Hypoglycemia, also known as low blood sugar, is very common in people suffering from diabetes. It is also referred to as insulin shock or insulin reaction. Hypoglycemia is characterized by abnormally low levels of blood glucose, usually less than 70mg/dL. It can affect all the organs of the body, especially the brain. Fortunately, serious hypoglycemia is rare in people under the age of 20.
People suffering from type 1 diabetes are most susceptible to hypoglycemia. People with type 1 diabetes do not produce insulin, while people suffering from type 2 diabetes have cells that do not respond to insulin. No matter the form of diabetes, people suffering from this disease need to take insulin to bring the blood sugar levels down.
Diabetes, the major cause of Hypoglycemia:
Blood sugar is the amount of glucose present in the body. Glucose is a natural sugar that comes from the carbohydrate rich food we eat. It is very essential for the normal functioning of the body. Diabetes affects the body’s ability to regulate the blood sugar levels in the body. It inhibits the production of insulin that causes the blood glucose or blood sugar level to be abnormally high in the body.
The signs and symptoms linked to hypoglycemia may be caused due to other illnesses as well.
Hypoglycemia / Low Blood Sugar Causes:
As mentioned above, diabetes is the most common cause leading to hypoglycemia. People with diabetes use a variety of treatments to keep the blood sugar level under control. Insulin injections are one of the most common treatments for diabetes. While insulin is useful for controlling high blood sugar, too much insulin can cause the blood sugar level to drop too low.
2. Certain Medications:
Certain medications can lead to hypoglycemia too. If a non-diabetic consumes diabetes medication, then he might develop hypoglycemia. Several other medications can cause hypoglycemia like Quinine, a medicine used to treat malaria. Salicylates, a drug used for treating rheumatoid arthritis and Propranolol used to treat high blood pressure may trigger a serious drop in blood sugar level.
3. Alcohol Abuse:
The liver generally stops releasing the stored glucose into the bloodstream if a person consumes too much alcohol and that leads to a drop in the sugar level in the body.
4. Diseases Of The Liver, Kidneys Or Pancreas:
Drug induced hepatitis can cause hypoglycemia too. People suffering from kidney disorders can also have problem in excreting glucose, which can result in low blood sugar.
5. Eating Disorders:
People with eating disorders such as crash diet and anorexia nervosa may find their blood sugar levels drop dramatically.
Insulinoma is a tumor in the pancreas that makes the pancreas produces too much insulin. Tumors in other parts of the body can also cause low blood sugar.
7. Endocrine Disorder like Adrenal Gland Deficiency:
Endocrine disorder or disorder of the pituitary gland can also lead to hypoglycemia. The pituitary gland controls the body’s production of hormones, which is needed to raise the blood sugar levels if they fall too low. These hormones include cortisol, released from the adrenal glands, glycogen released from the pancreas and adrenaline released from the adrenal gland medulla. Children suffering from endocrine disorder can experience abnormally low blood sugar levels than adults. Additionally, too much physical activity without eating anything can also cause a drop in blood sugar level.
8. Stomach Surgery:
Stomach surgery causes sugars to be absorbed too quickly, leading to excessively high insulin in the body. This too causes low blood sugar.
Hypoglycemia / Low Blood Sugar Symptoms:
The symptoms of low blood sugar can be different, depending on how low the sugar levels drop. While there is some degree of variability among people, most of them develop symptoms when the blood sugar levels reaches below 60 mg/dL. The first set of symptoms is called adrenergic or sympathetic because they relate to the nervous system’s response to hypoglycemia. It includes nervousness, intense hunger, palpitations, weakness and trouble while speaking. The vast majority of diabetics experience this degree of hypoglycemia.
Types of Hypoglycemia:
1. Mild Hypoglycemia:
Mild hypoglycemia is caused due to the release of extra adrenaline in the body. The symptoms of mild hypoglycemia include uncontrollable hunger and vomiting. It can also cause fast heartbeat. The skin will also turn cold and clammy. The individual can easily self-treat this type of hypoglycemia.
2. Moderate Hypoglycemia:
Moderate hypoglycemia is caused by the release of extra adrenaline and lack of glucose production in the body. Moderate hypoglycemia often makes the person short tempered, nervous, confused or afraid. It may also cause blurry vision and trouble in walking. Excessive sweating is also a possible symptom of moderate hypoglycemia.
3. Severe Hypoglycemia:
Severe hypoglycemia requires immediate medical intervention. The blood glucose levels during severe hypoglycemia drop to below 50 mg/dL. Severe hypoglycemia can be life threatening and requires an immediate medical attention. It may lead to seizure or nervous damage and in extreme cases, can even lead to coma or death.
4. Reactive Hypoglycemia:
Reactive hypoglycemia, also called postprandial hypoglycemia, occurs usually after eating meals high in carbohydrates. This causes the blood sugar level to rise rapidly, leading to excess production of insulin. People who have trouble digesting fructose, glucose and leucine may also suffer from extreme damage. It is also very common in people who have undergone gastric bypass or other surgery. People with reactive hypoglycemia can control symptoms by eating small and frequent meals and avoiding food high in carbohydrates.
5. Fasting Hypoglycemia:
Fasting hypoglycemia is a serious form of hypoglycemia that occurs in both diabetics and non-diabetics. The symptoms appear five hours after the last meal. The blood sugar level is usually lower than 50 mg/dL.
Please remember that the symptoms of low blood sugar can get worse if left untreated.
Diagnosis of Hypoglycemia / Low Blood Sugar:
The doctor will do a complete physical examination and ask questions about the health, medicines and the medical history if the patient is a diabetic. In case of a non-diabetic, the doctor will probably order a blood test to measure the blood sugar level in the body. Nowadays, a number of compact blood sugar testing kits are available with which you can test your sugar level at home! All one need to do is prick the finger and drop the blood on the test strip. The strip is then inserted in the machine. The result will come out in seconds. But do not rely solely on self-diagnosis if you suffer from acute hypoglycemia and seek a doctor who can chalk out a treatment plan for you.
Treatment for Hypoglycemia / Low Blood Sugar:
Hypoglycemia has two possible treatment approaches – immediate treatment and treating the underlying cause. The acute management of hypoglycemia involves the rapid delivery of glucose to the body. Some of the common treatment plans include:
You can treat a sudden attack of low blood sugar by eating sugary foods. Consume fruit juice, soda, milk, raisins and candies and wait for 15 minutes. Check your blood sugar again. If the blood sugar level is still low, then repeat the test. If you still do not feel better, then eat another snack. It this also does not work, then seek immediate medical help.
The American Diabetes Association recommended consuming 15 to 20 grams of carbohydrates daily to prevent the possibility of hypoglycemia. You can snack on the following food and beverages to relieve symptoms of hypoglycemia within minutes.
Candies or sweets:
- 1 tablespoon jelly
- 1 tablespoon honey
- Six hard candies
- 1 tablespoon sugar
- ½ cup of apple juice
- ½ cup of orange it grapefruit juice
- ½ cup of pineapple juice
- ½ cup of regular soda
- 1/3 cup of cranberry juice
- 1/3 cup of prune juice
- 1 cup of fat free milk
- 1 banana
- One small apple
- One small orange
- 2 tablespoons of raisin
- Fifteen grapes
- 3 to 4 glucose tablets or one glucose gel
These foods and beverages are easily absorbable and raise the blood sugar levels in the body. Do not give chocolate, candies, cookies, ice cream and bread to the patient. The body does not absorb sugar in the form of complex carbohydrates or sugar combined with fat and protein quickly. People, who take the diabetes medicine Acarbose, must consume only glucose and not sucrose to treat hypoglycemia. Sucrose is broken down in the body to produce glucose, but Acarbose blocks sucrose from breaking down into glucose.
If the hypoglycemia is caused by a chronic health problem, then you need to go to a doctor for a diagnosis and treatment.
If the hypoglycemic episode has progressed to the point at which the patient cannot take anything from the mouth, then more drastic measures are needed. If a person loses consciousness, they should be treated with 1 mg of glucagon injection. Glucagon is a hormone that stimulates the liver to release stored glucose into the blood if the levels are too low. A response is usually seen within a few minutes and last for about 90 minutes. Children under 5 years of age should be given a dose of 0.5 mg in the same manner. These kits are only available through prescription. Trust only a qualified medical expert to give you this injection. If a person has lost consciousness, do not place solids or liquid into their mouth. If glucagon is not available and the patient is not able to take anything by mouth, then emergency services should be called immediately.
Tips For Using Glucagon:
Inject the glucagon into the arm, buttock, and thighs by properly following the manufacturer’s instruction. The patient might experience nausea and vomiting after regaining consciousness. Do not provide foods or fluids and do not put hand or finger in the mouth.
Preventing Low Blood Sugar:
1. Keep A Check On Blood Sugar Levels:
Regularly checking the blood sugar levels can help you to prevent hypoglycemia before it drops dangerously low. Consult your doctor on how often you should check your blood sugar. Keep a portable blood sugar machine handy to identify the symptoms.
2. Eat Regularly:
It is very important to strike a balance between eating enough and not eating too much. Regular meals and snack are vital for keeping the blood glucose levels stable. Instead of eating three large meals, eat 6 small meals. This will help to stabilize blood glucose levels throughout the day.
Eat fiber rich foods like fruits, vegetables and whole grains. Consume foods high in protein such as poultry, fish, eggs and dairy products. Also, limit your caffeine and tea intake. Maintain a healthy diet and stay active throughout the day. Additionally, too much of physical activity without eating anything can also cause a drop in blood sugar level.
A heavy drinking session can trigger hypoglycemia. Thus, people with type 1 diabetes are advised to limit their daily alcohol intake and eat something after the drink.
Exercise for at least 30 minutes daily to keep the blood sugar level stable. Make sure to eat carbohydrate rich food before exercising.
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6. Be prepared:
People susceptible to low blood sugar should carry candies or fruit juices to fight the symptoms of hypoglycemia. If you’ve had low sugar levels in the past, then do the blood test before driving or operating any kind of machinery. Have a snack before leaving home, especially if your sugar level is less than 100 mg/dL. Diabetic patients who use insulin should always carry a sugar product with them for treating mild to moderate hypoglycemia.
7. Let People Know:
You should always inform your colleagues, family, and friends about the attacks of hypoglycemia. Explain the signs to them and what should be done to treat the symptoms. If possible, carry a diabetic ID with you, stating that you have diabetes or recurrent hypoglycemia.
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Follow the diabetes management plan carefully to treat low sugar. If you suffer from recurring hypoglycemic episodes, talk to your doctor about adjusting the diabetes management plan to fit your lifestyle. Get a glucagon injection prescribed to you, so that a family or friend can administer it as and when required. Remember, a low blood sugar is more dangerous than a brief episode of high blood sugar.