What is Hypoglycemia?
Hypoglycemia is a condition where blood sugar (glucose) levels fall below normal, typically less than 70 mg/dL. Glucose is the main source of energy for the body and brain, so when levels drop too low, it can cause a variety of symptoms and even become life-threatening if not treated promptly.
Hypoglycemia is most commonly seen in people with diabetes, especially those taking insulin or certain oral medications, but it can also occur in non-diabetic individuals under certain conditions.
What Causes Hypoglycemia?
The most common causes of hypoglycemia include:
- Diabetes medications: Especially insulin or sulfonylureas
- Skipping meals or eating too little
- Excessive exercise without proper food intake
- Alcohol consumption, especially on an empty stomach
- Critical illnesses: Such as liver disease, kidney disease, or infections
- Hormonal disorders: Such as adrenal insufficiency or certain tumors (e.g., insulinoma)
- Post-bariatric surgery: In some people after gastric bypass
What Are the Symptoms?
Symptoms of hypoglycemia can vary but usually develop quickly. Common signs include:
- Shakiness or tremors
- Sweating
- Hunger
- Dizziness or lightheadedness
- Confusion or difficulty concentrating
- Irritability or mood changes
- Fast heartbeat (palpitations)
- Blurred vision
- Weakness or fatigue
In severe cases, it may cause:
- Seizures
- Loss of consciousness
- Coma
How Is It Diagnosed?
Hypoglycemia is typically diagnosed based on three criteria known as Whipple’s triad:
- Symptoms consistent with low blood sugar
- A measured low blood sugar level (below 70 mg/dL)
- Relief of symptoms after raising blood sugar levels
Blood tests may be ordered to measure glucose, insulin, C-peptide, and other hormones, especially if the cause is unclear.
What Is the Treatment?
Treatment depends on the severity and cause:
For Mild to Moderate Hypoglycemia:
- Consume 15–20 grams of fast-acting carbohydrates, such as:
- Glucose tablets or gel
- Half a cup of fruit juice or regular soda
- 1 tablespoon of sugar or honey
- Recheck blood sugar after 15 minutes and repeat if still low
For Severe Hypoglycemia:
- If the person is unconscious or unable to swallow, emergency treatment includes:
- Glucagon injection (can be given by a caregiver)
- IV glucose in a medical setting
Long-term Management:
- Adjusting medications
- Eating regular, balanced meals
- Avoiding skipping meals or heavy alcohol intake
- Monitoring blood sugar levels frequently
Are There Any Complications?
If not treated promptly, hypoglycemia can lead to:
- Loss of consciousness
- Seizures
- Brain damage (in prolonged or repeated episodes)
- Increased risk of accidents or falls
- Cardiac arrhythmias in some individuals
Frequent episodes may also cause hypoglycemia unawareness, where the body stops showing warning symptoms, increasing risk of severe lows.
What Is the Outlook?
With proper awareness and management, most people can successfully control hypoglycemia and avoid serious complications. People with diabetes should work closely with their healthcare provider to adjust medications and lifestyle habits to prevent low blood sugar episodes.