Today we are going to give you a brief introduction to what hypoglycemia is, for those of you out there who may have recently been confronted or familiarized with the diagnose. We’ve been graced with the guest writer, Jacob Sten Peterson who is a well renowned expert on the subject, and are keen on giving you an intro. Without further ado, here we go:
By Jacob Sten Petersen, MSc, DMSc, Professor
Glucose is your body’s main energy source and vital for your survival. When you eat, your body breaks down carbohydrates from eg fruit, vegetables, bread, rice, pasta, milk and soft drinks into glucose that is then taken up into the blood stream. Insulin is one of the main hormones produced by beta cells in the pancreas that is regulating your blood glucose facilitating that glucose can be taken up from the blood and utilized as energy inside the cells, thus without insulin it will not be possible to sustain life.
Any extra glucose is primarily stored in your liver. If you haven’t eaten for several hours you blood sugar level will normally begin to drop. However, another hormone, glucagon produced by alpha cell in your pancreas, will be released and signal to your liver to release your glucose back to the blood stream thereby increasing your blood sugar levels so it stays within the normal range until you eat again. Normal blood glucose levels in healthy individuals are around 100 milligrams per deciliter (mg/dL) or 5.5 millimoles per liter (mmol/L).
Hypoglycemia is caused by a low level of blood sugar (glucose) and is often a associated complication to the treatment of type 1 diabetes and type 2 diabetes in particular in patients using insulin. The insulin producing beta cells are during type 1 diabetes being destroyed by our immune system in a process referred to as autoimmunity similar to joints being destroyed in Rheumatoid Arthritis. In type 2 diabetes the beta cells cannot keep up with the large demand for insulin due to an excessive caloric intake and consequently dies from exhaustion. Thus, both type 1 and type 2 diabetic patients will need insulin and since the insulin levels have to be regulated within a very small margin/range there is a risk of developing hypoglycemia in patients being treated with insulin.
There can also be other cause for developing hypoglycemia than treatment with insulin but they are more rare and include eg:
- Heavy drinking without eating can prevent your liver from releasing stored glucose, causing hypoglycemia.
- Severe hepatitis, can cause hypoglycemia again because the ability of the liver to release glucose is compromised.
- Eating disorders like anorexia nervosa, can result in the depletion of glucose from the liver and thereby cause hypoglycemia.
- Insulinoma which is a tumor in the pancreas overproducing insulin can result in hypoglycemia.
- Rare genetic disorders like hyperinsulinism where the regulation of insulin is defect so the beta cell in the pancreas overproduce insulin and thereby cause hypoglycemia.
Symptoms of Hypoglycemia
Immediate treatment of hypoglycemia is necessary when blood sugar levels are at 70 mg/dL or 3.9 mmol/L or below. Treatment involves quick steps to get your blood sugar level back into a normal range either with high-sugar/glucose foods or drinks or with medications like injection with glucagon that as mention above will results in release of glucose from the liver and thereby and increasing in your blood glucose levels.
If blood sugar levels become too low eg due to an excess of insulin, signs and symptoms may include:
- Difficult to concentrate, clumsiness, trouble talking, pale skin, confusion, feeling of hunger, sweating, shakiness, weakness, anxiety, headache.
If hypoglycemia is not treated symptoms can very fast deteriorate and develop into a life threating situation characterized by:
- An irregular heart rhythm, severe confusion, abnormal behavior such as the inability to complete routine tasks, blurred vision, shaking, seizures and finally loss of consciousness and death.
If a patient develops some of the above symptoms of severe hypoglycemia and countermeasure to elevate blood glucose (see below) fails and the symptoms are not improved, contact your doctor/hospital right away and/or seek emergency help. Always seek emergency help if a person is unconscious
Fortunately, hypoglycemia is a rarely today associated with death because treatment options for diseases associated with hypoglycemia like diabetes have much better treatment options then just a few decades ago. In addition, electronic glucose monitoring systems are now so advanced and small that they closely can monitor development of hypoglycemia and many times in advance warn the patient that they are of risk of developing hypoglycemia so appropriate countermeasures can be taken eg like ingestion of glucose/carbohydrates
It is important to remember that the symptoms associated with severe hypoglycemia sometimes may be confused with intoxication and treated as such which can be devastating for the individual since they will not receive the appropriate help. Therefore, if you suffer from a disease/condition causing hypoglycemia never to keep it a secret because it will be very difficult for people wanting to help to know what they should do.
The longer terms effect of have recurrent hypoglycemia includes learning disabilities, memory difficulties because your brain needs glucose to function properly and increased risk of cardiovascular disease.
Treatment For Hypoglycemia
Immediate treatment of hypoglycemia is necessary when blood sugar levels are at 70 mg/dL or 3.9 mmol/L or below. Treatment involves quick steps to get your blood sugar level back into a normal range either with high-sugar/glucose foods or drinks or with medications like injection with glucagon that as mention above will results in increasing blood glucose levels
Symptoms should begin to improve within 5 minutes, though full recovery may take 10–20 minutes. The amount of glucose/carbohydrate need to adjusted individually but normally 10-20 grams of carbohydrates will raise blood glucose into the normal range. This can be repeated if blood glucose does not normalized after 15 min. It is important to know that overfeeding does not speed recovery eg in a person with diabetes only result in hyperglycemia afterwards and potential increase in body weight.
References and further inspiration
By Jacob Sten Petersen, MSc, DMSc, Professor