Low Blood Sugar : What are the symptoms, causes And Treatment ?

Your blood sugar (glucose) level is below the normal range if you have hypoglycemia. Your body uses glucose as its major energy source.

Hypoglycemia and diabetes management frequently go hand in hand. Yet, low blood sugar can develop in people without diabetes as a result of several illnesses and treatments, many of which are unusual.

Treating hypoglycemia urgently is necessary. A fasting blood sugar reading of 70 mg/dL, or 3.9 mmol/L, or lower should be seen as a warning sign for hypoglycemia in many people. Your figures, however, could be different. Inquire with your doctor.

Your blood sugar should be brought down as quickly as possible during therapy, either by consuming a high-sugar meal or beverage or by taking medication. Long-term therapy necessitates locating and handling the reason for hypoglycemia.

Causes

When your blood sugar (glucose) level drops too low for normal body processes to continue, you have hypoglycemia. There are several potential causes for this. Low blood sugar is most frequently caused by a side effect of diabetic treatments.

Blood sugar control

Your body converts food into glucose when you eat. Insulin, a hormone made by the pancreas, aids in the entry of glucose, the body's primary energy source, into the cells. Insulin enables glucose to enter the cells and supply the energy required by your cells. Your muscles and liver both contain glycogen, which is a sort of extra glucose storage.

You will cease manufacturing insulin when you have not eaten in several hours and your blood sugar level falls.  Glucagon, a hormone produced by your pancreas, instructs your liver to release glucose into your bloodstream by dissolving glycogen that has been stored in your body. Until you eat again, this keeps your blood sugar levels within a normal range.

Glucose can also be produced by your body. Your kidneys and liver both play a major role in this process. The body may break down fat reserves and utilise the byproducts of fat breakdown as an alternate fuel during extended fasting.

Several causes include diabetes

If you have diabetes, you may not produce insulin (type 1 diabetes) or you may respond to insulin less favourably (type 2 diabetes). As a result, blood glucose levels increase and can rise to dangerously high levels. You might use insulin to solve this issue or other drugs to reduce blood sugar levels.

Using too much insulin or other diabetic drugs might result in hypoglycemia, which is when your blood sugar level drops too low. In addition, hypoglycemia might happen if you exercise more than normal or if you eat less than usual after taking your daily dosage of diabetic medication.

Potential causes other than diabetes

Those without diabetes are substantially less likely to experience hypoglycemia. Some causes include:

Medications. Accidentally ingesting someone else's oral diabetic medicine might result in hypoglycemia. Several drugs have the potential to cause hypoglycemia, particularly in young patients or those with renal disease. One such is the malaria drug quinine (Qualaquin).

Excessive alcohol consumption. Without eating, heavy drinking might prevent the liver from releasing glucose from its glycogen stores.

A few serious diseases. Hypoglycemia can be brought on by severe infections, renal disease, advanced heart disease, and liver diseases such as severe cirrhosis or hepatitis. Moreover, kidney problems might prevent your body from adequately eliminating drugs. An accumulation of drugs that reduce blood sugar levels, may have an impact on glucose levels.

Prolonged starvation. Malnutrition and famine can cause hypoglycemia because when you do not eat enough, your body uses up the glycogen stores it requires to produce glucose. Anorexia nervosa, an eating disorder, is one disease that can cause hypoglycemia and long-term malnutrition.

A surplus of insulin. You may create excessive amounts of insulin if you have a rare pancreatic tumour called an insulinoma which causes hypoglycemia. A surplus of insulin-like molecules can also be produced as a result of other cancers. The pancreas' peculiar cells can cause excessive insulin release, which leads to hypoglycemia.

Hormonal imbalances. Various diseases of the pituitary and adrenal glands may cause insufficient levels of specific hormones that control glucose synthesis or metabolism. If a child has too little growth hormone, they may have hypoglycemia.

Hypoglycemia following a meal

Usually, but not always, hypoglycemia happens after not eating. Hypoglycemic symptoms can manifest after specific meals, however, it is unknown why.

Reactive hypoglycemia, also known as postprandial hypoglycemia, can happen in patients who have had procedures that alter the stomach's normal function. The procedure most frequently linked to having a stomach bypass operation can cause this, but people who have undergone other procedures are also susceptible to it.

How can you tell if your blood sugar is low?

Immediately seek medical attention if

• You could have signs of hypoglycemia, but you do not have diabetes.
• You have diabetes, and despite trying to manage your hypoglycemia by drinking juice or regular (not diet) soft drinks, eating sweets, or taking glucose pills, nothing seems to work.
• If you have diabetes or a history of hypoglycemia and you experience severe hypoglycemia symptoms or you become unconscious, you should seek immediate medical attention.

Symptoms

Hypoglycemia symptoms and indicators can appear if blood sugar levels go too low and include:

• Seeming pale
• Shakiness
• Sweating
• Headache
• Hunger or sickness
• A rapid or erratic pulse
• Fatigue
• Irritation or worry
• Difficulty paying attention
• Unsteadiness or faintness
• Lips, tongue, or cheek tingling or numbness

Signs and symptoms of hypoglycemia can include:

• Unusual behaviour, confusion, or both, such as the inability to carry out daily chores
• Inability to coordinate
• Unsteady speech
• Fuzziness or tunnel vision
• Nightmares when sleeping

Extreme hypoglycemia may result in:

• Loss of awareness and inability to respond 
• Seizures

Treatments

Treatment of hypoglycemia 

If you show indications of hypoglycemia, do the following actions:

• Consume 15–20 grams of quick-acting carbs. They are sweet, protein- and fat-free meals and beverages that the body may quickly turn into sugar. Try fruit juice, honey, glucose tablets or gel, regular Coke (not diet Coke), genuine Coke, or sweets.
• After therapy, 15 minutes later, recheck blood sugar levels. Eat or drink another 15 to 20 grams of fast-acting carbohydrates, and then check your blood sugar levels again after 15 minutes if they are still under 70 mg/dL (3.9 mmol/L). Until the blood sugar level is more than 70 mg/dL (3.9 mmol/L), repeat these steps.
• Eat a meal or a snack. Having a meal once your blood sugar levels have returned to normal. A nutritious snack or supper can refill your body's glycogen stores and help you avoid another blood sugar decrease.

Treatment of severe hypoglycemia 

If you require assistance from someone to recover from hypoglycemia, it is considered severe. For instance, if you are unable to eat, you may require an IV glucose infusion or a glucagon injection.

In general, diabetics using insulin should keep a glucagon kit on hand in case of an emergency. The location of the kit and how to utilise it in an emergency should be made clear to family and friends.

Never attempt to feed or drink someone who is unresponsive while providing assistance. Call for emergency medical assistance if you do not have access to a glucagon kit or if you do not know how to use one.

Your healthcare professional must recognise the underlying issue that is causing your hypoglycemia and address it in order to prevent recurring cases of hypoglycemia. Depending on the underlying reason, therapy could entail:

Counselling on nutrition. A trained dietitian's examination of dietary practises and meal preparation may assist to lessen hypoglycemia.

Medications. In the event that a drug is to blame for your hypoglycemia, your doctor will probably advise adding, modifying, discontinuing, or terminating the medicine, or lowering the dosage.

Cancer therapy. The most common form of treatment for a pancreatic tumour is the surgical removal of the tumour. Sometimes it is essential to take medicine to treat hypoglycemia or surgically remove part of the pancreas.

Complications of Low Blood Sugar

Hypoglycemia left untreated might result in:

• Seizure
• Coma
• Death

Hypoglycemia may also result in:

• Weakness and vertigo
•  Falling Injuries
• Automobile collisions
• Dementia risk is higher in older persons
• Ignorance of hypoglycemia

Hypoglycemia unawareness can develop over time as a result of recurrent hypoglycemic episodes. Low blood sugar warning signals and symptoms like trembling or irregular heartbeats are no longer produced by the body or brain (palpitations). The possibility of severe, maybe fatal hypoglycemia rises when this occurs.

Your healthcare practitioner may change your therapy, boost your blood sugar level objectives, and suggest blood glucose awareness training if you have diabetes, recurrent hypoglycemia, and hypoglycemia unawareness.

Some individuals who are unaware of their hypoglycemia can utilise a continuous glucose monitor (CGM). The tool can notify you when you have low blood sugar.

Untreated diabetes

If you have diabetes, low blood sugar episodes can be uncomfortable and even scary. If you are worried about hypoglycemia, you could use less insulin to keep your blood sugar levels from falling too low. This may cause diabetes to become unmanageable. Discuss your fears with your doctor, and do not alter the dosage of your diabetic medication without first consulting him or her.

Pay attention to the diabetes management plan that you and your doctor have developed. The treatment of your diabetes and your risk of low blood sugar may be affected if you start taking new drugs, alter your eating or medication schedules, or start doing more activity. Discuss these adjustments with your healthcare provider.

Find out the warning signs and symptoms of low blood sugar. This can assist you in spotting hypoglycemia and treating it before it becomes too severe. You can detect whether your blood sugar is going low by often monitoring it.

For certain people, a continuous glucose monitor (CGM) is a useful alternative. CGMs have a receiver that may collect blood glucose readings via a little wire that is put under the skin. Some CGM devices will sound an alarm if blood sugar levels go too low.

In order to assist avoid hypoglycemia, certain insulin pumps now have CGM integration and have the ability to stop delivering insulin when blood sugar levels are falling too rapidly.

Always keep a fast-acting carbohydrate available to treat a falling blood sugar level before it reaches dangerously low levels, such as hard candies, juice, or glucose tablets.

Eating many little meals often throughout the day is a temporary solution for recurrent bouts of hypoglycemia to help keep blood sugar levels from falling too low. Though this is not suggested as a long-term tactic. Find the source of your hypoglycemia and treat it in collaboration with your healthcare doctor.

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