Hypoglycemia

Causes and Risks:
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.

Relative hypoglycemia is a fairly common occurrence in the newborn. Significant hypoglycemia may occur in a newborn infant from a gestational diabetic or a diabetic mother (called an IDM for "infant of diabetic mother"). If the mother's blood sugar was persistently high, the infant's pancreas assisted in controlling the excess blood sugar by secreting extra insulin. When the infant is born, that maternal blood sugar is no longer available and the increased insulin drives the infant's blood sugar down to dangerous levels. This is a medical emergency that may result in seizures and neurological damage if not treated.

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.

Prevention:
Diabetics should follow their health care provider's advice regarding diet, medications, and exercise .

Pregnant diabetic women should maintain careful control of their blood sugar. Gestational diabetes is recognized by repeat testing of expectant mothers. Upon delivery, routine blood sugar levels are obtained from the infant until the period for hypoglycemia is past.

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:

Additional symptoms that may be associated with this disease:



Signs and Tests:

This disease may also alter the results of the following tests:



Treatment:
For the immediate reaction, a snack containing sugar will raise the blood-glucose level , and an improvement in symptoms should be realized.

Infants of diabetic mothers that develop low blood sugars are treated with IV glucose solutions to maintain the blood sugar at normal levels. The glucose is slowly tapered over the next 24-48 hours while the infant begins to regulate its blood sugar at normal levels.

If 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.

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:

In the infant



Call Your Healthcare 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.