Hypoglycaemia

Hypoglycaemia is a condition characterized by an abnormally low level of blood sugar (glucose), your body's main energy source.

What is it?

Hypoglycaemia is commonly associated with diabetes. However, a wide variety of conditions, many of them rare, can cause low blood sugar in people without diabetes. Like fever, hypoglycaemia isn't a disease itself, it's an indicator of a health problem.

In people who don't have diabetes, some underlying causes of hypoglycaemia include: certain medications; alcohol; certain cancers; critical illnesses such as kidney, liver or heart failure; hormonal deficiencies; and disorders that result in your body producing too much insulin. Insulin is the hormone secreted by your pancreas that regulates your level of blood sugar.

Treatment of hypoglycaemia involves short-term steps to get your blood sugar level back into a normal range and long-term steps by your doctor to identify and treat the underlying cause of hypoglycaemia.

What causes it?

During digestion, your body breaks down carbohydrates from foods such as bread, rice, pasta, vegetables, fruit and milk products, into various sugar molecules. One of these sugar molecules is glucose, the main energy source for your body. Glucose is absorbed directly into your bloodstream after you eat, but it can't enter the cells of most of your tissues without the help of insulin — a hormone secreted by your pancreas.

Your pancreas is an organ located behind your stomach. When blood glucose levels rise, they signal cells, called beta cells, in your pancreas to release insulin. The insulin, in turn, unlocks your cells so that glucose can enter and also reduces glucose production by your liver. This lowers the amount of glucose in your bloodstream and prevents it from reaching dangerously high levels. As your blood sugar level returns to normal, so does the secretion of insulin from your pancreas.

If your pancreas produces and releases too much insulin into your blood, you have a condition called hyperinsulinemia. Hyperinsulinemia isn't a disease; it's an indication of an underlying health problem. When your pancreas releases too much insulin into your bloodstream, even more glucose enters your cells, and your liver can't release glucose into your bloodstream. The result is low blood sugar. In someone without diabetes, the normal range for a fasting blood sugar level is between 70 and 100 milligrams per deciliter (mg/dL). A low fasting blood sugar for someone without diabetes is defined as a level below 50 mg/dL.

Insulin also influences your liver, which plays a key role in maintaining normal blood sugar levels. After you eat, when insulin levels are elevated, your liver accepts extra sugar and stores it in the form of glycogen. Between meals as insulin levels come down, your liver breaks down glycogen (glycogenolysis) and releases glucose into your bloodstream, which keeps your blood sugar level within a narrow and normal range.

Insulin isn't the only factor in the very complex process by which your body attempts to maintain blood sugar in a normal range. Your blood sugar levels can become too low if your body's production of glucose is disrupted. Aside from your liver breaking down glycogen into glucose, your body also has the ability to manufacture glucose in a process called gluconeogenesis. This process occurs primarily in your liver, but also in your kidneys, and makes use of various substances that are precursors to glucose.

What are the symptoms?

Your brain needs a steady supply of glucose, for it neither stores nor manufactures its own energy supply. Hypoglycaemia can have these effects on your brain:

• Confusion, abnormal behavior or both, such as the inability to complete routine tasks.
• Visual disturbances, such as double vision and blurred vision.
• Seizures, uncommonly.
• Loss of consciousness, uncommonly.

Hypoglycaemia may also cause these other signs and symptoms:

• Heart palpitations.
• Tremor.
• Anxiety.
• Sweating.
• Hunger.

These signs and symptoms aren't specific to hypoglycaemia. There may be other causes. The only way to know for sure that hypoglycaemia is the cause is by having your blood sugar level measured.

Are there any natural therapies?

Treatment of hypoglycaemia involves two basic approaches:

• Urgent initial treatment to raise your blood sugar level.
• Treatment of the underlying condition that's causing your hypoglycaemia, to prevent it from recurring.

The initial treatment depends on your symptoms. It may be possible for you to take glucose tablets or eat food or candy to raise your blood sugar level. If your symptoms are more severe, impairing your ability to take sugar by mouth, you may need intravenous glucose or an injection of glucagon.

Did you know?

Hypoglycaemia can be an indication of any number of illnesses; some of them are potentially serious.