In this article, we will discuss the causes, diagnosis and treatment of hypoglycemia. We will also look at ways to prevent it from occurring.
Contents of this article:
Fast facts on hypoglycemia
Here are some key points about hypoglycemia. More detail and supporting information is in the main article.
- The brain needs a constant supply of glucose to function
- In hypoglycemia, the brain is starved of energy
- Hypoglycemia is not a disease, it is caused by other conditions
- Early symptoms of hypoglycemia can include hunger, sweating and trembling
- If hypoglycemia is not treated, it may lead to seizures
- The only sure way to diagnose hypoglycemia is via a blood test
- A common cause of hypoglycemia is diabetes
- Diabetics are susceptible to hypoglycemia because they do not produce adequate insulin
- Alcohol abuse and kidney disorders can also lower blood glucose levels.
What is hypoglycemia?The majority of people know when their blood sugar levels have dropped, and have time to do something about it. The typical signs of low sugar levels are hunger, trembling, shakiness, nausea, pallor, and sweating. Hypoglycemia is commonly linked with diabetes but many other conditions can also cause low blood sugar.
Medilexicon's medical dictionary describes hypoglycemia as:
"Symptoms resulting from low blood glucose (normal glucose range 60-100 mg/dL [3.3-5.6 mmol/L]), which are either autonomic or neuroglycopenic.
Autonomic symptoms include sweating, trembling, feelings of warmth, anxiety, and nausea. Neuroglycopenic symptoms include feelings of dizziness, confusion, tiredness, difficulty speaking, headache, and inability to concentrate."
Symptoms of hypoglycemia
One sign of low blood pressure is heart palpitations.
- Tremor (trembling/shakiness)
- Pallor (face goes pale)
- Heart palpitations
- Accelerated heart rate
- Tingling lips.
When the hypoglycemia is more severe the following signs or symptoms are possible:
- Concentration problems
- Irrational and disorderly behavior (similar to somebody who is drunk)
- Seizures (uncommon)
- Loss of consciousness (uncommon).
Causes of hypoglycemiaHypoglycemia can occur for several different reasons. It most commonly happens when a person with diabetes has taken too much insulin.
Blood-sugar regulation occurThe digestive system breaks down the carbohydrates from the food we eat into different sugar molecules, one of which is glucose - the body's main source of energy. Glucose goes straight into the bloodstream after we eat. However, glucose needs insulin - a hormone produced and excreted by the pancreas - before it can enter a cell. In other words, a cell would starve of energy if there were no insulin around, regardless of how much glucose there were.
After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, and lowers the blood sugar level. Any surplus glucose goes into the liver and muscles in the form of glycogen (stored glucose).
Insulin is responsible for bringing excess blood glucose levels back to normal.
If glucose levels have dropped because an individual has not eaten for a while, the pancreas secretes glucagon - another hormone - which triggers the breakdown of stored glycogen into glucose, which is released into the bloodstream, thus bringing glucose levels back up.
Hypoglycemia and diabetes
An insulin overdose can produce hypoglycemia
People with both types of diabetes need to take insulin - as well as other drugs - in order to bring their blood sugar levels down.
If a person with diabetes takes too much insulin, his/her blood sugar levels can drop too low - he/she has hypoglycemia.
A person who takes insulin may take in the normal amount for that time of day, but has eaten much less than usual, or done exercise - meaning that his/her insulin requirement for that moment is lower than usual.
In other words, taking too much insulin does not necessarily mean that the patient increased the dosage; it just means that the insulin taken in was excessive for the body's needs at that moment.
Other causes of hypoglycemia
- Some medications - if somebody who does not have diabetes swallows diabetes medication they may develop hypoglycemia. Quinine, a drug used for patients with malaria, can also cause hypoglycemia. Salicylates, which are used for treating rheumatic disease, and propronanolol for hypertension (high blood pressure may also trigger a serious drop in blood sugar levels
- Alcohol abuse - the liver can stop releasing stored glucose into the bloodstream if somebody has been drinking a lot
- Some liver diseases - drug-induced hepatitis can cause hypoglycemia
- Kidney disorders - people with kidney disorders may have problems excreting medications, which can result in abnormally low blood-sugar levels
- Not eating enough - people with eating disorders, such as anorexia nervosa, may find that their blood sugar levels drop dramatically
- Insulinoma - this is a tumor in the pancreas which can make the pancreas produce too much insulin
- Endocrine problems - some disorders of the adrenal and pituitary glands can lead to hypoglycemia. Children with these disorders are more likely to develop abnormally low blood sugar levels than adults
- Reactive hypoglycemia (postprandial hypoglycemia) - this is when the pancreas produces too much insulin after a meal
- Tumors - tumors in other parts of the body (not the pancreas) can cause hypoglycemia. This is very rare.
On the next page, we look at the diagnosis and treatment of hypoglycemia.