Hypoglycemia
(Low Blood Glucose; Low Blood Sugar)
Definition
Glucose is a type of sugar. It is your body's main source of energy. Hypoglycemia is a condition where the level of glucose in your blood becomes low enough to cause symptoms. For most people, this level is 50-60 mg/dl (milligrams per deciliter), though anything below 70 mg/dl is considered below normal. When blood glucose drops too low, your body does not have enough energy to function properly.
Glucose in Blood
Causes
Medication for diabetes is the most common cause particularly when combined with the following factors:
- Taking too much blood sugar-lowering medication
- Delaying or missing meals, or eating too little at meals
- Too much or too strenuous exercise
Reactive hypoglycemia may also occur in people without diabetes. It is now thought to be quite rare.
Other causes of hypoglycemia include:
- Drinking too much alcohol (especially binge drinking coupled with not eating)
- Prolonged fasting
- Early pregnancy
- Long periods of strenuous exercise
- Certain medications may increase the risk of hypoglycemia (people on beta blockers who exercise, aspirin in children)
- Certain pituitary or adrenal gland conditions
- Certain liver conditions
- Certain types of stomach surgery
- Certain autoimmune conditions
- Hereditary enzyme or hormone deficiencies
- A reaction to certain foods (rarely, eating unripe ackee fruit from Jamaica)
- Pancreatic tumors
- Tumors that produce an insulin-like hormone
-
Any severe or protracted illness, such as:
- Heart or kidney failure
- Metastatic cancer
- Malnutrition
- Severe infection
Risk Factors
Factors that can increase your risk for hypoglycemia include:
- Diabetes
- Drinking too much alcohol
- Fasting, particularly in combination with strenuous exercise
- Family history of hypoglycemia
Symptoms
Symptoms may come on slowly or suddenly.
Symptoms include:
- Sweating
- Nervousness
- Feeling faint
- Heart palpitations
- Hunger
- Headache
As hypoglycemia worsens symptoms may include:
- Fatigue
- Dizziness
- Weakness
- Inappropriate behavior or severe confusion
- Loss of consciousness
Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done.
If hypoglycemia is suspected, your doctor will try to document your low blood sugar. Your blood glucose levels will be measured while you are having symptoms.
If this is not possible, you may have a glucose tolerance test. This is a series of blood tests after taking glucose by mouth.
Other, less routine tests include:
- Laboratory tests for antibodies to insulin
- Imaging tests to check for a tumor, such as:
Treatment
Treatments include:
Sugar
Symptoms of low blood sugar can be relieved quickly by:
-
Eating sugar in a rapidly absorbable form, such as:
- Fruit
- Fruit juice
- Sugared soft drink
- Table sugar in water
- Candy
- Taking glucose tablets
- IV glucose (in severe cases)
Prevention
Measures that can help prevent hypoglycemia include:
People With Diabetes
- Monitor your medicine. Take it as prescribed.
- Follow the diet and exercise plans given by your doctor.
- Avoid drinking alcohol in excess.
American Diabetes Association
Hypoglycemia Support Foundation
Canadian Diabetes Association
Canadian Health Network
Beers MH. The Merck Manual of Medical Information. 2nd ed. London, England: Simon and Schuster, Inc; 2003.
Berkow R. The Merck Manual of Medical Information. New York, NY: Pocket; 2000.
Hypoglycemia. American Diabetes Association website. Available at: http://www.diabetes.org/for-parents-and-kids/diabetes-care/hypoglycemia.jsp. Accessed July 1, 2009.
Hypoglycemia. National Institute of Diabetes & Digestive & Kidney Diseases website. Available at: http://www2.niddk.nih.gov/. Published October 2008. Accessed July 1, 2009.
Last reviewed September 2011 by Igor Puzanov, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
