Hypoglycemia

Definition

Hypoglycemia is a condition that occurs when your blood sugar (glucose) is too low.

Alternative Names

Causes

Hypoglycemia results when your body's glucose is used up too rapidly, when glucose is released into the bloodstream too slowly, or when too much insulin is released into the bloodstream. Insulin is a hormone that reduces blood glucose. It is produced by the pancreas in response to increased glucose levels in the blood.

Hypoglycemia is relatively common in persons with diabetes. It occurs when too much insulin or diabetes medicine is taken, not enough food is eaten, or from a sudden increase in the amount of exercise without an increase in food intake.

Relative hypoglycemia is a fairly common condition in which a newborn's blood glucose is low. Babies born to mothers with diabetes may have severe hypoglycemia.

Severe hypoglycemia is a medical emergency that may result in seizures and damage to the baby's nervous system if not treated.

Severe hypoglycemia that results in unconsciousness is also called insulin shock.

Idiopathic hypoglycemia is hypoglycemia that occurs without a known cause. Persons with this type of hypoglycemia do not have diabetes.

Hypoglycemia may also be caused by:

• Insulin-secreting tumor of the pancreas
• Liver disease
• Ingestion of alcohol

It affects approximately 1 out of every 1,000 people.

Symptoms

• Cold sweats
• Confusion
• Convulsions
• Coma
• Double vision or blurry vision
• Fatigue
• General discomfort, uneasiness, or ill feeling (malaise)
• Headache
• Hunger
• Irritability (possible aggression)
• Nervousness
• Rapid heart rate
• Trembling

Other symptoms that may be associated with this disease:

• Decreased alertness
• Different size pupils
• Dizziness
• Excessive sweating
• Fainting
• Hallucinations
• Memory loss
• Muscle pain
• Paleness
• Pounding heartbeat (heartbeat sensations)
• Sleeping difficulty

Exams and Tests

Home monitoring of blood glucose levels will show readings lower than 50 mg/dL.

Serum glucose test will be low.

This disease may also alter the results of the following tests:

• Glucose tolerance test
• CSF collection
• Blood glucose monitoring

Treatment

A snack or drink containing sugar will raise the blood glucose level. You should see an immediate improvement in symptoms.

Infants that are born with hypoglycemia are given glucose through a vein until the body begins to control its own blood sugar level.

Persons with severe hypoglycemia are treated with glucose injections or the hormone glucagon. Immediate treatment is needed to prevent serious complications or death.

Your doctor may tell you to change your diet so that you get more even amounts of glucose into your body throughout the day. This may prevent further episodes of low blood sugar. You may be told to eat small, frequent meals with complex carbohydrates, fiber, and fat and to avoid simple sugars, alcohol, and fruit juice.

You should also eat meals at regular intervals, and balance extra exercise with extra food.

If hypoglycemia is caused by an insulinoma

Possible Complications

Untreated, hypoglycemia can lead to loss of consciousness and coma. In infants, seizures and permanent damage to the nervous system may occur.

Learn to recognize the early warning signs of hypoglycemia and treat yourself rapidly and appropriately.

When to Contact a Medical Professional

Go to the emergency room immediately or call a local emergency number (such as 911) if early signs of hypoglycemia do not improve after you've eaten a snack containing sugar.

Get immediate medical help if a person with diabetes or a history of hypoglycemia loses alertness or if you can't wake them up.

Prevention

If you have diabetes, make sure you follow your doctor's advice regarding diet, medications, and exercise.

If you have a history of hypoglycemia, you should keep a snack or drink containing sugar available at all times to take as soon as symptoms appear. If symptoms do not improve in 15 minutes, additional food should be eaten. A glucagon kit is available for those who have episodes of hypoglycemia that respond poorly to other types of treatment.

Cryer PE, Davis SN, Shamoon H. Hypoglycemia in diabetes. Diabetes Care. 2003; 26(6): 1902-1912.