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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  
glucose and RBC

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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:
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Risk Factors  

Factors that can increase your risk for hypoglycemia include:

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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
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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:
    • MRI scan —a test that uses radio waves and magnetic fields to make pictures of structures inside the body
    • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
    • Ultrasound—a test that uses sound waves to make pictures of structures inside the body
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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)
Medication  

Some people who have prolonged or severe hypoglycemia take glucagon . Glucagon is an injectable hormone. It raises blood sugar levels.

It can be used in emergencies when people have a severe reaction. It can be used if the person cannot take sugar by mouth.

Surgery  

Hypoglycemia may be caused by a tumor. In this case a surgery to remove the tumor may be needed.

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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.
Non-Diabetic People Prone to Hypoglycemia  
  • Avoid drinking too much alcohol.
  • Eat frequent, small meals (5 to 6 per day).
  • Take care to eat sufficiently before exercising.
People Prone to Severe Hypoglycemia  

In addition to the above measures:

  • Wear a medical alert bracelet or other medical alert identification.
  • Learn to recognize symptoms and take quick corrective measures.