Hypoglycemia is a condition defined by blood glucose levels falling below the normal range. Glucose, a type of sugar, is the primary fuel for the body’s cells, and the brain is particularly dependent on a steady supply to function correctly. For individuals with diabetes, hypoglycemia is classified as a blood sugar level below 70 milligrams per deciliter (mg/dL). In people without diabetes, the threshold is lower, around 55 mg/dL.
Symptoms of Hypoglycaemia
The initial signs of hypoglycemia are caused by the body’s release of epinephrine, also known as adrenaline, in response to falling glucose levels. These early warnings can include shakiness, nervousness, sweating, and chills. A person might also experience sudden hunger, a faster heartbeat, irritability, or tingling sensations around the lips. These symptoms signal the need to raise blood sugar.
As blood sugar continues to drop, the brain receives insufficient glucose, leading to more pronounced symptoms. This can manifest as difficulty concentrating, confusion, and drowsiness or weakness. Vision may become blurred and speech can become slurred, mimicking signs of intoxication. These symptoms require prompt attention to prevent progression.
If the condition is not addressed, severe hypoglycemia can occur, which is a medical emergency. The brain’s deprivation of glucose can trigger seizures or a loss of consciousness. Low blood sugar can also happen during sleep, a condition known as nocturnal hypoglycemia. Signs might include nightmares, crying out during sleep, or waking up tired or covered in sweat.
Causes of Low Blood Sugar
The most frequent cause of hypoglycemia is related to the management of diabetes. Individuals using insulin or certain other diabetes medications are at a higher risk. An episode can be triggered by administering too much medication, skipping or delaying meals, or not consuming enough carbohydrates to match the medication’s effect.
Hypoglycemia can also affect individuals without diabetes, though this is less common. One type is reactive hypoglycemia, which can happen a few hours after a meal high in simple carbohydrates. This occurs because the rapid absorption of sugar prompts a large release of insulin, which can cause blood glucose to drop too low. Other non-diabetic causes include excessive alcohol consumption, certain medications like quinine, critical illnesses, or a rare pancreatic tumor that produces excess insulin.
Immediate Treatment for a Hypoglycaemic Episode
For a conscious person experiencing mild to moderate symptoms, the goal is to quickly raise their blood sugar. The “Rule of 15” is a recommended guideline for this situation. This involves consuming 15 grams of a fast-acting carbohydrate, waiting 15 minutes, and then rechecking blood glucose levels. If levels are still below 70 mg/dL, the process should be repeated.
Examples of 15 grams of fast-acting carbohydrates include four ounces of fruit juice or regular soda, three to four glucose tablets, or one tablespoon of sugar or honey. Once blood sugar levels return to the target range, it is helpful to eat a small snack containing carbohydrates and protein, like cheese and crackers, if the next meal is more than an hour away. This helps stabilize blood sugar.
In cases of severe hypoglycemia where an individual is confused, disoriented, or has lost consciousness, they should not be given food or drink by mouth due to the risk of choking. This situation requires immediate emergency medical attention. If a glucagon emergency kit is available and a bystander knows how to use it, it should be administered right away. Glucagon is a hormone that stimulates the liver to release stored glucose, raising blood sugar levels. The person should be placed in the recovery position to prevent choking if they vomit.
Long-Term Management and Prevention
Preventing future episodes of hypoglycemia requires regular monitoring of blood glucose levels. This provides the necessary data to understand patterns and make timely adjustments to prevent levels from dropping too low.
A structured meal plan that balances carbohydrate intake throughout the day can help maintain stable blood sugar levels. Avoiding skipping meals and ensuring snacks are available, especially around exercise, is an important strategy. Planning for physical activity by either adjusting medication doses or consuming additional carbohydrates can prevent exercise-induced hypoglycemia.
Working closely with a healthcare provider is important for long-term management. A doctor can review medications that may be contributing to low blood sugar and make adjustments to the treatment regimen. A comprehensive management plan tailored to an individual’s lifestyle and health status is the most effective way to reduce hypoglycemic events.