• Saturday February 22,2020

Hypoglycemia (low blood sugar)

Hypoglycemia is a drop in blood glucose below a level of about 60 mg / dl or 3.3 mmol / l. Hypoglycaemia is not a disease of its own in the medical sense, but rather a condition caused by other circumstances or diseases.

What is hypoglycemia?

After the first examination, a so-called blood sugar test takes place right at the beginning. With a small prick into the fingertip, a small amount of blood is taken up by means of a test strip, which can be evaluated immediately on site using a blood glucose meter.
© Piman Khrutmuang - stock.adobe.com

Hypoglycaemia is said to occur when the blood sugar level drops below certain levels. Here important organs such as the brain are not sufficiently supplied with glucose (sugar), which can lead to neurological deficits.

Hypoglycaemia is usually recognized by its symptoms, but there is not always a symptom. Depending on the severity of the hypoglycemia, the symptoms are divided into three groups.

First symptoms - also called autonomic or adrenergic drawing - manifest as cravings, nausea, vomiting, sweating and palpitations. In the further course of neurological deficits are added such. Confusion, coordination and visual disturbances. The symptoms are signs that the glucose deficiency has already affected the central nervous system. This group of symptoms are called neuroglycopic signs.

Failure to treat hypoglycaemia in the future may result in paralysis, hypoglycemic shock, and seizures. The third group of symptoms is called nonspecific signs. These are concomitant symptoms that are not characteristic of hypoglycaemia. However, nausea, dizziness and headache may be the first signs of hypoglycaemia.

causes

The causes of hypoglycaemia are very diverse. Often there are underlying diseases such. For example, diabetes mellitus. In this case, an excessively high dose of insulin may be the cause of hypoglycaemia, so that one speaks here of a so-called diabetic hypoglycemia.

Another form is the so-called reactive hypoglycemia. This often affects overweight and obese people. High intake of carbohydrates causes too much insulin to be released into the bloodstream in the short term, causing the sugar content to drop rapidly.

Further causes are heavy physical stress in the occupation as well as in the sport, since in this case the energy reserves of the body are used up, so that with a Nichtausgleich a Unterzuckerung can occur. Alcohol abuse causes the body to have more sugar, as the organs need the energy to break down the alcohol. As a result of alcohol abuse, the liver is usually severely damaged, so that it is no longer or only partially able to store or rebuild glucose.

The hormones also have an influence on the blood sugar content, they are necessary helpers to make glucose from amino acids. In various diseases such. As cancer, kidney disease and pancreatitis, various hormones such as cortisol can no longer be formed, which can lead to hypoglycemia.

Medications, gluten and fructose intolerance as well as food allergies can also be causes of hypoglycaemia.

Symptoms, complaints & signs

Hypoglycemia is characterized by symptoms such as cravings, tremors and difficulty concentrating. In many patients hypoglycemia causes severe fatigue and fatigue, often associated with impaired consciousness. These symptoms are accompanied by increased irritability and inner restlessness. In isolated cases, hypoglycaemia causes skin irritation.

Sufferers then temporarily suffer from severe itching and redness that can occur throughout the body. However, hypoglycaemia can also cause serious complications. If the hypoglycaemia is not compensated quickly, the person can lose consciousness or even go into a coma.

In less severe cases, hypoglycaemia leads to a very strong malaise in the person concerned. Mostly there is a feeling of sickness that slowly decreases after stabilization of the blood sugar level. Hypoglycaemia usually occurs suddenly or over a few hours and persists for a few hours.

If the blood sugar level is compensated early, the symptoms and discomfort can be reduced, but the concentration disorders and dizziness often persist for some time. In diabetic patients, hypoglycaemia can have life-threatening consequences. If we do not give the patient immediate insulin, he may lose consciousness and fall into a diabetic coma.

Diagnosis & History

The hypoglycemia is diagnosed by the general practitioner. Symptoms such as shaking, sweating, cravings, difficulty concentrating are first indications. After the first examination, a so-called blood sugar test takes place right at the beginning. With a small prick into the fingertip, a small amount of blood is taken up by means of a test strip, which can be evaluated immediately on site using a blood glucose meter.

In the evaluation, it should be noted whether the patient is a diabetic or not. Non-diabetics are said to have a hypoglycaemia of less than 60 mg / dl. In diabetics, however, a value of less than 80 mg / dl may be considered as hypoglycaemia, as they are usually used to higher blood sugar levels.

Slight hypoglycaemia such as B. can occur after sporting activity, are relatively harmless. Frequent onset, however, can lead to a habituation, so that life-threatening complications in the form of hypertension and CHD (coronary heart disease) can arise.

Since hypoglycaemia sometimes has no symptoms, a slight hypoglycaemia can be overlooked and immediately form severe hypoglycaemia. The course of a severe hypoglycaemia with hypoglycemic shock may u. U. life threatening. Since this condition is often associated with paralysis and unconsciousness, immediate emergency medical help is needed.

Studies in type 2 diabetics have shown that recurrent severe hypoglycaemia increases the risk of developing dementia later.

complications

Hypoglycemia severely limits the life of the patient. Not infrequently, sufferers faint and lose consciousness, which can occur mainly through strenuous physical activities or sports activities. It comes to a concentration disorder and a coordination disorder. The victim suffers from cravings and often trembles.

Furthermore, there is an inner restlessness and the patient suffers from perspiration or panic attacks. If it comes to unconsciousness, then the patient may injure in a possible fall or suffocate afterwards. As a rule, help from another person is always necessary. If the hypoglycemia persists over a longer period of time, it can also lead to damage to the organs or to paralysis.

These are in many cases not reversible and therefore can not be treated later. Likewise, there is an increased risk of dementia due to hypoglycaemia. The treatment of hypoglycaemia is in most cases acute by the addition of glucose. There are no further complications. The symptoms and consequential damage, however, depend on the duration of hypoglycaemia.

When should you go to the doctor?

Symptoms of cravings, weakness, and tremors may be due to hypoglycaemia. A doctor should be consulted if the symptoms persist for several days or reoccur within a few weeks. If further symptoms such as irritability, inner restlessness or lack of concentration occur, medical advice is also required. A low blood sugar level indicates diabetes or other serious illness that, if not already done, needs to be diagnosed and treated. Therefore, a doctor should be consulted at the first sign of hypoglycaemia.

If symptoms of paralysis, panic attacks or coordination problems occur, it is best to call the emergency physician or to bring the affected person immediately to the nearest clinic. Persons suffering from diabetes mellitus, cancer, pancreatitis or hormonal imbalances should consult with the responsible physician if signs of hypoglycaemia occur. Even overweight people and alcoholics are among the risk groups, the symptoms should immediately clarify. With children who show signs of low blood sugar levels is best gone to the pediatrician.

Treatment & Therapy

In the treatment of hypoglycemia one can distinguish between acute therapy and long-term therapy. The form of therapy depends on the blood sugar values.

The immediate therapy can look like this:

If the blood sugar value is less than 80 mg / dl usually a meal is enough to balance the glucose balance again.

At levels below 60 mg / dl, one to two pieces of glucose (1 BE) help reduce the symptoms of hypoglycaemia. After about 30 minutes, a blood glucose test should take place.

In case of severe hypoglycaemia with levels below 50 mg / dl, emergency medical care is urgently required, since only an intravenous dose of glucose can help to balance the blood sugar balance. Furthermore, close blood glucose monitoring over a longer period is required.

The long-term therapy includes at the beginning of an intensive education of the person concerned. If hypoglycaemia is present in a diabetic, relatives should also learn how to use pre-filled glucagon syringes so that they can be injected into the thigh or buttocks of the person in need.

prevention

Preventive measures for hypoglycaemia include the education and training of those affected and their relatives. People who frequently suffer from low blood sugar should regularly check their blood sugar level. For this there are cheap devices for household use, which can be carried because of their manageability also with them.

It is important that sufferers eat regularly and healthy, especially when there are physical strains. Alcohol should be avoided. Patients should always take glucose for immediate therapy. Furthermore, it makes sense to keep a hypoglycemia diary, which indicates when and in which activities the hypoglycaemia occurs.

aftercare

Hypoglycemia (low blood sugar) requires follow-up even after timely and successful treatment. This applies on the one hand the regeneration of the weakened organism and on the other hand the prevention of a new hypoglycemia. First of all, the patients affected by hypoglycaemia enjoy physical rest and also avoid mental agitation.

Both have an effect on the blood sugar level, which, however, should be kept at a stable level after successfully treated hypoglycaemia, as long as the person has to recover from the disease. Part of the aftercare is therefore the initial renunciation of sport, which must be maintained for a long time. In addition, measures are to be planned with regard to the future that counteract hypoglycaemia during exercise.

These include, above all, regular meal breaks and, if necessary, measuring the blood sugar level. The same applies to the working life of the patients, especially when doing physically more or less strenuous activities. For the follow-up of a disease-related hypoglycaemia is also necessary to develop an adequate menu.

This includes not only the type and extent of meals, but also the time of their ingestion. A professional nutritionist can offer meaningful support. In addition, those affected arrange regular follow-up appointments with their doctor in order to keep a constant eye on the long-term blood glucose levels and, if necessary, to be able to respond quickly.

You can do that yourself

Low blood sugar can be due to a number of different causes. Which self-help measures the patient can take depends on what triggers this disorder.

Low blood sugar can, for example, result from diabetes mellitus. Especially in poorly drugged diabetics can lead to hypoglycaemia again and again. Those affected can counteract this by having their blood sugar levels tested regularly and using the prescribed medication in accordance with the regulations.

Obese people, who tend to binge, often suffer from reactive hypoglycaemia. If too many carbohydrates are consumed during a binge, the body reacts with excessive insulin secretion, which can cause the blood sugar level to drop drastically. If this happens more often, the affected people have to change their diet. Addictive behavior may require the help of a therapist. This also applies to people whose sugar levels are regularly too low due to continued alcohol abuse. When high levels of alcohol are added, the body uses more sugar to break down the toxin. In addition, a liver previously damaged by alcohol can only store less glucose, which aggravates the problem.

In addition, heavy exercise, such as exercise, can result in more sugar being consumed than being consumed. This can be prevented by regular breaks and small snacks.


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