HYPOGLYCEMIA

 

Introduction: Hypoglycemia meaning abnormally low blood glucose level occurs when the blood glucose falls below 50 to 60 mg/dL. It can be caused by too much insulin or oral hypoglycemic agents, too little food, or excessive physical activity.

Hypoglycemia may occur at any time. It often occurs before meals, especially if meals are delayed or if snacks are omitted. Middle-of-the-night hypoglycemia may occur because of peaking evening NPH or Lente insulins, especially in patients who have not eaten a bedtime snac.  INSULIN

CLINICAL MANIFESTATIONS: The symptoms of hypoglycemia may be grouped into two categories: adrenergic symptoms and central nervous system symptoms. Hypoglycemic symptoms may occur suddenly and unexpectedly and vary from person to person. Patients who have blood glucose in the hyperglycemic range (200 mg/dL or greater) may feel hypoglycemic with adrenergic symptoms when blood glucose quickly drops to 120 mg/ dL (6.6 mmol/L) or less. Patients with usual blood glucose levels in the low range of normal may not experience symptoms when blood glucose slowly falls under 50 mg/dL (2.7 mmol/L).

A decreased hormonal (adrenergic) response to hypoglycemia may occur in patients who have had diabetes for many years. Patient must perform blood glucose checks frequently. As the glucose falls, the normal surge of adrenaline does not occur, and patient does not feel the usual adrenergic symptoms (sweating and shakiness).

RELATED;

1.  GLUCOSE AND THE PANCREAS

2.  THE ENDOCRINE PANCREAS

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