Hypoglycaemia (low blood sugar)

Hypoglycaemia is a condition characterized by an abnormally low level of glucose (blood sugar) in the blood. Glucose is the body's primary energy source, and low levels can cause a variety of symptoms and, in severe cases, can be life-threatening.

Symptoms

The symptoms of hypoglycaemia can vary depending on the severity and how quickly blood sugar levels drop. Common symptoms include:

• Mild Hypoglycaemia:

  • Shaking or trembling
  • Sweating
  • Feeling hungry
  • Palpitations (rapid or irregular heartbeat)
  • Anxiety or nervousness
  • Irritability
  • Dizziness or lightheadedness

• Moderate Hypoglycaemia:

  • Difficulty concentrating
  • Confusion or disorientation
  • Weakness or fatigue
  • Blurred or impaired vision
  • Headache
  • Slurred speech
  • Unsteady movements

• Severe Hypoglycaemia:

  • Seizures
  • Loss of consciousness
  • Coma

Causes

Hypoglycaemia can be caused by a variety of factors, often related to diabetes management, but it can also occur in individuals without diabetes. Common causes include:

1. Diabetes-Related Causes:

   • Insulin: Taking too much insulin or other diabetes medications.
   • Skipping Meals: Missing a meal or eating less than usual can cause blood sugar levels to drop.
   • Increased Physical Activity: Exercising more than usual without adjusting food intake or medications.
   • Alcohol Consumption: Drinking alcohol, especially on an empty stomach, can cause blood sugar levels to drop.

2. Non-Diabetes-Related Causes:

   • Certain Medications: Some medications can cause hypoglycaemia as a side effect.
   • Hormone Deficiencies: Conditions affecting adrenal or pituitary glands can cause low blood sugar.
   • Severe Illness: Liver or kidney diseases can interfere with glucose regulation.
   • Insulinomas: Rare tumors of the pancreas that produce excess insulin.
   • Reactive Hypoglycaemia: Occurs after eating, due to an excessive insulin response.

Diagnosis

Diagnosing hypoglycaemia involves several steps:

1. Medical History and Symptoms: Reviewing symptoms, medical history, and any medications taken.
2. Blood Glucose Test: Measuring blood sugar levels during symptoms to confirm hypoglycaemia.
3. Whipple's Triad: A classic diagnostic criterion that includes:
   • Symptoms of hypoglycaemia
   • Low plasma glucose concentration
   • Relief of symptoms after raising blood glucose levels
4. Additional Tests: For individuals without diabetes, further testing might be needed to identify underlying causes, such as hormone level tests or imaging studies.

Treatment

The immediate goal of treating hypoglycaemia is to raise blood sugar levels quickly. Long-term management focuses on preventing future episodes.

1. Immediate Treatment:

   • Quick-Acting Carbohydrates: Consuming 15-20 grams of fast-acting carbohydrates (e.g., glucose tablets, juice, regular soda) and rechecking blood sugar levels after 15 minutes.
   • Glucagon: For severe hypoglycaemia, glucagon injections can be administered if the person is unconscious or unable to consume sugar orally. Family members or caregivers should be trained to use a glucagon kit.

2. Long-Term Management:

   • Regular Monitoring: Frequent blood glucose monitoring to detect and treat low levels early.
   • Medication Adjustments: Working with a healthcare provider to adjust diabetes medications as needed.
   • Dietary Changes: Eating regular meals and snacks, particularly those that include complex carbohydrates and proteins to maintain stable blood sugar levels.
   • Exercise Planning: Planning physical activity and adjusting food intake or medication accordingly.
   • Education: Understanding the signs of hypoglycaemia and how to respond promptly.

Complications

If not properly managed, hypoglycaemia can lead to several complications:

• Injuries: Accidents or injuries resulting from fainting or seizures.
• Neurological Damage: Severe, prolonged hypoglycaemia can cause brain damage.
• Cardiovascular Events: Increased risk of heart problems due to the strain on the cardiovascular system.
• Fear of Hypoglycaemia: Anxiety about future episodes can lead to poor diabetes management or overconsumption of food to avoid low blood sugar.

Prevention

Preventing hypoglycaemia involves careful management and lifestyle adjustments:

• Regular Eating Schedule: Eating balanced meals and snacks at regular intervals.
• Monitor Blood Glucose: Keeping track of blood sugar levels, especially before and after activities or meals.
• Adjust Medications: Working with healthcare providers to adjust diabetes medications as needed.
• Carry Emergency Supplies: Always having quick-acting carbohydrates on hand.
• Avoid Alcohol on an Empty Stomach: Reducing the risk of alcohol-induced hypoglycaemia.

When to See a Doctor

Seek medical advice if:

• You experience frequent or severe episodes of hypoglycaemia.
• You have difficulty managing blood sugar levels despite following treatment plans.
• You develop new or unusual symptoms.

Conclusion

Hypoglycaemia is a condition characterized by abnormally low blood sugar levels, which can cause a range of symptoms from mild discomfort to severe medical emergencies. It is crucial to recognize the symptoms, understand the causes, and implement appropriate treatment and prevention strategies. With careful management and regular monitoring, individuals with hypoglycaemia can lead healthy and active lives.