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Hypoglycemia

Hypoglycemia occurs when your body's blood sugar is too low. It is a severe health issue that must be corrected immediately. If you are prone to hypoglycemia, you should learn to recognize the signs of its onset and know what steps to take to bring your blood sugar up to a safe level.

Last Modified: June 9, 2022
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What Is Hypoglycemia?

Hypoglycemia is a state in which your body’s blood glucose (also known as blood sugar) falls to a critically low level. It is most often experienced by people with diabetes, but it can also happen to non-diabetics in certain circumstances.

All foods contain glucose in varying amounts. It is your body’s primary source of fuel. If you do not have enough of it available to maintain your body’s functions (70 mg/dl or 4 mmol/l), your body struggles to perform normally.

Low blood sugar causes a variety of cognitive and neurological symptoms like shaking and lightheadedness. It also alters your body’s ability to support critical organs like your muscles and brain.

Symptoms of Hypoglycemia

The most common symptoms of hypoglycemia include weakness and behavioral changes. Other early symptoms include:

  • Fatigue
  • Shakiness
  • Anxiety
  • Pale skin
  • Sweating
  • Hunger
  • Irritability
  • Numb or tingling skin

If the condition progresses, you can experience neurological issues like confusion and seizures.

Never ignore symptoms of hypoglycemia. They indicate that your body is in urgent need of more fuel.

If symptoms arise, always stop what you are doing and take steps to bring your blood sugar back up.

Hypoglycemia Complications

If you do not treat hypoglycemia as soon as possible, you may experience life-altering complications. The most serious are:

  • Seizures
  • Coma
  • Death

Hypoglycemia does not go away without action, and it only gets worse if left untreated. No one should ignore presenting symptoms of hypoglycemia.

When to Seek Medical Attention

The time to seek medical help for hypoglycemia is when symptoms show up and do not abate after eating or drinking something sugary.

There is too much at stake to put off a visit to an urgent-care facility, including potential permanent brain damage. If you find yourself dealing with symptoms outside of regular clinic hours, go to the nearest emergency room or call 9-1-1 for emergency help. Do not wait for the next day to get treatment.

Hypoglycemia Unawareness

Hypoglycemia unawareness is when someone fails to notice that they are experiencing symptoms of low blood sugar. They may not realize the need to take action until after their symptoms become severe or they see a too-low blood sugar reading on one of their routine tests.

Hypoglycemia unawareness is most common in people who have Type 1 diabetes, but it can happen to anyone who experiences hypoglycemia. Researchers are still investigating how best to help people avoid it.

Some potential approaches include offering more information on hypoglycemia, providing people with strategies to improve their bodily awareness, and prescribing medication that makes hypoglycemia symptoms more obvious.

Causes of Hypoglycemia

The main cause of hypoglycemia is when something goes wrong with your body’s natural blood-sugar regulation processes.

Each time you eat, your body breaks food down into its component parts, including glucose. Your body responds by releasing insulin hormones and using some glucose as fuel to maintain healthy blood sugar levels. Insulin tells your body to convert the rest of the glucose into glycogen, a stable form of glucose that you store for energy needed later.

After several hours without food, your body begins to run out of fuel, and your blood sugar drops. In response, your body releases another hormone, glucagon.

Glucagon tells your liver to turn glycogen reserves into glucose for needed fuel. If you don’t have enough stored glycogen to meet your needs, your body uses stored fats and amino acids to produce the needed glucose.

Causes for People with Diabetes

Most people who experience hypoglycemia also have diabetes. The reason for this is that diabetes directly interferes with your body’s ability to process sugars.

Type 1 and type 2 diabetes are frequently treated with insulin, a hormone that regulates blood sugar. Because people who take insulin for diabetes cannot easily alter their dose to accommodate dietary changes or extra exercise, it is easy for them to take too much. Doing so causes blood sugar levels to drop unexpectedly, leading to hypoglycemia.

Doctors also treat type 2 diabetes with metformin, a medication that reduces the amount of glucose your body produces and absorbs. Metformin can lead to hypoglycemia if the dosage is too high or if food intake is abnormally low.

Causes for People Without Diabetes

People who do not have diabetes can also experience hypoglycemia symptoms. This can happen because of a variety of medical conditions and lifestyle factors.

Most common are:
  • Alcohol consumption. Consuming alcohol causes the body to release more insulin. This leads to an immediate drop in blood sugar that can affect even occasional drinkers.
  • Pancreatic tumors. Certain pancreatic tumors can cause your body to produce abnormal amounts of insulin. This leads to chronically low blood sugar levels that can easily dip low enough to cause hypoglycemia symptoms.
  • Organ failure. Liver or kidney failure alters the way your body processes the food you eat. This may make you more susceptible to hypoglycemia.
  • Infection. Certain infections (especially sepsis) may trigger metabolic changes that lead to hypoglycemia.
  • Hormones. Hormones such as cortisol, adrenaline and glucagon help to regulate blood sugar levels in your body. Imbalanced levels of these hormones may cause hypoglycemia.
  • Weight loss surgery. Some people who undergo weight loss surgery experience changes in their metabolism that alter the way their body processes glucose. These people experience an abnormally high spike in glucose levels after eating. This prompts their body to produce too much insulin at once, leading to a rapid drop in blood sugar.
  • Medications. Medications like beta-blockers, SGLT2 inhibitors, and indomethacin may cause low blood sugar. Let your doctor know if you experience symptoms of hypoglycemia while taking a new medication.

Non-diabetic hypoglycemia is rare, but it is just as serious as the hypoglycemic episodes that someone with diabetes experiences.

Always discuss any symptoms of hypoglycemia with your doctors. They may recommend getting tested for some of the conditions described above.

Treatment of Hypoglycemia

Treating hypoglycemia requires getting your blood sugar to normal levels. To do this, follow the 15-15 rule: Take 15-20mg of carbohydrates, then wait 15 minutes. You can also give yourself a shot of glucagon if your doctor prescribed it for you. Your symptoms should go away after either treatment. If possible, test your blood sugar to verify that it worked.

Because hypoglycemia is a severe problem that often goes ignored, many healthcare providers treat it by training people to recognize hypoglycemic symptoms and by outlining actions to take to avert an emergency.

Researchers are exploring new ways to determine who is most at risk for hypoglycemic episodes. Your health information will allow doctors to provide these people with additional information on hypoglycemia, its symptoms and its potential complications. This may help increase engagement in this population and motivate them to manage their blood sugar levels more carefully before hypoglycemic episodes happen.

The medical community is also working on making hypoglycemia rarer by improving insulin delivery mechanisms. For example, many adults and children with type 1 diabetes use insulin pumps with automatic sensors to treat their condition.

Pumps continually monitor your blood sugar levels and regulate the amount of insulin they deliver based on those readings. They will automatically stop dispensing insulin when your blood sugar dips too low, preventing many instances of hypoglycemia.

Prevention of Hypoglycemia

Preventing hypoglycemia is difficult without identifying an underlying cause. Tell your doctors if you have experienced hypoglycemic symptoms in the past. They likely will recommend diabetes testing.

Depending on the results of that test, they may investigate other potential health problems.

Based on test results, your doctor may recommend:
  • Eating meals and snacks at designated times throughout the day.
  • Adjusting your medications.
  • Using an insulin pump with automatic sensors.

You may also need to moderate the amount of exercise you do while taking insulin. Discuss your activity levels with your doctor so they can prescribe the right amount of insulin for your lifestyle.

Please seek the advice of a medical professional before making health care decisions.
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