Low blood sugar, also known as hypoglycemia, can be a dangerous condition. Low blood sugar can happen in people with diabetes who take medicines that increase insulin levels in the body. Taking too much medication, skipping meals, eating less than normal, or exercising more than usual can lead to low blood sugar.
Blood sugar is also known as glucose.
Without enough glucose, your body cannot perform its normal functions.
Your blood sugar is considered low when it drops below 70 mg/dL. Immediate treatment for low blood sugar levels is important.
What causes hypoglycaemia?
Insulin is normally produced in the pancreas and helps the cells in the body absorb glucose from the blood. Normally, the glucose level rises after a meal.
Too much insulin in the blood and other diseases can cause hypoglycaemic episodes (also known as ‘hypos’).
What can cause hypoglycaemic episodes in non-diabetic patients?
Too much insulin in the blood:
- reactive hypoglycaemia
- a tumour – very often benign – in the insulin-producing pancreas. This is a very rare condition indeed
- an overdose of insulin or diabetic tablets either by mistake or on purpose.
- a disease in the adrenal glands (Addison’s disease)
- a weakened pituitary gland
- a severe reduction in liver function
- patients who have had their stomach removed
- sometimes cancer
- fasting, malnutrition
- following alcohol ingestion.
Reactive hypoglycaemia is possibly the most common reason for hypoglycaemia in non-diabetics but is often overdiagnosed.
This form of hypoglycaemia is probably caused by an overproduction of insulin from the pancreas after a large meal with a lot of carbohydrates.
The insulin can still be detected even after several hours, although the level should be back to normal at this time.
This condition is probably most common in overweight people and those with Type 2 diabetes, where the large demand for insulin can sometimes cause too much insulin to be produced in the pancreas.
There is some evidence to suggest that reactive hypoglycaemia can precede Type 2 diabetes.
What Are the Symptoms of Low Blood Sugar?
Symptoms of low blood sugar can occur suddenly. They include:
- blurry vision
- rapid heartbeat
- sudden mood changes
- sudden nervousness
- unexplained fatigue
- pale skin
- difficulty sleeping
- skin tingling
- trouble thinking clearly or concentrating
- loss of consciousness
If you have hypoglycemic unawareness, a condition in which you do not know your blood sugar level is dropping, your blood sugar can drop so quickly you may not even have warning symptoms.
When this occurs, you can faint, experience a seizure, or even go into a coma.
Very low blood sugar is a medical emergency. If you know that someone is diabetic and he or she is experiencing these symptoms, help him or her to eat 15 grams of quickly digesting carbohydrate, such as:
- a half cup of juice or regular soda
- 1 tablespoon of honey
- 4 or 5 saltine crackers
- 3 or 4 pieces of hard candy or glucose tablets
- 1 tablespoon of sugar
Serious Complications from Spells of Low Blood Sugar
Mildly low blood sugar levels are somewhat common for people with diabetes; however, severely low blood sugar levels can be life-threatening.
They may lead to seizures and nervous system damage. Immediate treatment is critical. It is important to learn to recognize your symptoms and treat them fast.
For people at risk of low blood sugar, having a glucagon kit, a medication that raises blood sugar levels, is important. Talk to your healthcare provider for more information.
You may also want to talk with friends, family members, and coworkers about how to care for you if your blood sugar drops too low.
They should learn to recognize low blood sugar symptoms and know how to use the glucagon kit, as well as understand the importance of calling 911 if you lose consciousness.
Wearing a medical identification bracelet is a good idea. It can help emergency responders care for you properly if you need emergency attention.
Treat low blood sugar as soon as possible. Avoid driving if you are experiencing low blood sugar, as it can increase your risk of accident.
How is the diagnosis made?
The diagnosis is made by measuring the blood glucose level. If the glucose level is below 2.5mmol/l, you have hypoglycaemia.
If a tumour in the pancreas is suspected, the patient is admitted to a hospital for observation for three days, where the glucose level is closely monitored.
If this drops below a certain point, the insulin level in the blood is measured. If this is high, it suggests a tumour in the pancreas, which will be looked for, and if found, removed.
Exercise and diet
Exercise lowers the blood glucose level but will normally not cause hypoglycaemic episodes in otherwise healthy people.
If symptoms of hypoglycaemia are experienced during sport or exercise, try eating some complex carbohydrates – starch, pasta for example – before beginning.
During the exercise consume simple carbohydrates like glucose, in sports drinks for example.
When reactive hypoglycaemia has been diagnosed, the most important thing to do is to change the diet.
It should consist of a lot of complex carbohydrates – potatoes, rice, pasta, etc – and be divided into more, but smaller meals – breakfast, lunch, dinner and three in-between meals – to avoid the big fluctuations in the insulin secretion from the pancreas.
How is hypoglycaemia treated?
Reactive hypoglycaemia is treated with diet changes as described above. If a tumour in the pancreas is found, it is usually removed.
However, if this cannot be done, the condition can be controlled by injecting sandostatin (Octreotide). Weakened adrenal and pituitary glands are treated with medication.
How Can Episodes of Low Blood Sugar Be Prevented?
Regularly checking your blood sugar level can help you keep it in your target range. Talk to your doctor about when and how often you should check your blood sugar.
If you have had low blood sugar episodes in the past, you may wish to check your blood sugar levels before driving (or operating other types of machinery).
Consider having a snack before you leave your home or if your blood sugar levels are less than 100 mg/dL.