Hypoglycemia in Patients with Diabetes

 

 

 

 

     Hypoglycemia occurs when blood glucose levels fall below 50 milligrams per deciliter (mg/dL) in healthy individuals, or below 70 mg/dL in people with diabetes. In the general population, when hypoglycemia arises from fasting, the body is typically able to maintain blood glucose levels through autonomic nervous system mechanisms and hormonal regulation.

 

 

 

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However, diabetic patients who manage their blood glucose with medication may experience hypoglycemia if they consume insufficient food or engage in excessive physical activity. This condition can be dangerous and may result in loss of consciousness.

 

 

 

 

 

 

Symptoms of Hypoglycemia

Physical Symptoms:

• Hunger
• Excessive sweating
• Anxiety
• Trembling hands, restlessness
• Palpitations, rapid heartbeat
• Elevated systolic blood pressure
• Numbness around the mouth or in other areas

 

Neurogenic (Brain-related) Symptoms:

• Low body temperature
• Fatigue, dizziness, headache
• Slowed response, confusion, lack of concentration, blurred vision, slurred speech, drowsiness, forgetfulness
• Behavioral changes
• Hemiparesis (weakness on one side of the body), resembling a stroke
• Loss of consciousness and seizures

 

Causes of Hypoglycemia

Hypoglycemia is often a side effect of insulin or other antidiabetic medications and may be exacerbated by several contributing factors:

 

• Inadequate carbohydrate intake: Carbohydrates are digested into glucose, which raises blood glucose levels. Insufficient intake can result in dangerously low blood sugar.
• Fasting: Extended periods without food, including during sleep, can cause blood sugar levels to fall too low.
• Excessive exercise: Physical activity beyond usual levels can lower blood glucose levels for up to 24 hours post-exercise.
• Alcohol consumption on an empty stomach: Alcohol impairs the body’s ability to regulate blood glucose, especially when consumed without food. It can also mask the symptoms of hypoglycemia, increasing the risk of severe episodes.
• Illness: Illness can reduce appetite or prevent food intake, leading to hypoglycemia. Diabetic patients and their caregivers should learn how to manage diabetes during concurrent illnesses.

 

Managing Hypoglycemia

Upon noticing symptoms, one should immediately check blood glucose levels using a fingertip blood test and respond accordingly:

 

1. Mild symptoms with full consciousness

If it occurs close to a main meal, eat immediately. If it occurs between meals, consume a snack such as:

 

• 240 mL of low-fat milk
• One medium-sized fruit
• 2–3 crackers

 

2. Moderate symptoms with full consciousness

Consume a fast-absorbing carbohydrate, such as:

 

• ½ cup of fresh fruit juice (unsweetened)
• 2 pieces of candy or 2 sugar cubes
• ½ cup of sweet beverage (2 tablespoons of syrup diluted to 120 mL)
• 3 teaspoons of granulated sugar
• 3 teaspoons of honey

 

 

 

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Then follow with a meal containing complex carbohydrates, such as bread, rice, or noodles.

 

 

 

3. Severe symptoms

     If the patient is unconscious or having seizures, do not give anything orally due to the risk of aspiration. Seek immediate medical attention.

 

 

 

 

 

 

Preventing Hypoglycemia

• Blood glucose monitoring: Regular blood glucose checks help plan appropriate meals and exercise. Patients with a history of unrecognized hypoglycemia should monitor more frequently, especially before driving, exercising, or working at heights.
• Consistent eating habits: A well-structured meal plan with regular snacks and appropriate carbohydrate intake is essential to maintain stable blood sugar levels.
• Avoid alcohol on an empty stomach.
• Exercise appropriately: Exercise can lower blood sugar during and for hours afterward. Diabetic patients should monitor blood glucose before, during, and after physical activity.
• Consult a physician: For advice on medication use, appropriate carbohydrate intake, and personalized exercise planning.