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Hypoglycemia, or hypoglycemia, develops gradually as blood sugar levels drop. The foreshadowing symptoms appear first. As glucose levels decline further, symptoms of hypoglycaemia worsen, including coma, which can be fatal. What are the causes and symptoms of hypoglycemia? What is its treatment?

Hypoglycemia(otherwisehypoglycemia , Latinhypoglycaemia ), meanslow blood sugar (glucose)- less than 70mg / dL

However, in some patients the symptoms of hypoglycaemia may occur at higher or much lower blood sugar values ​​(e.g. 40 mg / dl).

You can also talk about hypoglycaemia when the patient has symptoms of hypoglycaemia, and after the administration of carbohydrates his condition improves. Then you don't need to measure your blood sugar to diagnose hypoglycemia.

Hypoglycemia is most common in people with diabetes (more often type 1 than type 2 diabetes), usually during intensive insulin therapy, although it can also occur in people who are not diabetic.

Hypoglycemia - causes

In people with diabetes, hypoglycemia can be caused by too much injected insulin.

Of oral antidiabetic drugs, hypoglycemia can be caused by old generation drugs - especially sulfonylureas (but less frequently than insulin).

The next-generation drugs, gliptin, are "intelligent" and only lower blood sugar when it is too high.

Too low blood sugar can also be the result of some medications, alcohol.

The cause of hypoglycaemia may also be a dietary error - a delayed, missed or too small meal, as well as too long a break between meals or an increased interval between insulin injection and a meal.

Unplanned, prolonged or strenuous exercise also has an impact on the drop in blood sugar levels. Drinking too much alcohol, especially on an empty stomach, can also lower your blood sugar levels.

In people who are not diabetic, hypoglycemia can also be caused by nervous tension and stress. These two factors stimulate the adrenal glands to continue working and producing, among others, adrenaline thatstops the pancreas from producing too much insulin.

However, with a stressful lifestyle, the adrenal glands can overload, which results in adrenaline deficiency, and thus - excessive insulin production. And too much of this substance in the body dangerously lowers blood sugar levels.

Hypoglycemia - what diseases can it indicate?

In people who are not diabetic, hypoglycemia may be a symptom of liver disease (eg acute liver failure) and kidney disease, and less commonly of insulinoma, a cancer of the pancreas. Low sugar may also indicate:

  • adrenal insufficiency (e.g. in Addison's disease)
  • pituitary gland failure
  • hypothyroidism
  • glycogen storage diseases (e.g. Pompe disease)

Hypoglycemia - how to recognize its symptoms?

The symptoms of hypoglycemiaare the result of a glucose deficiency in the central nervous system. First, the foreshadowing symptoms appear.

It is possible for some patients to develop early symptoms of hypoglycaemia with a delay or not at all. This is known as "hypoglycemic unawareness". It especially applies to patients who have diabetes for a long time or have frequent episodes of hypoglycaemia.

Later they are accompanied by symptoms of severe hypoglycaemia. In the final stages of hypoglycaemia, there is loss of consciousness and coma. If the patient is not given first aid, he may die.

Symptoms of hypoglycemiadevelop gradually as blood sugar levels drop. Thanks to this, a patient in the initial stage of development of hypoglycaemia is able to cope with himself, e.g. by eating something sweet.

Worse if the first symptoms of hypoglycaemia are ignored. Then the patient is not able to provide himself properly, and failure to give glucose may lead to coma and even death.

Early symptoms of hypoglycemiaSymptoms of severe hypoglycaemia
strong feeling of hungerdifficulty associating and thinking
nausea and vomitingdisorientation
anxietyspeech and coordination disorders
irritability and nervousnessmemory impairment
pallormemory loss
wet sweatscoma
accelerated heartbeat
moderate pressure increase
dilated pupils
According to an expertDr. Anna Staniszewska, MD, Chair and Department of Experimental and Clinical Pharmacology of the Medical University of Warsaw

Hypoglycaemia and excessive sleepiness

Excessive sleepiness is a very common symptom of fluctuating blood sugar levels. If it is accompanied by other symptoms - more frequent and increased urination, increased thirst, or weight loss, then you may suspect diabetes. Sleepiness can also be a symptom of both hypo- and hyperglycaemia.

In hypoglycemia it is accompanied by, among others drenching sweats, feeling hungry, and in hyperglycemia dry mouth, and in addition to the feeling of hunger, increased thirst. In early hypoglycemia (initial symptoms), the first autonomic symptoms appear, incl. sweating, pallor, restlessness, and then neuroglycopenia symptoms - from the CNS, including somnolence.

Hypoglycemia like intoxication

The symptoms of hypoglycaemia can be like falling in love, drunk and even going crazy.

It happens that a person with low blood sugar is taken to a sobering-up center, where he is not given medical help (glucose administered orally or intravenously, depending on the patient's condition, or glucagon - intramuscularly).

Therefore, patients with diabetes should wear an information bracelet, an appropriate information card in their wallet, and a glucagon kit.

Night hypoglycemia

Sometimes hypoglycemia happens in a dream. Its symptoms can be nightmares, and when you wake up, you feel like you have a hangover.

Worth knowing

Hypoglycemia at night - what to do?

The patient should check the blood glucose level between the 2nd and 4th night (then hypoglycaemia is the most common), especially if he is treated with NPH insulin and experiences fatigue, headaches in the morning or sleeps restlessly at night, sweats, as these symptoms could indicate the presence of nocturnal hypoglycaemia.

If your blood sugar at night is lower than 70 mg / dL, you may be diagnosed with nocturnal hypoglycaemia. Then you should see a doctor to solve this problem. It is worth knowing that at night there should always be something sweet next to the sick bed - just in case.

Hypoglycemia - treatment and first aid

First aid in a hypoglycemic attackshould be provided as soon as possible after the first symptoms of a drop in blood glucose appear. If the patient is not treated, he or she may lead to coma and even death.

1) Slight hypoglycemia

In the case of mild to moderate hypoglycaemia, patientis conscious and can help himself. Then the first aid consists of:

  • administration of simple carbohydrates that will quickly enter the bloodstream, e.g. sugar cubes, water with a teaspoon of sugar, coca-cola (but not light, i.e. zero). After 10 minutes, the patient should feel better. Fortunately, diabetics know that they can have a hypoglycemic attack, so they usually carry glucose tablets, liquid or gel, or something sweet with them
  • administration of complex carbohydrates (e.g. sandwiches made of whole grain bread), which release sugar much slower into the bloodstream, and thus - prevent the recurrence of hypoglycaemia
  • blood glucose control (after 1 hour)

Chocolate is not recommended in case of hypoglycaemia!

In case of hypoglycaemia, it is not advisable to eat chocolate and products containing it (e.g. bars), because chocolate contains fat that delays the absorption of carbohydrates. Light products are also not recommended.

2) Moderate to severe hypoglycaemia

With moderate to severe hypoglycaemia, the patient is conscious but requires the help of others. Then you should look for glucagon in his stuff (diabetic patients usually carry the drug with them), which must be administered intramuscularly (in a dose of 1 mg). If the patient's condition does not improve after 10 minutes, another dose should be administered.

3) Severe hypoglycaemia - patient is unconscious

You cannot give anything by mouth to an unconscious person, as it may cause you to choke. Place the sick person in the side position, with their head tilted back, and call for an ambulance. In such a situation, it is necessary to administer glucose intravenously (20% solution), followed by a 10% solution. glucose. Only after regaining consciousness, can carbohydrates be administered and blood glucose monitored.

For 10 percent of all deaths from diabetes correspond to hypoglycaemia.

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