Hypoglycemia

Diabetes and Foot Problems Slideshow

Medical Author: Ruchi Mathur, MD
Medical Editor: William C. Shiel Jr, MD, FACP, FACR and Melissa Conrad Stöppler, MD

• What is hypoglycemia?
• Who is at risk for hypoglycemia?
• I thought high blood sugar was bad. Why is low blood sugar also bad?
• Can the body protect itself from hypoglycemia?
• What are symptoms of hypoglycemia and how low is too low?
• How is hypoglycemia treated?
• Is there anything else that should be done to manage hypoglycemia?
• Patient Discussions: Hypoglycemia - Effective Treatments

Hypoglycemia & Diabetes: How Low Can You Go? Medical Author: Ruchi Mathur, M.D. Medical Editor: William C. Shiel, Jr., MD, FACP, FACR I am fortunate to have a team of great nurses and a wonderful nutritionist in my office. As I was on my way into see a patient, I overheard one of our nurses going into a great deal of detail educating a young patient with diabetes about the concerns of low blood sugar. Her talk reminded me that this is a subject of great importance to patients with diabetes. I will take this opportunity to highlight information on issues related to hypoglycemia. Namely, what are the signs and symptoms of hypoglycemia, when should you be concerned, what to do for treatment, and when you should seek medical attention. Despite significant advances in diabetes treatment, hypoglycemia (low blood sugar or glucose) is still a common problem among patients who are trying to achieve better control of their blood sugar. Read more about hypoglycemia and diabetes. » Top Searched Hypoglycemia Terms: reactive hypoglycemia, hypoglycemia diet, hypoglycemia symptoms, low blood sugar, hypoglycemia treatment, diabetes, hypoglycemia & pregnancy, diabetic shock symptoms, metabolic disorder

What is hypoglycemia?

Hypoglycemia is the clinical syndrome that results from low blood sugar. The symptoms of hypoglycemia can vary from person to person, as can the severity. Classically, hypoglycemia is diagnosed by a low blood sugar with symptoms that resolve when the sugar level returns to the normal range.

Who is at risk for hypoglycemia?

While patients who do not have any metabolic problems can complain of symptoms suggestive of low blood sugar, true hypoglycemia usually occurs in patients being treated for diabetes (type 1 and type 2). Patients with pre-diabetes who have insulin resistance can also have low blood sugars on occasion if their high circulating insulin levels are further challenged by a prolonged period of fasting. There are other rare causes for hypoglycemia, such as insulin producing tumors (insulinomas) and certain medications. These uncommon causes of hypoglycemia will not be discussed in this article, which will primarily focus on the hypoglycemia occurring with diabetes mellitus and its treatment.

Despite our advances in the treatment of diabetes, hypoglycemic episodes are often the limiting factor in achieving optimal blood sugar control. In large scale studies looking at tight control in both type 1 and type 2 diabetes, low blood sugars occurred more often in the patients who were managed most intensively. This is important for patients and physicians to recognize, especially as the goal for treating patients with diabetes become tighter blood sugar control.

I thought high blood sugar was bad. Why is low blood sugar also bad?

The body needs fuel to work. One of its major fuel sources is sugars, which the body gets from what is consumed as either simple sugar or complex carbohydrates. For emergency situations (like prolonged fasting), the body stores a stash of sugar in the liver as glycogen. If this store is needed, the body goes through a biochemical process called gluco-neo-genesis (meaning to "make new sugar") and converts these stores of glycogen to sugar. This backup process emphasizes that the fuel source of sugar is important (important enough for human beings to have developed an evolutionary system of storage to avoid a sugar drought).

Of all the organs in the body, the brain depends on sugar (which we are now going to refer to as glucose) almost exclusively. Rarely, if absolutely necessary, the brain will use ketones as a fuel source, but this is not preferred. The brain cannot make its own glucose and is 100% dependent on the rest of the body for its supply. If for some reason, the glucose level in the blood falls (or if the brain's requirements increase and demands are not met) there can be effects on the function of the brain.

Hypoglycemia - Effective Treatments

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