Hypoglycemia simply means low levels of glucose in the blood. Glucose is the main source of energy and harmfully low levels of it can cause symptoms such as dizziness, anxiety, sweating and loss of consciousness. Usually, glucose levels below 50mg/dL cause symptoms to arise.

CAUSES

Hypoglycemia occurs due to various reasons in both diabetic and non-diabetic patients. It is more common in diabetic patients, occurring due to overdoses, medications, infections, diet patterns, activities, and metabolic changes. In both groups, it can be due to insulin-releasing tumors, endocrine defects, liver diseases, kidney failure, starvation and use of drugs like insulin and some anti-depressants.

CLINICAL FEATURES

Symptoms of hypoglycemia in the early phase often include hunger, sweating, anxiety, weakness, inability to concentrate, tremors, dizziness, and palpitations. Without a quick resolution, this may progress to confusion, fainting, convulsions, loss of consciousness, coma and death.

MANAGEMENT

Following presentation, an assessment of the patient’s history will be done. The drug and feeding history would be enquired alongside medical history. The use of alcohol and family history of diabetes or diabetes-related diseases will also be noted.

A physical examination noting the vital signs, endocrine and neurological signs should be done. A random blood sugar test should be done immediately the patient presents at a health facility. Diabetic patients should be taught to identify signs of hypoglycemia and conduct sugar tests on themselves. To follow-up and investigate the cause, an oral glucose tolerance test should be done. This will suggest the likely causes of the problem. Immunochemistry tests and radiological studies assessing insulin function will also be done to investigate excess production of endogenous hormones.

The aim of treatment of hypoglycemia is to supply glucose to the body. Hence, ingestion of glucose-containing fluids is recommended. Diabetic patients on insulin therapy take these fluids when they notice symptoms of hypoglycemia. Depending on the effectiveness of glucose administration, other medications might also be prescribed.

If hypoglycemia is recurrent and due to insulin-releasing tumors, surgery is recommended.

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