Hypoglycemia

Hypoglycemia (hypoglycaemia in British English) is the medical term for a pathologic state produced by a lower than normal level of glucose (sugar) in the blood. The term hypoglycemia literally means "under-sweet blood" (Gr. hypo-, glykys, haima). Hypoglycemia can produce a variety of symptoms and effects but the principal problems arise from an inadequate supply of glucose as fuel to the brain, resulting in impairment of function (neuroglycopenia). Derangements of function can range from vaguely "feeling bad" to coma and (rarely) permanent brain damage or death. Hypoglycemia can arise from many causes and can occur at any age.

What are symptoms of hypoglycemia, and how low is too low?

The body's biochemical response to hypoglycemia usually starts when sugars are in the high/mid 60's. At this point, the liver releases its stores and the hormones mentioned above start to activate. In many patients, this process occurs without any clinical symptoms.

While there is some degree of variability among people, most will usually develop symptoms suggestive of hypoglycemia when blood glucose levels are lowered to the mid 50's. The first set of symptoms are called neuro-genic (or sympathetic) because they relate to the nervous system's response to hypoglycemia. Patients may experience any of the following;

* nervousness,
* sweating,
* intense hunger,
* trembling,
* weakness,
* palpitations, and
* often have trouble speaking.

In most patients, these symptoms are easily recognizable. The vast majority of patients with diabetes only experience this degree of hypoglycemia if they are on medications or insulin. Patients (diabetic or with insulin resistance) with high circulating levels of insulin who fast or lower their carbohydrate intake drastically should also be cautioned. These patients may also experience modest hypoglycemia.