Hypoglycemia (cont.)
Can the body protect itself from hypoglycemia?
When the circulating level of
blood glucose falls, the brain actually senses the drop. The brain then sends
out messages that trigger a series of events, including changes in hormone and
nervous system responses that are aimed at increasing blood glucose levels.
Insulin secretion decreases and hormones that promote higher blood glucose
levels, such as glucagon, cortisol, growth hormone, and epinephrine all
increase. As mentioned above, there is a store in the liver of glycogen that can
be converted to glucose rapidly.
In addition to the biochemical processes that occur, the body starts to
consciously alert the affected person that is needs food by causing the signs
and symptoms of hypoglycemia discussed below.
What are symptoms of hypoglycemia, and how low is too low?
The body's biochemical response to hypoglycemia usually
starts when sugars are in the high/mid 70's. At this point, the liver releases
its stores and the hormones mentioned above start to activate. In many people,
this process occurs without any clinical symptoms. The amount of insulin
produced also declines in an attempt to prevent a further drop in glucose.
While there is some degree of variability among people, most will usually
develop symptoms suggestive of hypoglycemia when blood glucose levels are
lowered to the mid 60's. The first set of symptoms are called adrenergic (or
sympathetic) because they relate to the nervous system's response to
hypoglycemia. Patients may experience any of the following;
- nervousness,
- sweating,
- intense hunger,
- trembling,
- weakness,
- palpitations, and
- often have
trouble speaking.
In most patients, these symptoms are easily recognizable. The
vast majority of patients with diabetes only experience this degree of
hypoglycemia if they are on medications or insulin. Patients (with diabetes or
who have
insulin resistance) with high circulating levels of insulin who fast or lower
their carbohydrate intake drastically should also be cautioned. These
individuals
may also experience modest hypoglycemia.
Anyone who has experienced an episode of hypoglycemia describes a sense of
urgency to eat and resolve the symptoms. And, that's exactly the point of these
symptoms. They act as warning signs. At this level, the brain still can access
circulating blood glucose for fuel. The symptoms provide a person the
opportunity to raise blood glucose levels before the brain is affected.
If a person does not or cannot respond by eating something to raise blood
glucose, the levels of glucose continue to drop. Somewhere in the 50 mg/dl
range, most patients progress to neuro-glyco-penic ranges (the brain is not
getting enough glucose). At this point, symptoms progress to confusion,
drowsiness, changes in behavior,
coma, and seizure.
Next: How is hypoglycemia treated? »
- insulin - Establishes the medication insulin, a drug used for the treatment of type 1 and type 2 diabetes mellitus.
- Hemoglobin A1c Test - Hemoglobin A1c test is used as a standard tool to determine blood sugar control for patients with diabetes
- Night Sweats - Night sweats have many different causes. A doctors must take a complete medical history and order tests to find the cause of the underlying medical condition that is responsible for night sweats.
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