Hypoglycaemia: Warning Signs and Treatment

Glucose is the body’s primary energy source. Hypoglycaemia or low blood sugar is a medical condition in which your blood sugar (glucose) level drops below the normal range, often defined as a blood glucose concentration of less than 70 mg/dL or 4mmol/L.

What causes hypoglycaemia?

In diabetic patients

If you have diabetes, there is a chance that your sugar levels may sometimes get too low as a result of your treatment. Factors which contribute to hypoglycaemia in people with diabetes include:

• Medications:Diabetic medications such as sulfonylureas and insulin may result in low blood sugar if not taken as prescribed.
• Alcohol consumption: Excessive alcohol can interfere with blood sugar regulation, risking hypoglycaemia. 
• High physical activity: Increased physical activity without adjusting the medications or insulin intake levels could result in hypoglycaemia.
• Skipping meals: Missing meals or not eating enough carbohydrates can lead to low blood sugar, especially in individuals on diabetes medications.

In people without diabetes

Hypoglycaemia can also affect those who do not have diabetes. Some of the causes include:

• Alcohol consumption:Particularly when alcohol is consumed on an empty stomach.
• Being ill:When you are ill, you might find it difficult to eat properly or keep food down, which can cause your blood glucose levels to drop.
• Critical illnesses: Severe infections, kidney disease, or liver disorders can lead to hypoglycaemia.

What are its symptoms?

The symptoms of hypoglycaemia vary depending on the extent of the drop in blood sugar levels. Identifying the symptoms early and taking appropriate actions to prevent the condition from worsening can be a life saver. 

Common symptoms of hypoglycaemia include:

• Jittery 
• Hungry
• Tired
• Dizziness or confused
• Fast heartbeat
• Headache
• Vision changes
• Sweating
• Anxious or irritable

Symptoms of severe hypoglycaemia include:

• Seizures
• Loss of consciousness

What are the potential complications of hypoglycaemia?

Complications of hypoglycaemia may vary depending on the severeness:

• Impact on diabetes management: Fear of hypoglycaemia can lead patients to maintain higher blood glucose levels intentionally, potentially resulting in poor glycaemic control and increased risk of long-term complications of diabetes. 

• Cognitive decline: Repeated episodes of severe hypoglycaemia may contribute to long-term cognitive impairment, especially in children and the elderly.

• Hypoglycaemia unawareness: Frequent hypoglycaemic episodes can impair the body’s ability to recognise the early signs of low blood sugar, making future episodes more dangerous.

How is it treated?

The treatment methods may vary depending on the severity of the issue.

If you have diabetes and experience symptoms of hypoglycaemia or if your blood sugar levels drop below 4 mmol/L, follow these steps:

• Consume fast-acting carbohydrates: Drink a small glass of fruit juice or a sugary fizzy drink. Take five glucose or dextrose tablets.

• Recheck blood sugar levels: Test your blood sugar after 10 to 15 minutes. If it is still below 4 mmol/L, consume another sugary snack or drink and test again after 10 minutes.

• Maintain blood sugar levels: Once your blood sugar is above 4 mmol/L and symptoms improve, eat something to stabilise your blood sugar, such as biscuits, a sandwich, or your next scheduled meal.

If someone is experiencing severe hypoglycaemia and loses consciousness:

• Avoid giving them anything to eat or drink, as they might not be able to swallow safely.
• Place them in the recovery position.
• If available and you know how to use it, give them a glucagon injection immediately.
• If they begin to recover within 10 minutes and can swallow safely, provide them with food or drink to raise their blood sugar.
• Remain with them until they have fully recovered.

Call for an ambulance if you suspect someone has very low blood sugar and they are unresponsive or unconscious, and:

• You do not have a glucagon injection or do not know how to use it.
• You have administered a glucagon injection, but they have not recovered within 10 minutes.
• They have been drinking alcohol, which can complicate hypoglycaemia.

 How is hypoglycaemia managed and prevented?

Prevention of hypoglycaemia is essential as it prevents the situation from worsening further. Here are some of the strategies to prevent it from happening.

• Monitor regularly: Blood sugar levels should be regularly monitored to detect any fluctuations.
• Consuming a well-balanced diet: Eating a well-balanced diet will help you to keep your blood sugar levels within the healthy range. 
• Medication management: If you have diabetes, follow your doctor’s instructions regarding medication dosages and timing.
• Regular meals and snacks: Avoid skipping snacks and meals to maintain steady blood sugar levels throughout the day. Do not start a diet schedule without consulting your doctor. 
• Exercise safely: High intensity exercises can cause a steep dip in sugar levels. Therefore, be mindful of how much you exercise and adjust your insulin or other medications appropriately in consultation with your doctor.
• Limit alcohol intake: If you consume alcohol, do so in moderation and be aware of its impact on blood sugar levels.

Make an appointment at Pantai Hospitals

Get in touch with us to book an appointment today for a consultation, or visit our Endocrinology Department at your nearest Pantai Hospital.

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