Hypoglycemia

Hypoglycemia, commonly known as low blood glucose, occurs when blood sugar levels fall below 70 mg/dL. Glucose is vital as it provides energy to the body's cells. Though more common among individuals with diabetes, hypoglycemia can also affect those without this condition. Typically, healthy individuals maintain normal glucose levels efficiently. However, non-diabetic hypoglycemia can suggest underlying health issues. It’s important to differentiate between a "sugar crash" post high-carbohydrate meal, which doesn't lower glucose levels significantly, and genuine hypoglycemia. Unlike hyperglycemia (high blood sugar), hypoglycemia requires careful monitoring using a glucometer for accurate blood glucose assessment.

Causes

• Diabetes is the leading cause of hypoglycemia, affecting people with Type 1, Type 2, and gestational diabetes. Despite their efforts, individuals with diabetes frequently encounter blood glucose fluctuations due to:

• Exercise

• Diabetes medications like insulin or oral drugs (sulfonylureas, glinides)

• Illness

• Skipping meals

• Alcohol consumption

• Non-diabetic hypoglycemia is commonly caused by medications that lower blood sugar.

Symptoms

Hypoglycemia symptoms begin to manifest when blood sugar levels fall below 70 mg/dL. These can vary between individuals but often include:

• Hunger

• Fast heartbeat

• Shakiness

• Anxiety

• Sweating

• Tingling

• Dizziness

• Weakness

• Drowsiness

• Confusion

Some may not notice these early symptoms, known as "hypoglycemia unawareness," increasing the risk of severe episodes. Without treatment, hypoglycemia can become a medical emergency, possibly resulting in seizures, coma, or even death. Regular blood sugar monitoring, especially for diabetic patients, is crucial. Continuous glucose monitors (CGM) offer significant advantages in preventing critical episodes.

Diagnosis

Diagnosis involves measuring blood glucose levels, where a level below 70 mg/dL confirms hypoglycemia. Diabetics can self-test using glucometers, while persistent low blood sugar warrants healthcare consultation to adapt treatment plans. Non-diabetics suspecting hypoglycemia should consult healthcare providers for evaluation. Assessment often involves a physical exam, symptom discussion, and tests, such as fasting blood glucose or mixed-meal tolerance tests, conducted in the morning after fasting. Improvement in symptoms post carbohydrate-rich meal or sugary drink further supports diagnosis.

Treatments

Swift identification and response to hypoglycemia are vital to manage this condition, particularly for diabetics. Treatment often involves fast-acting carbohydrates, avoiding fiber- and fat-rich foods that can hinder sugar absorption. Options offering 15 grams of carbs include: 4 glucose tablets, 1 tube of glucose gel, ½ cup fruit juice or soda, 6 large jelly beans, or 1 tablespoon of sugar/honey.

The "15-15 rule" helps manage blood sugar levels between 55 to 69 mg/dL: consume 15 grams of carbs, wait 15 minutes, then check levels again. Repeat if levels remain below 70 mg/dL. A blood glucose below 55 mg/dL indicates a serious condition, possibly requiring help. Inform those around you to call 911 if you remain unresponsive, unable to consume sugar, or experience confusion, seizures, or unconsciousness.

Healthcare providers may prescribe glucagon for emergencies, either inhalable or injectable, to raise blood sugar. Ensure that friends and family know how to administer it. Having an emergency treatment plan helps avert crises.

Living

For those with hypoglycemia, particularly diabetics, continuous vigilance is key for safety and preparedness. Maintain open communication with healthcare providers to address concerns. A medical alert bracelet provides essential information in emergencies. Teach those around you how to recognize symptoms and respond, including when to call emergency services like 911. Carry essential supplies—glucometer, fast-acting glucose, and prescribed glucagon in case swallowing is impaired, consciousness is lost, or a seizure occurs. Educating others on glucagon administration is equally crucial.