Hypoglycemia

Defining hypoglycemia

Hypoglycemia is the condition where the body’s sugar level falls below the normal range. Though it is commonly associated with diabetes, it can also occur in non-diabetic people too. Sugar is the primary source of energy for our cells. When the sugar level reduces below the normal values, the body can start exhibiting a number of symptoms such as loss of consciousness, pangs of hunger, sweating etc. The onset of these symptoms is often sudden.

Causes and risk factors

The hormone insulin is responsible for breaking down sugar in our body which gets converted to energy in the cells.

Higher levels of insulin cause faster metabolism of sugar which causes the glucose levels to dip.

This usually happens with diabetes medications.

These medicines increase the production of insulin to control the elevated glucose levels associated with diabetes.

This is why diabetic people have more hypoglycemic tendencies as compared to non-diabetic people.Other reasons that could trigger hypoglycemic symptoms are:

• Diabetic patients who haven’t eaten in a long while can witness their blood sugar levels dropping.
• Exercising more than the required amount can also cause the glucose levels to drop as the body uses more energy for these activities.
• Diabetic patients who consume alcohol can also go in the hypoglycemic phase.
• In non-diabetic people, several medical conditions can lead to hypoglycemia. These could range from kidney or liver failures to metabolic disorders such as hypothyroidism.
• Starvation is the leading cause of hypoglycemia. Eating disorders such as anorexia could also make a person hypoglycemic.
• In hospitalized patients whose diet has been restricted for treatment, purposes can suffer from hypoglycemia.
• Individuals who are in pre-diabetic condition will also find themselves frequently going in the hypoglycemic phase.

Conditions symptomatic of hypoglycemia

When the brain senses a drop in the blood sugar level, it sends a range of signals to the body which aims to restore normalize the condition.

This includes changes in the hormonal and metabolic functioning of the body.

The production of insulin needs to be regulated at this point to bring the blood sugar levels to normal values.

This triggers a chain of bodily reactions which are seen as the symptoms of hypoglycemia.

Every organ in the human body is solely dependent on glucose for its energy needs, including the brain. Hence, hypoglycemia can adversely affect the functioning of the brain too, in addition to the normal working of other organs.

• The main symptoms of hypoglycemia are dizziness, an onset of fatigue, and sweating.
• Extreme pangs of hunger.
• Anxiety and increased palpitations.
• Confusion and irritability.
• Trembling and shaking of the body.
• In extreme cases, seizures, unconsciousness and even coma.

Driving and/or operating heavy machinery is strictly prohibited when these symptoms arise.

Diagnosis of hypoglycemia

Since hypoglycemia is often a result of underlying diabetic or a pre-diabetic condition, the correct diagnosis procedure includes the doctor asking a detailed medical history about the following factors:

• The frequency of symptoms.
• The current list of medications.
• If diabetic, then recent blood sugar reports.
• Lifestyle choices – alcohol intake, exercises, diet, sleeping patterns.

The diagnostic method employed here mainly involves checking fasting sugar levels at different times of the day to observe the sugar spikes. The normal glucose levels of human should lie between the ranges of 70-110 mg/dL. A value lesser than 70mg/dL (around 50-70 mg/dL) implies that the person suffers from hypoglycemia.  For those who exhibit hypoglycemia just after eating, mixed-meal tolerance test is used to determine the blood sugar levels.

After these sugar levels have been observed, the doctor will ask the person to increase the sugar level in a controlled manner and observe the frequency of symptoms. If the symptoms go away once the sugar-levels were restored, it means that the person was hypoglycemic.

Treating hypoglycemia

The treatment measures adopted for hypoglycemia are often long-term in nature. The immediate treatment method involves restoring the glucose levels to the normal range by consuming 15 grams of fast-acting carbohydrate. The person can eat/drink any one of these to achieve this result:

• 3-4 glucose tablets or one tube of glucose in gel form.
• Hard candies which are not sugar-free.
• Fruit juice or skim milk (1 cup).
• ½ cup sugar-containing aerated drink.
• 1 tbsp honey

If the symptoms of hypoglycemia still persist (after 15 minutes check blood sugar), then one more round of one of these foods should be consumed. In the extreme case that the person has lost consciousness due to hypoglycemia, he/she should be injected with glucagon.

Feeding glucose-containing food to an unconscious person will cause him/her to choke hence this technique should be avoided.

People who frequently face these symptoms and are being treated for insulin should ideally keep a glucagon kit with them.

Medication dosage is adjusted according to the blood sugar levels. Sometimes, a tumor in the pancreas may be responsible for glucose level fluctuations. In this case, a surgical removal of the tumor is required to treat the condition.

List of preventive measures

• Follow the diabetes treatment plan strictly along with the prescribed diet and lifestyle changes.
• Include proper exercise routines to manage blood-sugar levels.
• Glucose levels should be monitored regularly through CGM (Continuous Glucose Monitor) devices.
• Carry some amount of fast-acting carbohydrate food with you.
• Avoid eating processed carbohydrates.
• Don’t allow large gaps between meals. Keep eating small meals every 2-3 hours to regulate your glucose levels.
• Regulate alcohol intake. Do not consume alcohol on empty stomach.
• Have an identification badge which tells that you are diabetic. This will help people to provide you the immediate medical help needed in case of severe hypoglycemic incidents.

References