Hypoglycemia
Hypoglycemia, also known as low blood sugar, is a condition that occurs when glucose levels become too low to provide sufficient fuel for the body. Normally, the body breaks down food, particularly carbohydrates, and absorbs the resulting glucose. Insulin, a hormone secreted by the pancreas, plays an important role in monitoring the amount of glucose in the body. For this reason, patients with diabetes, in whom the pancreas malfunctions, are most susceptible to hypoglycemia.
Diabetics must rely on the injection of insulin to regulate their blood glucose levels. If too much insulin is taken, the patient's blood glucose level can drop precipitously, resulting in hypoglycemia. Hypoglycemia can also occur in individuals who are not diabetic.
Causes of Hypoglycemia
While hypoglycemia can occur in non-diabetics, it is a common occurrence in diabetic patients. Non-diabetic hypoglycemia can be the result of fasting, certain medications, excessive alcohol consumption, diseases or tumors. In diabetics, hypoglycemia can be caused by the following:
- Depletion of glucose levels due to fasting or exercise
- Inefficient release of glucose into the bloodstream
- Excessive insulin
- Improper diet
- Alcohol consumption
- Certain medications
- Changes in an exercise routine
- Hormone deficiency
- Systemic infection
Hypoglycemia is often the result of inappropriate administration of insulin, when either the dosage is incorrect or the medication is taken at the wrong time.
Symptoms of Hypoglycemia
Symptoms of hypoglycemia can mimic symptoms of a variety of other problems, so it is important for patients with diabetes to be aware of them. Because symptoms tend to be somewhat individualized, patients should become familiar with their own physiological signs of early distress. Early symptoms of hypoglycemia may include some combination of the following:
- Anxiety or irritability
- Blurred or double vision
- Confusion
- Difficulty speaking
- Dizziness or headache
- Hunger
- Pallor, sweating, trembling
- Rapid pulse, pounding heart
- Sleepiness
- Tingling around the mouth
Left untreated, hypoglycemia can rapidly become dangerous and even life-threatening. Symptoms of more advanced hypoglycemia include the following:
- Poor concentration
- Unprovoked anger
- Impaired coordination
- Numbness in the mouth or tongue
- Nightmares
If diabetic hypoglycemia continues unabated, it can result in delirium, loss of consciousness, coma and death.
Diagnosis of Hypoglycemia
While hypoglycemia can be fairly simple to diagnose when symptoms are present, if a physician is consulted once the symptoms have passed, steps are taken to precipitate an observable episode. Usually the patient is required to fast in order to provoke symptoms; such fasting is sometimes done in a hospital setting. If the patient's symptoms tend to occur after eating, the doctor tests the patient's glucose levels following a meal.
Low glucose levels are documented by analyzing a sample of the patient's blood. The diagnosis of hypoglycemia is confirmed when the administration of blood glucose results in the disappearance of symptoms.
Treatment of Hypoglycemia
Mild cases of hypoglycemia are treated by the administration of sugar through food, drink or glucose tablets. Diabetics should always be carefully monitored by their endocrinologists to keep any episodes of hypoglycemia to a minimum. Eating small, frequent meals can help to keep glucose levels stable. Other treatments the doctor may prescribe are:
- Avoiding sugary foods
- Eating a protein or complex carbohydrate at bedtime
- Reducing, or altering the time of, the evening insulin dose
When hypoglycemic episodes occur in patients who are not diabetic, a full investigation must be done to determine and treat the underlying condition. In some rare instances, the problem is an insulin-releasing tumor, or insulinoma, which, though almost always benign, must be surgically removed.