Hypoglycemia
Hypoglycemia is a pathologic state that is caused by neuronal glucose deprivation. Brain metabolism depends primarily on glucose as energetic material. When blood glucose levels decrease a group of homeostatic mechanisms come into play as a reaction to that phenomenon. This syndrome is called hypoglycemia.
Causes of hypoglycemia
The main cause of hypoglycemia is intentional or accidental overdose of antidiabetic medication, insulin or oral drugs, or failure to eat as planned after taking those medications. There are other causes as well, both in diabetic or non-diabetic people.
Another serious cause of hypoglycemia is the 'insulinoma', a pancreatic tumor that is derived from B (beta) cells of islets of Langerhans. These tumours are hormonally active, producing and releasing insulin into bloodstream. C-peptide levels can distinguish between abnormally high insulin levels that result from overproduction, and those caused by administration of exogenous insulin.
Hypoglycemia can differ in both its causes and treatments depending on whether or not the person has diabetes.
Hypoglycemia can occur in people with diabetes who take certain medications to keep their blood glucose levels in control. Usually hypoglycemia is mild and can easily be treated by eating or drinking something with carbohydrate. But left untreated, hypoglycemia can lead to loss of consciousness.
Two types of hypoglycemia can occur in people who do not have diabetes: reactive (postprandial, or after meals) and fasting (postabsorptive). Reactive hypoglycemia is not usually related to any underlying disease; fasting hypoglycemia often is.
In reactive hypoglycemia, symptoms appear within 4 hours after you eat a meal. Not all causes are not well understood, though some are. Researchers are still debating which causes are more prevalent.
Fasting hypoglycemia is diagnosed from a blood sample that shows a blood glucose level of less than 50 mg/dL after an overnight fast, between meals, or after exercise.Causes include certain medications, alcohol, critical illnesses, hormonal deficiencies, some kinds of tumors, and certain conditions occurring in infancy and childhood.
Hypoglycemia is usually divided into "reactive hypoglycemia" and "functional hypoglycemia." Reactive hypoglycemia refers to hypoglycemia caused by external influences, like diet and medication use. This type is more amenable to management or cure. Functional hypoglycemia refers to hypoglycemia caused by a malfunction, possibly metabolic, within the sufferer. This type is harder to manage. Functional hypoglycemia is caused by an overproduction of insulin, or a malfunctioning of the body's insulin-management system (insulin resistance. Hypoglycemia is also known as idiopathic if no physical cause for the bloodsugar drop can be discerned.
Symptoms of hypoglycemia
Generally they can be divided into effects on the central nervous system and those caused by release of antagonistic hormones.
It should be said that severity of hypoglycemic symptoms depends on
level of blood glucose drop, speed of the drop and overall health status.
- impaired consciousness and cognitive properties
- overwhelming fatigue
- tremor
- constant hunger
- sweats
- nervousness, anxiety
- restlessness
- fear of dying
- confusion, delirium
- dizziness
- fainting
- headaches
- muscle pain
- memory loss
In severe cases the symptoms can resemble various mental illnesses; when left untreated the condition can even induce coma.
Treatment
For a hypoglycemic episode, if the patient is conscious, eating or drinking something that is rich in simple carbohydrates, such as fruit juice, hard candy, 4 oz. of non-diet soda, etc. can be enough.
If not, intravenous injection of glucose and/or injection of glucagon that
is a hormone with antagonistic properties counteracting the
hypoglycemic state. When injecting anything to a diabetic patient under a state of Hypoglycemia, one must be careful not to inject insulin accidentally, under the typical confusion this type of emergency brings. This would cause the diabetic person immediate death.
For long-term treatment, of reactive hypoglycemia, some experts recommend:
- eat small meals and snacks about every 3 hours
- exercise regularly
- choose high-fiber foods
- avoid or limit foods high in sugar, especially on an empty stomach
- eat a variety of foods including:
- meat, poultry, fish, or nonmeat sources of protein
- starchy foods such as whole-grain bread, rice, and potatoes
- fruits
- vegetables
- dairy products
Treatment for fasting hypoglycemia varies a great deal by cause. See a medical professional to further examine the cause so an appropriate treatment option can be used.
See also
