Understanding Hypoglycemia: Signs of Dangerously Low Blood Sugar

Hypoglycemia, commonly known as low blood sugar, is a condition that occurs when the level of glucose in the blood drops below normal. It's particularly common among people with diabetes, especially if they take insulin or certain oral medications, but it can also affect individuals without diabetes under specific circumstances. Recognizing the signs and understanding the causes of low blood sugar are critical for prompt treatment and preventing severe complications.

What is Hypoglycemia and Why Does It Happen?

Hypoglycemia occurs when your blood glucose levels fall too low to adequately fuel your body’s functions. Glucose, a simple sugar derived from the food we eat, is the primary source of energy for our cells, particularly brain cells. The brain is highly sensitive to drops in glucose and requires a constant supply to function properly. A Dietitian S Review Of Blood Sugar Support Supplements

Common Causes in People with Diabetes

• Excess Insulin: Taking too much insulin or injecting it at the wrong time can lead to a rapid drop in blood sugar.
• Skipping Meals: Not eating enough carbohydrates, or delaying or skipping meals can reduce the glucose available in the bloodstream.
• Increased Physical Activity: Exercise uses glucose for energy. Without adjusting insulin dosage or eating extra carbohydrates, strenuous activity can cause hypoglycemia.
• Alcohol Consumption: Alcohol can interfere with the liver’s ability to release stored glucose into the bloodstream, particularly when consumed on an empty stomach.

Common Causes in People Without Diabetes

While less frequent, hypoglycemia can also occur in individuals without diabetes. Possible causes include: Type 2 Diabetes And Your A1C How To Lower Your Number Safely

• Reactive Hypoglycemia: This condition occurs when the body releases too much insulin after eating, causing a sudden drop in blood sugar within a few hours after a meal.
• Certain Medications: Some medications, such as quinine (used to treat malaria) and certain antibiotics, can occasionally lead to hypoglycemia.
• Medical Conditions: Rare tumors of the pancreas (insulinomas), liver disease, kidney disease, and adrenal or pituitary gland disorders can disrupt blood sugar regulation.
• Severe Illness: Serious infections or organ failure can sometimes deplete glucose stores and lead to hypoglycemia.

Recognizing the Signs of Hypoglycemia

The symptoms of low blood sugar can vary from person to person and can range from mild to severe. It’s important to be aware of these signs and symptoms so you can take prompt action.

Mild to Moderate Symptoms

• Shakiness: A feeling of trembling or shakiness, often felt in the hands and legs.
• Sweating: Unexplained perspiration, especially when not physically active.
• Dizziness or Lightheadedness: A sensation of feeling faint or unsteady.
• Hunger: An intense feeling of hunger, even after recently eating.
• Irritability or Anxiety: Feeling anxious, nervous, or unusually irritable.
• Rapid Heartbeat: A racing or pounding heart.
• Confusion: Difficulty concentrating or thinking clearly.
• Blurred Vision: Temporary changes in vision, such as blurry or double vision.
• Weakness: Feeling tired or weak, with a lack of energy.

Severe Symptoms

If left untreated, hypoglycemia can progress to more severe symptoms, which require immediate medical attention: How To Achieve Normal Blood Sugar Levels For Long Term Health

• Loss of Coordination: Difficulty with balance and motor skills.
• Seizures: Uncontrolled muscle spasms or convulsions.
• Loss of Consciousness: Passing out or becoming unresponsive.
• Coma: A prolonged state of unconsciousness.

Symptom Category	Specific Symptoms	Severity
Mild to Moderate	Shakiness, sweating, dizziness, hunger, irritability, rapid heartbeat, confusion, blurred vision, weakness	Can usually be treated with quick-acting carbohydrates.
Severe	Loss of coordination, seizures, loss of consciousness, coma	Requires immediate medical intervention (e.g., glucagon injection).

What to Do When You Suspect Hypoglycemia

If you suspect that you or someone else is experiencing hypoglycemia, immediate action is crucial.

Step-by-Step Guide

1. Check Blood Sugar (If Possible): If the person has a glucose meter, check their blood sugar level immediately. If it is below 70 mg/dL, proceed to the next step.
2. Consume Quick-Acting Carbohydrates: If the person is conscious and able to swallow, give them 15-20 grams of quick-acting carbohydrates. Examples include:
   • 4 ounces (120 milliliters) of juice or regular (non-diet) soda
   • 1 tablespoon of sugar, honey, or corn syrup
   • 3-4 glucose tablets
   • Hard candies (check labels for carb content)
3. Wait 15 Minutes and Recheck: After 15 minutes, recheck the blood sugar level. If it is still below 70 mg/dL, repeat the process with another 15-20 grams of carbohydrates.
4. Follow Up with a Meal or Snack: Once the blood sugar is back within the normal range, eat a meal or snack containing both carbohydrates and protein to help stabilize the blood sugar and prevent another drop. Examples include:
   • A slice of whole-wheat bread with peanut butter
   • Cheese and crackers
   • A small serving of yogurt with fruit

When to Seek Emergency Medical Attention

• Severe Symptoms: If the person is experiencing severe symptoms such as seizures, loss of consciousness, or coma, call emergency services immediately.
• Unresponsiveness: If the person is unable to swallow or is unresponsive, do not attempt to give them anything by mouth. Administer glucagon if available and you know how to use it, and call for emergency medical assistance.
• Frequent Episodes: If the person is experiencing frequent episodes of low blood sugar, even with treatment, consult a healthcare professional for further evaluation and management.

Preventing Hypoglycemia

Prevention is key to managing low blood sugar, especially for individuals with diabetes.

For People with Diabetes

• Monitor Blood Sugar Regularly: Check blood sugar levels as directed by your healthcare provider.
• Take Medications as Prescribed: Follow your doctor’s instructions carefully when taking insulin or oral diabetes medications.
• Coordinate Meals and Medication: Balance the timing and amount of your meals with your medication dosages.
• Adjust Insulin for Exercise: If you exercise, adjust your insulin dosage or consume extra carbohydrates as needed.
• Be Cautious with Alcohol: Drink alcohol in moderation and always with food.
• Carry Identification: Wear a medical ID bracelet or carry a card that indicates you have diabetes and what to do in case of an emergency.
• Keep a Hypoglycemia Kit: Keep a kit containing quick-acting carbohydrates, such as glucose tablets or juice, readily available at home, work, and in your car.

For People Without Diabetes

• Eat Balanced Meals: Consume regular, balanced meals containing a mix of carbohydrates, protein, and healthy fats.
• Avoid Skipping Meals: Try not to skip meals, particularly breakfast.
• Limit Sugary Foods and Drinks: Reduce your intake of refined sugars and processed foods.
• Consult a Healthcare Professional: If you experience frequent symptoms of hypoglycemia, seek medical advice to determine the underlying cause.

The Importance of Early Recognition and Action

Hypoglycemia can be a serious condition if left untreated. Early recognition of the symptoms and prompt action to raise blood sugar levels are critical for preventing severe complications. Understanding the causes, knowing how to respond, and taking steps to prevent future episodes can help you or a loved one manage low blood sugar effectively and maintain overall health and well-being. Always consult with a healthcare professional for personalized advice and treatment plans.

By Dana M. Harris, M.D.