Hypoglycemia - Types, Causes, Symptoms, Treatment and Prevention

Overview: What is Hypoglycaemia?

Hypoglycaemia is a condition marked by abnormally low blood sugar (glucose) levels, typically defined as a blood glucose level below 70 mg/dL. Glucose is the body’s primary source of energy, and when its levels drop too low, it can disrupt essential bodily functions, sometimes becoming life-threatening if not addressed promptly.

While most commonly associated with diabetes, hypoglycaemia can also occur in individuals without diabetes, though less frequently. It is not a disease in itself, but a clinical sign that something is wrong with the body’s ability to regulate glucose.

How Blood Sugar is Regulated:

After consuming carbohydrates, glucose enters the bloodstream. The hormone insulin, produced by the pancreas, helps cells absorb glucose for energy. Excess glucose is stored in the liver as glycogen. When blood sugar levels drop, another hormone, glucagon, signals the liver to convert glycogen back into glucose to maintain balance.

In individuals with diabetes, especially those taking insulin or certain oral medications, this balance can be disrupted. The body may produce too much insulin or fail to respond adequately with glucagon, leading to dangerously low blood sugar.

Why It Matters:

Hypoglycaemia can develop suddenly and progress rapidly. Common symptoms include shakiness, confusion, sweating, rapid heartbeat, and in severe cases, seizures or unconsciousness. It’s crucial to recognise the signs early and take immediate action, such as consuming fast-acting sugar (like candy or juice), especially if you have diabetes.

If left untreated, hypoglycaemia can lead to serious complications, including brain damage or even death. Therefore, anyone experiencing symptoms should check their blood sugar and seek medical advice to determine the underlying cause and appropriate treatment.

Types of Hypoglycaemia

Hypoglycaemia can be classified into different types based on its underlying cause and timing of occurrence. Understanding the type helps in tailoring treatment and preventive strategies.

1. Diabetic Hypoglycaemia

This is the most common form, occurring in people with diabetes—especially those on insulin therapy or certain oral medications.

• It happens when blood glucose drops too low, often due to skipping meals, overdosing insulin, or exercising without adjusting medication or food intake.
• This type requires immediate correction, usually by consuming a fast-acting source of glucose like fruit juice or candy.

2. Reactive Hypoglycaemia (Postprandial Hypoglycaemia)

Reactive hypoglycaemia occurs after eating, typically within a few hours of a high-carbohydrate meal.

• The body produces more insulin than needed, causing a rapid drop in blood sugar.
• It may occur in individuals with or without diabetes, and is sometimes seen after gastric bypass surgery.
• Managing diet and meal composition often helps control this condition.

3. Fasting Hypoglycaemia

This type occurs when the body’s blood sugar drops due to prolonged periods without food, such as during overnight fasting or intense calorie restriction.

• It may also indicate underlying health conditions such as hormonal deficiencies, severe infections, liver disease, or insulin-producing tumors.

4. Hormonal Hypoglycaemia

Although not always listed separately, hypoglycaemia can be caused by hormonal imbalances, such as:

• Low cortisol or growth hormone levels
• Impaired glucagon response (common in people with diabetes)
  These hormones play a key role in glucose regulation, and their deficiency can contribute to low blood sugar levels.

Symptoms of Hypoglycaemia

The brain requires a steady supply of glucose to function properly. When blood sugar levels drop too low, it can affect both mental and physical performance. Recognizing the early signs of hypoglycaemia is important to prevent serious complications.

Common signs and symptoms include:

• Shakiness or trembling
• Rapid heartbeat or a fluttering sensation in the chest
• Excessive sweating
• Intense hunger
• Headache or light-headedness
• Sudden fatigue or weakness
• Dizziness or difficulty maintaining balance
• Anxiety, nervousness, or irritability
• Pale or clammy skin
• Numbness or tingling, especially around the mouth
• Confusion or difficulty concentrating
• Blurred vision or other visual disturbances
• Slurred speech or difficulty speaking
• Inability to perform routine tasks
• Seizures in severe cases
• Loss of consciousness in rare but serious cases

It is important to note that these symptoms can also be caused by other medical conditions. Checking your blood glucose levels during such episodes is the only way to confirm whether you are experiencing hypoglycaemia.

What are the Causes of Hypoglycaemia?

Hypoglycaemia occurs when blood sugar (glucose) levels fall too low to support normal bodily functions. While it is most commonly linked to diabetes treatment, hypoglycaemia can also affect people without diabetes. The causes are generally classified based on whether the individual has diabetes or not.

1. In People with Diabetes

Hypoglycaemia is a frequent side effect of diabetes treatment, especially when glucose-lowering medications are not balanced with food intake or activity levels.

• Use of insulin or oral anti-diabetic medications
• Skipping or delaying meals after taking diabetes medication
• Excessive physical activity without adjusting medication or food intake
• Incorrect medication dosage, such as taking more insulin than prescribed

2. In People without Diabetes

Although less common, hypoglycaemia in non-diabetic individuals may occur due to various underlying conditions or external factors:

• Side effects of certain medications, such as antibiotics, quinine, or aspirin (especially in children)
• Excessive alcohol consumption, particularly without eating
• Severe liver or kidney disease, which can affect glucose production or clearance
• Prolonged fasting or malnutrition, leading to depletion of stored glucose
• Pancreatic disorders, such as insulinoma (a rare insulin-producing tumour) that causes excessive insulin release
• Hormonal deficiencies, including low levels of cortisol, growth hormone, or glucagon, which help regulate glucose levels

Identifying the underlying cause is key to managing hypoglycaemia effectively. If you experience frequent low blood sugar episodes, consult a doctor for proper evaluation and treatment.

How to Treat Hypoglycaemia

Hypoglycaemia treatment depends on the severity of the symptoms and how low the blood sugar level has dropped. Prompt action is essential to restore normal glucose levels and prevent complications.

For Mild to Moderate Hypoglycaemia (when the person is conscious):

1. Consume Fast-Acting Carbohydrates
   Eat or drink something that raises blood sugar quickly, such as:
   • Glucose tablets or gel
   • Half a cup of fruit juice or regular (non-diet) soft drink
   • A spoonful of sugar or honey
   • Hard candy
2. Follow the 15-15 Rule
   • Wait 15 minutes, then check your blood sugar.
   • If it is still below 70 mg/dL, consume another dose of fast-acting sugar.
   • Repeat this cycle every 15 minutes until your blood sugar level rises above 70 mg/dL.
3. Eat a Balanced Snack
   Once your blood sugar is back to normal, eat a small snack (such as a sandwich or fruit with protein) to help stabilize glucose levels and prevent another dip.

For Severe Hypoglycaemia (when the person is confused, unconscious, or having a seizure):

• Do not give anything by mouth. The person could choke.
• Seek immediate medical help.
• If available, a trained family member or caregiver can:
  • Administer a glucagon injection (a hormone that raises blood sugar quickly)
  • Or medical professionals may provide an intravenous glucose injection at the hospital

Treating the Underlying Cause

If hypoglycaemia is recurrent or not related to diabetes, the doctor will investigate the root cause. Treatment may involve:

• Adjusting or changing medications
• Managing other health conditions (such as liver, kidney, or adrenal disorders)
• In rare cases, surgical removal of insulin-producing pancreatic tumors (insulinomas) may be required

Important: Always keep a glucose source nearby if you are at risk, and educate close contacts about what to do in case of a hypoglycaemic episode.

Can You Prevent Hypoglycaemia?

Yes, hypoglycaemia can often be prevented—especially if you have diabetes—by taking consistent and proactive steps to manage your condition. Understanding your body’s glucose patterns, staying alert to early symptoms, and following a structured plan can significantly reduce the risk of low blood sugar episodes.

Steps to Prevent Hypoglycaemia:

1. Follow a personalized diabetes management plan
   • Work closely with your doctor or diabetes educator to manage medications, meals, and physical activity.
   • Adjust insulin or other medications as needed based on your blood sugar trends.
2. Monitor your blood sugar regularly
   • Use a blood glucose meter or a Continuous Glucose Monitor (CGM) to track your levels throughout the day.
   • Pay extra attention before and after exercise, meals, or medication changes.
3. Plan your meals wisely
   • Consider eating 5–6 small meals or snacks a day instead of three large meals to keep blood sugar levels stable.
   • Always discuss dietary changes with your doctor or dietitian before making adjustments.
4. Be prepared for emergencies
   • Keep glucose tablets, fruit juice, or candy with you—especially when traveling or staying away from home for extended periods.
5. Discuss any new medications or lifestyle changes with your doctor
   • Some drugs or changes in routine (like increased exercise or skipped meals) may impact your blood sugar levels.
   • Understanding potential side effects in advance can help you plan better.
6. Stay informed and vigilant
   • Learn to recognize early symptoms of hypoglycaemia such as shakiness, sweating, or confusion.
   • Educate family, friends, or coworkers so they can assist you if an episode occurs.

Hypoglycaemia is a manageable condition. With proper guidance, regular monitoring, and good planning, you can minimize its occurrence and maintain better control over your health.

When to See a Doctor for Hypoglycaemia?

You should consult a doctor if you frequently experience symptoms such as confusion, fainting, or dizziness. If hypoglycaemia leads to seizures, loss of consciousness, or unresponsiveness, seek emergency medical attention immediately.

Call 1860-500-1066 to book an appointment.

How to Avoid Being Caught Unaware by Hypoglycaemia

Especially for individuals on diabetes medication, the following steps can help reduce the risk of unexpected episodes:

• Learn what triggers your low blood sugar levels
• Monitor your blood glucose regularly using a glucose meter
• Keep quick sources of sugar, such as glucose tablets or sweet snacks, readily available
• Inform family members, friends, and coworkers about your condition and how they can help during an episode
• Be cautious when using over-the-counter medications, particularly those for cold and cough, as some may affect blood sugar levels
• Treat symptoms immediately by consuming fast-acting carbohydrates to stabilize blood sugar

Conclusion

Hypoglycaemia is a potentially serious condition that occurs when blood sugar levels drop below normal. While it is most commonly associated with diabetes, it can also affect individuals without diabetes due to a variety of underlying causes. Recognizing the early signs, understanding the risk factors, and taking prompt action are essential to prevent complications.

With the right treatment, lifestyle adjustments, and ongoing medical support, most episodes of hypoglycaemia can be effectively managed or even prevented. If you experience symptoms frequently or without explanation, it is important to consult a healthcare professional for a proper diagnosis and tailored care plan.

Staying informed, prepared, and in regular communication with your doctor is the key to living safely and confidently with or at risk of hypoglycaemia.

Frequently Asked Questions (FAQs) About Hypoglycaemia

1. What is Reactive Hypoglycaemia?
Reactive hypoglycaemia refers to low blood sugar that occurs a few hours after eating a meal, especially one high in carbohydrates. It typically occurs within four hours of eating and may be more common in individuals with a history of gastric surgery or insulin sensitivity.

2. What are the common tests for Hypoglycaemia?
Doctors may conduct a series of blood tests to measure glucose levels during symptoms. Standard tests include:

• Five-hour glucose tolerance test
• Mixed Meal Tolerance Test (MMTT) for diagnosing reactive hypoglycaemia
• Fasting blood sugar test
• In some cases, continuous glucose monitoring (CGM) may be recommended.

3. Do I need to visit a specialist doctor if I have Hypoglycaemia?
Yes. If you experience frequent episodes, consult an endocrinologist or diabetologist, especially if you have diabetes or unexplained low blood sugar levels. You may also need evaluation for conditions like insulinoma or hormonal deficiencies.

4. Do I need to follow a special diet if I have Hypoglycaemia?
Yes. A hypoglycaemia-friendly diet includes:

• Frequent, small meals
• Low-glycaemic index carbohydrates
• Protein-rich snacks
• Avoiding refined sugars
  Include foods like whole grains, yogurt, fruits, and nuts. Always consult your doctor or a dietitian before making changes.

5. Is Hypoglycaemia related to stress?
Yes. Chronic stress, anxiety, and poor sleep can impact hormones involved in blood sugar regulation and may trigger reactive hypoglycaemia in some individuals. Managing stress, getting adequate sleep, and eating regularly can help stabilize glucose levels.

6. Can exercise cause Hypoglycaemia?
Yes. Intense or prolonged physical activity, especially without proper carbohydrate intake, can lower blood sugar levels—particularly in people taking insulin or other glucose-lowering medications. It is advisable to check your blood sugar before and after exercising.

7. What should I do if I feel symptoms of Hypoglycaemia?
If symptoms occur, consume a fast-acting source of sugar immediately—like fruit juice, glucose tablets, or a spoon of sugar. Recheck your blood glucose after 15 minutes, and eat a snack once levels normalize.

8. Is Hypoglycaemia dangerous?
Yes, if left untreated, hypoglycaemia can lead to seizures, unconsciousness, and even death. That’s why early recognition and prompt treatment are essential.

9. Can children have Hypoglycaemia?
Yes. Hypoglycaemia can occur in children, especially those with type 1 diabetes, inborn metabolic disorders, or during long gaps between meals. Pediatric evaluation is essential if symptoms are noticed.

10. Can alcohol trigger Hypoglycaemia?
Yes. Drinking alcohol on an empty stomach or in large quantities can block the liver from releasing glucose, leading to hypoglycaemia—especially in individuals with diabetes.