WHAT IS HYPOGLYCEMIA: SYMPTOMS, CAUSES, DIAGNOSIS, AND MORE


Hypoglycemia occurs when your blood sugar (glucose) level falls below the normal range. Glucose is the primary source of energy in your body.

Diabetes therapy is frequently associated with hypoglycemia. Other medicines and diseases, many of which are uncommon, can induce low blood sugar in persons who do not have diabetes.

Hypoglycemia must be treated right away. A fasting blood sugar of 70 milligrams per deciliter (mg/dL) or 3.9 millimoles per liter (mmol/L) or below should act as a warning sign of hypoglycemia for many people. However, your figures may differ. Inquire with your doctor.

Treatment entails fast returning your blood sugar to normal levels, either by a high-sugar food or drink or through medicine. Long-term therapy necessitates determining and addressing the source of hypoglycemia.


WHAT ARE THE SYMPTOMS OF HYPOGLYCEMIA?

When blood sugar levels go too low, hypoglycemia symptoms might include:
  • Looking pallid
  • Shakiness
  • Sweating
  • Headache
  • Anxiety or irritability
  • Concentration problems
  • Nausea or hunger
  • An irregular or rapid heartbeat
  • Fatigue
  • Feeling dizzy or lightheaded
  • Lip, tongue, or cheek tingling or numbness
As hypoglycemia worsens, the following signs and symptoms may appear:
  • Confusion, strange conduct, or both, such as difficulty completing normal activities
  • Coordination problems
  • Speech that is slurred
  • Tunnel vision or hazy eyesight
  • Sleeping nightmares
Severe hypoglycemia can result in:
  • Inability to respond (loss of consciousness)
  • Seizures


WHAT ARE THE CAUSES OF HYPOGLYCEMIA?

When your blood sugar (glucose) level drops too low for body processes to continue, you have hypoglycemia. This can happen for a variety of reasons. The most prevalent cause of low blood sugar is a side effect of diabetic treatments.

Regulating blood sugar

When you eat, your body converts carbohydrates into glucose. Glucose, your body's primary energy source, enters cells with the aid of insulin, a hormone produced by the pancreas. Insulin permits glucose to enter cells and give the fuel they require. Extra glucose is stored as glycogen in your liver and muscles.

When you haven't eaten in several hours and your blood sugar level falls, your body stops generating insulin. Another pancreatic hormone, glucagon, tells your liver to break down stored glycogen and release glucose into your circulation. This keeps your blood sugar levels stable until you eat again.

Your body is also capable of producing glucose. This process takes place mostly in your liver, but also in your kidneys. Fasting over an extended period of time allows the body to break down fat storage and utilise the byproducts of fat breakdown as an alternative fuel.

Diabetes-related potential causes

If you have diabetes, you may not produce insulin (type 1 diabetes) or you may be less sensitive to it (type 2 diabetes). As a result, glucose accumulates in the circulation to dangerously high amounts. To address this issue, you may need to use insulin or other blood sugar-lowering drugs.

However, using too much insulin or other diabetic drugs might cause your blood sugar level to drop too low, resulting in hypoglycemia. Hypoglycemia can also happen if you eat less than normal after taking your diabetic medication, or if you exercise more than usual.

Possible causes without diabetes

Hypoglycemia is substantially less prevalent in those who do not have diabetes. Among the possible causes are:
  • Medications: Taking someone else's oral diabetic medicine by mistake might result in hypoglycemia. Other drugs, particularly in youngsters or those with renal disease, might cause hypoglycemia. Quinine (Qualaquin), for example, is a malaria treatment.
  • Some serious diseases: Hypoglycemia can be caused by severe liver diseases such as hepatitis or cirrhosis, severe infection, renal failure, or advanced heart disease. Kidney problems might also prevent your body from adequately excreting drugs. This can impact glucose levels owing to an accumulation of blood sugar-lowering drugs.
  • Prolonged starvation: Hypoglycemia can arise as a result of malnutrition or famine, when your body's glycogen stores are depleted and the glycogen stores required to produce glucose are depleted. Anorexia nervosa is an example of a condition that can produce hypoglycemia and result in long-term hunger.
  • Excessive alcohol consumption: Drinking excessively without eating can prevent the liver from releasing glucose into the circulation from its glycogen reserves. This can result in hypoglycemia.
  • Insulin overproduction: Insulinoma, a rare pancreatic tumor, can cause you to generate too much insulin, resulting in hypoglycemia. Other tumors can also cause an excess of insulin-like chemicals to be produced. Unusual pancreatic insulin-producing cells can result in excessive insulin release, resulting in hypoglycemia.
  • Hormone deficiency: Certain adrenal gland and pituitary tumor diseases can result in insufficient levels of hormones that govern glucose synthesis or metabolism. Children can get hypoglycemia if they have insufficient growth hormone.


After-meal hypoglycemia

Hypoglycemia normally occurs when you haven't eaten anything, although it doesn't always happen. Hypoglycemia symptoms might develop after some meals, although the actual cause is unknown.

This kind of hypoglycemia, known as reactive hypoglycemia or postprandial hypoglycemia, can develop in persons who have had stomach procedures that interfere with the stomach's normal function. The most frequent operation linked with this is gastric bypass surgery, although it can occur in persons who have undergone other surgeries as well.


WHAT ARE THE COMPLICATIONS OF HYPOGLYCEMIA?

Hypoglycemia left untreated might result in:
  • Seizure
  • Coma
  • Death
Hypoglycemia can also result in:
  • Weakness and dizziness
  • Falls
  • Injuries
  • Car crashes
  • Elderly people are more likely to get dementia.

Hypoglycemia unawareness

Repeated bouts of hypoglycemia might develop to hypoglycemia unawareness over time. The body and brain no longer generate warning indicators of low blood sugar, such as shakiness or irregular heartbeats (palpitations). When this happens, the risk of severe, perhaps fatal hypoglycemia rises.

If you have diabetes, frequent episodes of hypoglycemia, or hypoglycemia unawareness, your doctor may change your therapy, boost your blood sugar level objectives, and suggest blood glucose awareness training.

Some persons with hypoglycemia are candidates for a continuous glucose monitor (CGM). When your blood sugar falls too low, the gadget will notify you.


Diabetes that is untreated

Low blood sugar episodes can be unpleasant and worrisome if you have diabetes. Fear of hypoglycemia may prompt you to take less insulin in order to keep your blood sugar level from dropping too low. This can result in uncontrollable diabetes. Discuss your fears with your doctor, and don't adjust your diabetic medication dose without first consulting with your doctor.


HOW IS HYPOGLYCEMIA DIAGNOSED?

If you have hypoglycemia symptoms, your doctor will most likely do a physical exam and evaluate your medical history.

If you use insulin or another diabetic medicine to control your blood sugar and have hypoglycemia, use a blood glucose meter to check your levels. If your blood sugar level is low (less than 70 mg/dL), follow your diabetic treatment plan.

Keep a record of your blood sugar testing results and how you addressed low blood sugar levels so that your doctor may evaluate the data and help you change your diabetes treatment plan.

If you do not take any drugs that are known to induce hypoglycemia, your doctor will want to know:
  • What were your symptoms and signs?: If you don't experience hypoglycemia symptoms at your initial visit with your doctor, he or she may have you fast overnight or longer. This will allow low blood sugar symptoms to arise, allowing for a diagnosis. It's also likely that you'll need to fast for a lengthy period of time — up to 72 hours — at a hospital.
  • When you have symptoms, what is your blood sugar level?: Your doctor will take a blood sample to be tested in the lab. If your symptoms arise after a meal, blood sugar testing may be performed.
  • Do your symptoms go away as your blood sugar levels rise?


WHAT ARE THE TREATMENTS FOR HYPOGLYCEMIA?

Immediate treatment for hypoglycemia

If you are experiencing hypoglycemic symptoms, you should do the following:
  • Consume 15 to 20 grams of quick-acting carbs: These are sugary meals or beverages that have little protein or fat and are quickly converted to sugar in the body. Glucose pills or gel, fruit juice, genuine (not diet) Coke, honey, or sweet candies are all good options.
  • Check blood sugar levels 15 minutes after therapy: If your blood sugar level is still less than 70 mg/dL (3.9 mmol/L), eat or drink another 15 to 20 grams of fast-acting carbohydrate and retest it after 15 minutes. Repeat these instructions until your blood sugar level is higher than 70 mg/dL (3.9 mmol/L).
  • Eat a snack or lunch: Once your blood sugar has returned to normal, having a nutritious snack or meal can help avoid another decrease and refill your body's glycogen stores.

Immediate treatment of severe hypoglycemia

If you require assistance to recover from hypoglycemia, it is considered severe. If you are unable to eat, you may require a glucagon shot or intravenous glucose.

In general, patients with diabetes who use insulin should keep a glucagon kit on hand in case of an emergency. Family and friends must be aware of where to find the kit and how to utilize it in an emergency.

If you are assisting someone who is unconscious, do not attempt to feed or drink the individual. If you don't have a glucagon kit or don't know how to use it, get emergency medical assistance.


Treatment of an underlying disease

Preventing recurring hypoglycemia needs your health care practitioner to diagnose and treat the underlying cause of hypoglycemia. Treatment may include the following, depending on the cause:
  • Nutritional advice: A licensed dietitian can help you assess your eating habits and meal planning to help avoid hypoglycemia.
  • Medications: If a drug is the source of your hypoglycemia, your doctor will most likely recommend adding, modifying, or discontinuing the prescription, or reducing the dosage.
  • Tumor treatment: A tumor in your pancreas is usually treated surgically by removing the tumor. In some situations, hypoglycemic treatment or partial pancreatic resection are required.


HOW CAN HYPOGLYCEMIA BE PREVENTED?

If you are diabetic

Follow the diabetes management plan that you and your doctor have created. If you start taking new drugs, modify your eating or medication schedules, or start doing new exercises, talk to your doctor about how these changes may influence your diabetes management and your risk of low blood sugar.

Learn about the signs and symptoms of low blood sugar. This can help you detect and manage hypoglycemia before it becomes dangerously low. Checking your blood sugar level on a regular basis alerts you when it is low.

Some people may benefit from a continuous glucose monitor (CGM). A CGM uses a small wire implanted beneath the skin to deliver blood glucose measurements to a receiver. Some CGM units will sound an alarm if your blood sugar levels go too low.

Some insulin pumps are now connected with CGMs and can stop insulin administration if blood sugar levels drop too rapidly, aiding in the prevention of hypoglycemia.

Always keep a fast-acting carbohydrate on hand, such as juice, hard candies, or glucose tablets, to address a dropping blood sugar level before it becomes dangerously low.


If you are not diabetic

Eating many little meals throughout the day is a stopgap treatment for repeated bouts of hypoglycemia to help prevent blood sugar levels from falling too low. This method, however, is not recommended as a long-term plan. Work with your doctor to determine and address the source of your hypoglycemia.

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