DIABETIC HYPOGLYCEMIA

General Information

DEFINITION--Hypoglycemia means low blood sugar. When the blood sugar decreases considerably below normal, a group of symptoms develop. Hypoglycemia develops when there is too much insulin or not enough food for the condition you are in at any point in time. It is more frequent in insulin-dependent type diabetes.

BODY PARTS INVOLVED--Endocrine and metabolic.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Mild:

• Hunger; weakness; nervousness.
• Emotional ups and downs; difficulty in concentrating.
• Sweating; headache.

Moderately severe:

• Increased weakness; excessive perspiration.
• Skin cold and clammy to touch.
• Numbness about mouth and/or fingers.
• Pounding of heart.
• Loss of memory.
• Double vision.
• Staring expression.
• Difficulty in walking.
• Unawareness of surroundings.

Severe:

• Twitching of muscles; unconsciousness; convulsions.
• Passing urine unknowingly.

CAUSES

• Exercising more than usual.
• Eating meals at times other than regular hours.
• Skipping meals or eating only parts of meals.
• Loose bowel movements, diarrhea or vomiting your last meal (can also elevate blood sugar).
• Infection (can also elevate blood sugar).
• Are upset or excited (may increase blood sugar).
• Adverse reaction from other medications.
• Excessive insulin dosage.

RISK INCREASES WITH

• Presence of other disorders (such as kidney or liver disease, hypothyroidism, alcoholism, gastroenteritis, congestive heart failure).
• Elderly patient.
• "Tight control" type patient.

HOW TO PREVENT

• Maintaining a regular schedule of diet, medication and exercise.
• Regular blood-glucose testing.
• Learn to recognize the early symptoms of hypoglycemia and take prompt action. Make sure family and friends know about the symptoms so if you become disoriented or confused, they can give you something sweet.
• Always have access to a simple sugar.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.

APPROPRIATE HEALTH CARE

• Doctor's treatment (sometimes).
• Hospitalization for complications or if there is any doubt about the cause.

POSSIBLE COMPLICATIONS

• Diabetic shock or seizures.
• Permanent brain damage.

PROBABLE OUTCOME--Full recovery is the usual outcome but is dependent on quickness of the diagnosis and treatment.

How To Treat

GENERAL MEASURES--

• If patient is alert to take food or drink, prompt consumption of a sugar-containing food or beverage that can be rapidly absorbed, such as unsweetened juices, Lifesaver candies, glucose tablets or syrup. If there are more than 30 minutes to the next meal, some fat or starch should also be taken (bread and butter).
• If the patient is drowsy or unconscious, glucagon should be administered. Diabetic patients and their families should have glucagon always available and know how to inject it.
• Check blood-sugar about 15-20 minutes after treatment to ensure the desired effect.
• If no glucagon is available, get the patient to the nearest emergency facility or telephone for emergency help.
• Determine the cause of the hypoglycemia. The insulin dosage may need to be adjusted.
• See Resources for Additional Information.

MEDICATION--If hospitalized, your doctor may prescribe intravenous dextrose.

ACTIVITY--Rest until symptoms resolve.

DIET--Maintain the regular diet unless eating habits are the cause of the hypoglycemia. Adjustments may need to be made.

Call Your Doctor If

• You have symptoms of hypoglycemia that are not controlled by simple measures.
• Attacks are recurring.
• Adjustments need to be made in insulin dosages.