
  • The list of their typical lifestyle habits, including the consumption of alcohol, meals and exercise routines. Also, please note the recent changes in these habits, such as a new exercise routine, or a new job in the that have changed the times in which to eat.
  • Make a list of questions to ask your health care provider.

Questions to ask your health care provider if you have diabetes include:

  • Are my signs and symptoms due to hypoglycemia?
  • What do you think is the cause of my low blood sugar?
  • Do I need to adjust my treatment plan?
  • Do I need to change my diet or exercise routine?
  • I have other health conditions. How can I manage these conditions?

Questions to ask your health care provider if you have not been diagnosed with diabetes include:

  • Is hypoglycemia, the most likely cause of my symptoms?
  • What else could be the cause?
  • What tests do I need?
  • What self-care measures, including lifestyle changes, can I take to help improve your symptoms?
  • You should see a specialist?

What to expect from your doctor

Your health care provider may ask you questions such as:

  • What symptoms have you been experiencing?
  • To make your symptoms usually occur?
  • Is there something that seem to trigger your symptoms?
  • Have you been diagnosed with other medical conditions?
  • What medications are you currently taking?

Your doctor will ask additional questions based on your responses, symptoms, and needs. Prepare and anticipate the questions will help you make the most of your appointment time.

Symptoms and treatment of Hypoglycemia