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Hypogylcemia

Hypoglycemia results when glucose is used up too rapidly, when glucose is released into the bloodstream more slowly than is needed by the body, or when excessive insulin (a hormone secreted by the pancreas in response to increased glucose levels in the blood) is released into the bloodstream.

Hypoglycemia is relatively common in diabetics. It occurs when too much insulin or oral antidiabetic medication is taken, not enough food is eaten, or from a sudden increase in the amount of exercise without increasing the intake of food.

Hypoglycemia can occur as an idiopathic (without known cause) condition. In this case, people who are not diabetic and who do not have other known causes of hypoglycemia experience symptoms of the disorder.

Hypoglycemia can occur because of an insulin-secreting tumor of the pancreas, liver disease, or as a response to the ingestion of alcohol. Hypoglycemia occurs in adults, infants, and children. The incidence is approximately 1 out of 1000 people.

People who are known to experience hypoglycemia should keep a snack available at all times to take as soon as symptoms appear. If symptoms do not improve in 15 minutes, additional food should be eaten. A glucagon kit may be obtained by prescription for episodes of hypoglycemia that respond poorly to treatment.

Symptoms:
  • fatigue
  • general discomfort, uneasiness, or ill feeling (malaise)
  • nervousness
  • irritability
  • trembling
  • headache
  • hunger
  • cold sweats
  • rapid heart rate
  • blurry or double vision
  • confusion
  • convulsions
  • coma
Additional symptoms that may be associated with this disease:
  • sweating, excessive
  • sleeping difficulty
  • paleness
  • muscle pain
  • memory loss
  • heartbeat sensations
  • hallucinations
  • fainting
  • eyes, pupils different size
  • dizziness
  • consciousness, decreased


Signs and tests:
  • Serum glucose level is low.
  • Self-monitoring of blood glucose levels show low readings (less than 50 mg/dl).


This disease may also alter the results of the following tests:
  • glucose tolerance test
  • CSF collection
  • blood glucose monitoring


Treatment:


  • Requires immediate reaction, a snack containing sugar will raise the blood-glucose level, and an improvement in symptoms should be realized.
  • Blood-sugar levels are so low in a person that unconsciousness or inability to swallow develops, emergency medical treatment is needed. This is called insulin shock. An injection of glucose solution or the hormone glucagon will be given immediately.
  • For long-term management, dietary modifications may be necessary to deliver glucose to the body more evenly throughout the day and thereby preventing further hypoglycemic attacks. Small, frequent meals with complex carbohydrates, fiber, and fat; and the avoidance of simple sugars, alcohol, and fruit juice are dietary modifications that may be recommended. Eat meals at regular intervals, and balance extra exercise with extra food.
  • If hypoglycemia is caused by an insulinoma (insulin secreting tumor), surgery to remove the tumor is indicated.
Expectations (prognosis):

Severe hypoglycemia can often be avoided by knowing the early warning signs of hypoglycemia and using appropriate self-treatment. Untreated hypoglycemia can progress to unconsciousness and prolonged lack of glucose to the brain may cause permanent impairment.

Complications:
  • loss of consciousness
  • coma


Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if early signs of hypoglycemia do not improve after a snack containing sugar, or if a diabetic (or other person known to experience hypoglycemia) becomes unresponsive or unarousable.

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