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Health Condition

Hypoglycemia

About This Condition

“Hypoglycemia” is the medical term for low blood sugar (glucose).

People with diabetes who use medications, particularly insulin, to control their blood glucose sometimes develop hypoglycemia. This can be caused by not having a stable intake of carbs—not eating enough of them, eating them erratically, or not adjusting for an increase in physical activity—to balance the blood glucose-lowering effect of these medications.1,2

Early symptoms of hypoglycemia typically come on quickly and can include shakiness, anxiety, irritability, hunger, confusion, light headedness, and rapid heartbeat, but some people do not experience or detect these early symptoms.3 Hypoglycemia can contribute to falls, accidents, and other kinds of injuries; if untreated, it can progress from severe confusion to unconsciousness, seizure, coma, or even death.4 In addition, over time, people with diabetes who have repeated episodes of hypoglycemia appear to have a higher risk of dementia.5

People who use insulin to control their diabetes can generally prevent hypoglycemia by using their insulin as prescribed and sticking to an eating pattern that provides the same amounts of carbs at the same times each day. Using a blood glucose monitor can help people identify when their blood glucose is getting low so they can take steps to prevent hypoglycemia. Alcohol makes controlling blood glucose levels with insulin difficult, so drinking alcohol in moderation is best.2

People with diabetes using diabetes medications other than insulin can usually prevent hypoglycemia by eating on a regular schedule, making wise food choices, and having a consistent exercise program. Fasting for lab tests, delaying meals, increasing physical activity, and sleeping are examples of situations that increase the risk of hypoglycemia. Being aware of the risks, watching for symptoms, and monitoring blood glucose can help people with diabetes act fast to avoid hypoglycemia.4

Symptoms

Common symptoms of hypoglycemia are fatigue, anxiety, headaches, difficulty concentrating, sweaty palms, shakiness, excessive hunger, drowsiness, abdominal pain, and depression.

Other Therapies

A diet of frequent, small, high-protein, low-carbohydrate meals is often recommended. If illness prevents eating, hospitalization for intravenous glucose injections is typically required. In cases of pituitary or adrenal insufficiency, hormone replacement may be prescribed. For hypoglycemia due to an insulin-producing tumor, surgical removal of the tumor is usually recommended.

References

1. Standards of medical care in diabetes—2017: Promoting health and reducing disparities in populations. American Diabetes Association, Diabetes Care 2017;40:S6–10.

2. Standards of medical care in diabetes—2017: Lifestyle management. American Diabetes Association, Diabetes Care 2017;40:S33–43.

3. Hypoglycemia (Low Blood Glucose). American Diabetes Association [last edited 2015 Jul 1]. Available from URL: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html?loc=type1-exercise.

4. Standards of medical care in diabetes—2017: Glycemic targets. American Diabetes Association, Diabetes Care 2017;40:S48–56.

5. Standards of medical care in diabetes—2017: Comprehensive medical evaluation and assessment of comorbidities. American Diabetes Association, Diabetes Care 2017;40:S25–32.

6. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

7. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

8. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

9. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

10. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

11. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

12. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

13. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

14. Hopman WP, Houben PG, Speth PA, Lamers CB. Glucomannan prevents postprandial hypoglycaemia in patients with previous gastric surgery. Gut 1988;29:930-4.

15. Kneepkens CM, Fernandes J, Vonk RJ. Dumping syndrome in children. Diagnosis and effect of glucomannan on glucose tolerance and absorption. Acta Paediatr Scand 1988;77:279-86.

16. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

17. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

18. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

19. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

20. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

21. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

22. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

23. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

24. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

25. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

26. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

27. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

28. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

29. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

30. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

31. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

32. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

33. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

34. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

35. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

36. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

37. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

38. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

39. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

40. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

41. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

42. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

43. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

44. Sanders LR, Hofeldt FD, Kirk MC, Levin J. Refined carbohydrate as a contributing factor in reactive hypoglycemia. South Med J 1982;75:1072-5.

45. Permutt MA. Postprandial hypoglycemia. Diabetes 1976;25:719-33.

46. O'Keefe SJD, Marks V. Lunchtime gin and tonic as a cause of reactive hypoglycemia. Lancet 1977;1:1286-8.

47. Hofeldt FD. Reactive hypoglycemia. Metabolism 1975;24:1193-208.

48. Rippere V. “A little something between meals”: masked addiction not low blood blood-sugar. Lancet 1979;1:1349 [letter].

49. Watson JM, Jenkins EJ, Hamilton P, et al. Influence of caffeine on the frequency and perception of hypoglycemia in free-living patients with type 1 diabetes. Diabetes Care 2000;23:455-9.

50. Anderson JW, Herman RH. Effects of carbohydrate restriction on glucose tolerance of normal men and reactive hypoglycemic patients. Am J Clin Nutr 1975;28:748-55.

51. Ullrich IH, Peters PJ, Albrink JA. Effect of low-carbohydrate diets high in either fat or protein on thyroid function, plasma insulin, glucose, and triglycerides in healthy young adults. J Am Coll Nutr 1985;4:451-9.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.

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