Hypoglycemia – Symptoms and Causes

What is Hypoglycemia?

Hypoglycemia occurs when blood sugar levels drop below normal range. Blood glucose is essential for your body’s energy needs. When levels fall too low, immediate action is required. Target levels may vary by individual.

Many cases of hypoglycemia are linked to diabetes treatments. However, certain medications and various medical conditions can cause low blood sugar even in people without diabetes.

Treatment approaches:

1. Quick relief through consuming sugar-rich foods or drinks
2. Taking prescribed medication when needed
3. Long-term management by identifying and addressing underlying causes

If you experience frequent episodes of low blood sugar, consult with your healthcare provider to determine appropriate blood glucose targets and treatment strategies.

Symptoms

People with low blood sugar may experience several signs. These include looking pale, shaking, sweating, and headaches. You might feel hungry or sick to your stomach. Your heart might beat fast or irregularly.

Feeling tired, irritable, or anxious is common. You may have trouble focusing, feel dizzy, or notice tingling in your lips or tongue.

As blood sugar drops further, symptoms worsen. You might become confused or act strangely. Simple tasks may become difficult. Your coordination might suffer, and your speech may slur. Vision can become blurry. If asleep, you might have nightmares.

In severe cases, a person may:

• Lose consciousness
• Have seizures

When to Get Medical Help

See a doctor right away if:

• You have symptoms of low blood sugar but don’t have diabetes
• You have diabetes and your low blood sugar doesn’t improve after treatment (drinking juice or regular soda, eating candy, or taking glucose tablets)

Get emergency help if someone with diabetes or a history of low blood sugar shows severe symptoms or becomes unconscious.

What Causes Low Blood Sugar?

Your body needs a steady supply of blood sugar (glucose) to work properly. After you eat, food breaks down into glucose that enters your bloodstream. A hormone called insulin helps this glucose move from your blood into your cells.

Any extra glucose gets stored in your liver and muscles as glycogen for later use. When you haven’t eaten for a while, your blood sugar drops.

Your body stops making insulin and releases a different hormone called glucagon. This tells your liver to turn stored glycogen back into glucose and release it into your blood. This keeps your blood sugar levels steady between meals.

Your body can also make glucose from other sources. This happens mainly in your liver and kidneys. During long periods without food, your body can break down fat stores to use as fuel.

Causes in People With Diabetes

People with diabetes have problems with insulin. Those with type 1 diabetes don’t make insulin. Those with type 2 diabetes don’t respond well to it. This causes blood sugar to build up to high levels.

Taking insulin or diabetes medications helps lower blood sugar. But sometimes these treatments can make blood sugar drop too low, causing hypoglycemia. This happens when:

• You take too much medication
• You eat less food than usual
• You exercise more than normal
• You drink alcohol

Causes in People Without Diabetes

Low blood sugar is less common in people without diabetes. Here are some possible causes:

Taking the Wrong Medications

• Accidentally taking someone else’s diabetes pills
• Some medications like quinine (used for malaria)
• Drug interactions, especially in people with kidney problems

Alcohol Consumption

• Heavy drinking without eating can stop your liver from releasing glucose

Serious Health Conditions

• Severe liver disease (hepatitis, cirrhosis)
• Serious infections
• Kidney disease
• Advanced heart disease

Not Getting Enough Food

• Long-term starvation
• Eating disorders like anorexia nervosa

Hormone problems

• Rare pancreatic tumors (insulinomas) that produce too much insulin
• Other tumors making insulin-like substances
• Abnormal pancreatic cells releasing excess insulin
• Adrenal or pituitary hormone deficiencies
• Growth hormone shortage in children

Low Blood Sugar After Eating

Sometimes low blood sugar happens after meals instead of during fasting. This is called reactive or postprandial hypoglycemia. Doctors aren’t completely sure why this happens.

This type often occurs in people who have had stomach surgeries that change how food moves through the digestive system. Gastric bypass surgery is the most common example, but other stomach operations can cause this problem too.

The rapid movement of food and quick absorption of glucose can trigger an excessive insulin response, causing blood sugar to drop too low shortly after eating.

Health Complications

People who have many low blood sugar episodes over time may stop feeling the warning signs. Their body no longer sends clear signals like shakiness or fast heartbeat when blood sugar drops too low.

This makes severe, life-threatening drops more likely.

Poorly Managed Diabetes

Fear of low blood sugar can lead some people with diabetes to take less insulin than they need. This happens because they’re trying to avoid the scary feeling of blood sugar dropping too low.

Consequences of undertreating diabetes:

• High blood sugar levels
• Poor diabetes control
• Long-term health problems

Untreated or severe low blood sugar episodes can cause:

• Seizures
• Coma
• Death in extreme cases

Other dangers include:

• Dizziness and weakness
• Falls and injuries
• Car accidents
• Higher dementia risk in older adults

If you’re afraid of low blood sugar, talk with your healthcare provider instead of changing medication doses on your own.

Ways to Prevent Low Blood Sugar

Living with diabetes means being careful about blood sugar levels. If you change medications, eating habits, or exercise routines, talk with your doctor about how these changes might affect your blood sugar.

Always carry treatment supplies such as:

• Juice
• Hard candy
• Glucose tablets

These fast-acting carbohydrates can quickly raise your blood sugar when needed.

For People without Diabetes

If you experience low blood sugar but don’t have diabetes, eating small meals throughout the day can temporarily help prevent blood sugar drops. However, this isn’t a good long-term solution.

The most important step is to work with your healthcare provider to find and treat the underlying cause of your hypoglycemia.

Your doctor can help determine why your blood sugar levels are dropping. They can then create a treatment plan that addresses the root problem rather than just managing symptoms.