| Hypoglycemia | |
|---|---|
| Other names | Hypoglycaemia, hypoglycæmia, low blood glucose |
 | |
| Glucose meter | |
| Specialty | Endocrinology |
| Symptoms | Clumsiness, difficulty talking, confusion, loss of consciousness, seizures[1] |
| Usual onset | Rapid[1] |
| Causes | Medications (insulin and sulfonylureas), sepsis, kidney failure, certain tumors, liver disease[1][2][3] |
| Diagnostic method | Blood sugar level < 3.9 mmol/L (70 mg/dL) in a diabetic[1] |
| Treatment | Eating foods high in simple sugars, dextrose, glucagon[1] |
Hypoglycemia, also known as low blood sugar, is a fall in blood sugar to levels below normal.[1] This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness, seizures or death.[1] A feeling of hunger, sweating, shakiness and weakness may also be present.[1] Symptoms typically come on quickly.[1]
The most common cause of hypoglycemia is medications used to treat diabetes mellitus such as insulin and sulfonylureas.[2][3] Risk is greater in diabetics who have eaten less than usual, exercised more than usual or drunk alcohol.[1] Other causes of hypoglycemia include kidney failure, certain tumors (such as insulinoma), liver disease, hypothyroidism, starvation, inborn error of metabolism, severe infections, reactive hypoglycemia and a number of drugs including alcohol.[1][3] Low blood sugar may occur in otherwise healthy babies who have not eaten for a few hours.[4]
The glucose level that defines hypoglycemia is variable.[1] In people with diabetes, levels below 3.9 mmol/L (70 mg/dL) are diagnostic.[1] In adults without diabetes, symptoms related to low blood sugar, low blood sugar at the time of symptoms and improvement when blood sugar is restored to normal confirm the diagnosis.[5] Otherwise, a level below 2.8 mmol/L (50 mg/dL) after not eating or following exercise may be used.[1] In newborns, a level below 2.2 mmol/L (40 mg/dL), or less than 3.3 mmol/L (60 mg/dL) if symptoms are present, indicates hypoglycemia.[4] Other tests that may be useful in determining the cause include insulin and C peptide levels in the blood.[3]
Among people with diabetes, prevention is by matching the foods eaten with the amount of exercise and the medications used.[1] When people feel their blood sugar is low, testing with a glucose monitor is recommended.[1] Some people have few initial symptoms of low blood sugar, and frequent routine testing in this group is recommended.[1] Treatment of hypoglycemia is by eating foods high in simple sugars or taking dextrose.[1] If a person is not able to take food by mouth, glucagon by injection or in the nose may help.[1][6] The treatment of hypoglycemia unrelated to diabetes includes treating the underlying problem as well and a healthy diet.[1] The term "hypoglycemia" is sometimes incorrectly used to refer to idiopathic postprandial syndrome, a controversial condition with similar symptoms that occur following eating but with normal blood sugar levels.[7][8]
References edit
- ^ a b c d e f g h i j k l m n o p q r s t "Hypoglycemia". National Institute of Diabetes and Digestive and Kidney Diseases. October 2008. Archived from the original on 1 July 2015. Retrieved 28 June 2015.
- ^ a b Yanai H, Adachi H, Katsuyama H, Moriyama S, Hamasaki H, Sako A (February 2015). "Causative anti-diabetic drugs and the underlying clinical factors for hypoglycemia in patients with diabetes". World Journal of Diabetes. 6 (1): 30–6. doi:10.4239/wjd.v6.i1.30. PMC 4317315. PMID 25685276.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ a b c d Schrier, Robert W. (2007). The internal medicine casebook real patients, real answers (3rd ed.). Philadelphia: Lippincott Williams & Wilkins. p. 119. ISBN 978-0-7817-6529-9. Archived from the original on 1 July 2015. Retrieved 18 August 2019.
- ^ a b Perkin, Ronald M. (2008). Pediatric hospital medicine : textbook of inpatient management (2nd ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 105. ISBN 978-0-7817-7032-3. Archived from the original on 1 July 2015. Retrieved 18 August 2019.
- ^ Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER, Service FJ (March 2009). "Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline". J. Clin. Endocrinol. Metab. 94 (3): 709–28. doi:10.1210/jc.2008-1410. PMID 19088155.
- ^ "FDA approves first treatment for severe hypoglycemia that can be administered without an injection". FDA. 11 September 2019. Archived from the original on 17 May 2020. Retrieved 11 November 2019.
- ^ Talreja, Roshan S. (2005). The internal medicine peripheral brain. Philadelphia, Pa.: Lippincott Williams & Wilkins. p. 176. ISBN 978-0-7817-2806-5. Archived from the original on 3 August 2020. Retrieved 18 August 2019.
- ^ Dorland's illustrated medical dictionary (32nd ed.). Philadelphia: Elsevier/Saunders. 2012. p. 1834. ISBN 978-1-4557-0985-4. Archived from the original on 3 August 2020. Retrieved 18 August 2019.