The Effects Of Hypoglycemia

Glucose, a form of sugar, is the body's main fuel. Hypoglycemia, or low blood sugar, occurs when blood levels of glucose drop too low to fuel the body's activity.

Carbohydrates (sugars and starches) are the body's main dietary sources of glucose. During digestion, the glucose is absorbed into the blood stream (hence the term "blood sugar"), which carries it to every cell in the body. Unused glucose is stored in the liver as glycogen.

Hypoglycemia can occur as a complication of diabetes, as a condition in itself, or in association with other disorders.

The amount of glucose in the blood is controlled mainly by the hormones insulin and glucagon. Too much or too little of these hormones can cause blood sugar levels to fall too low (hypoglycemia) or rise too high (hyperglycemia). Other hormones that influence blood sugar levels are cortisol, growth hormone, and catecholamines (epinephrine and norepinephrine).

A person with hypoglycemia may feel weak, drowsy, confused, hungry, and dizzy. Paleness, headache, irritability, trembling, sweating, rapid heart beat, and a cold, clammy feeling are also signs of low blood sugar. In severe cases, a person can lose consciousness and even lapse into a coma.

The symptoms associated with hypoglycemia are sometimes mistaken for symptoms caused by conditions not related to blood sugar. For example, unusual stress and anxiety can cause excess production of catecholamines, resulting in symptoms similar to those caused by hypoglycemia but having no relation to blood sugar levels.

The most common cause of hypoglycemia is as a complication of diabetes. Diabetes occurs when the body cannot use glucose for fuel because either the pancreas is not able to make enough insulin or the insulin that is available is not effective. As a result, glucose builds up in the blood instead of getting into body cells.

The aim of treatment in diabetes is to lower high blood sugar levels. To do this, people with diabetes may use insulin or oral drugs, depending on the type of diabetes they have or the severity of their condition. Hypoglycemia occurs most often in people who use insulin to lower their blood sugar. All people with type 1 diabetes and some people with type 2 diabetes use insulin. People with type 2 diabetes who take oral drugs called sulfonylureas are also vulnerable to low blood sugar episodes.

Conditions that can lead to hypoglycemia in people with diabetes include taking too much medication, missing or delaying a meal, eating too little food for the amount of insulin taken, exercising too strenuously, drinking too much alcohol, or any combination of these factors. People who have diabetes often refer to hypoglycemia as an "insulin reaction."

Hypoglycemia in people who do not have diabetes is far less common than once believed. However, it can occur in some people under certain conditions such as early pregnancy, prolonged fasting, and long periods of strenuous exercise. People on beta blocker medications who exercise are at higher risk of hypoglycemia, and aspirin can induce hypoglycemia in some children. Drinking alcohol can cause blood sugar to drop in some sensitive individuals, and hypoglycemia has been well documented in chronic alcoholics and binge drinkers. Eating unripe ackee fruit from Jamaica is a rare cause of low blood sugar.

A diagnosis of reactive hypoglycemia is considered only after other possible causes of low blood sugar have been ruled out. Reactive hypoglycemia with no known cause is a condition in which the symptoms of low blood sugar appear 2 to 5 hours after eating foods high in glucose.

Ten to 20 years ago, hypoglycemia was a popular diagnosis. However, studies now show that this condition is actually quite rare. In these studies, most patients who experienced the symptoms of hypoglycemia after eating glucose-rich foods consistently had normal levels of blood sugar--above 60 mg/dL. Some researchers have suggested that some people may be extra sensitive to the body's normal release of the hormone epinephrine after a meal.

People with symptoms of reactive hypoglycemia unrelated to other medical conditions or problems are usually advised to follow a healthy eating plan. The doctor or dietitian may suggest that such a person avoid foods high in carbohydrates; eat small, frequent meals and snacks throughout the day; exercise regularly; and eat a variety of foods, including whole grains, vegetables, and fruits.

Fasting hypoglycemia occurs when the stomach is empty. It usually develops in the early morning when a person awakens. As with other forms of hypoglycemia, the symptoms include headache, lack of energy, and an inability to concentrate. Fasting hypoglycemia may be caused by a variety of conditions such as hereditary enzyme or hormone deficiencies, liver disease, and insulin-producing tumors.

In hereditary fructose intolerance, a disorder usually seen in children, the body is unable to metabolize the natural sugar fructose. Attacks of hypoglycemia, marked by seizures, vomiting, and unconsciousness, are treated by giving glucose and eliminating fructose from the diet.

Galactosemia, a rare genetic disorder, hampers the body's ability to process the sugar galactose. An infant with this disorder may appear normal at birth, but after a few days or weeks of drinking milk (which contains galactose), the child may begin to vomit, lose weight, and develop cataracts. The liver may fail to release stored glycogen into the blood, triggering hypoglycemia. Removing milk from the diet is the usual treatment.

Glycine can be used for the treatment of hypoglycemia. Glycine stimulates the release of glucagon, which mobilizes glycogen, which is then released into the blood as glucose. Hypoglycemia can cause potassium loss.

Discuss It!