Hypoglycemia

Hypoglycemia, also called low blood sugar, occurs when your blood glucose (blood sugar) level drops too low to provide enough energy for your body's activities. In adults or children older than 10 years, hypoglycemia is uncommon except as a side effect of diabetes treatment, but it can result from other medications or diseases, hormone or enzyme deficiencies, or tumors.

Glucose, a form of sugar, is an important fuel for your body. Carbohydrates are the main dietary sources of glucose. Rice, potatoes, bread, tortillas, cereal, milk, fruit, and sweets are all carbohydrate-rich foods.

After a meal, glucose molecules are absorbed into your bloodstream and carried to the cells, where they are used for energy. Insulin, a hormone produced by your pancreas, helps glucose enter cells. If you take in more glucose than your body needs at the time, your body stores the extra glucose in your liver and muscles in a form called glycogen. Your body can use the stored glucose whenever it is needed for energy between meals. Extra glucose can also be converted to fat and stored in fat cells.

When blood glucose begins to fall, glucagon, another hormone produced by the pancreas, signals the liver to break down glycogen and release glucose, causing blood glucose levels to rise toward a normal level. If you have diabetes, this glucagon response to hypoglycemia may be impaired, making it harder for your glucose levels to return to the normal range.

Symptoms

Symptoms of hypoglycemia include

hunger
nervousness and shakiness
perspiration
dizziness or light-headedness
sleepiness
confusion
difficulty speaking
feeling anxious or weak

Hypoglycemia can also happen while you are sleeping. You might

cry out or have nightmares
find that your pajamas or sheets are damp from perspiration
feel tired, irritable, or confused when you wake up

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Hypoglycemia: A Side Effect of Diabetes Medications

Hypoglycemia can occur in people with diabetes who take certain medications to keep their blood glucose levels in control. Usually hypoglycemia is mild and can easily be treated by eating or drinking something with carbohydrate. But left untreated, hypoglycemia can lead to loss of consciousness. Although hypoglycemia can happen suddenly, it can usually be treated quickly, bringing your blood glucose level back to normal.

Causes of Hypoglycemia

In people taking certain blood-glucose lowering medications, blood glucose can fall too low for a number of reasons:

meals or snacks that are too small, delayed, or skipped
excessive doses of insulin or some diabetes medications, including sulfonylureas and meglitinides (Alpha-glucosidase inhibitors, biguanides, and thiazolidinediones alone should not cause hypoglycemia but can when used with other diabetes medicines.)
increased activity or exercise
excessive drinking of alcohol

Prevention

Your diabetes treatment plan is designed to match your medication dosage and schedule to your usual meals and activities. If you take insulin but then skip a meal, the insulin will still lower your blood glucose, but it will not find the food it is designed to break down. This mismatch might result in hypoglycemia.

To help prevent hypoglycemia, you should keep in mind several things:

Your diabetes medications. Some medications can cause hypoglycemia. Ask your health care provider if yours can. Also, always take medications and insulin in the recommended doses and at the recommended times.

What to Ask Your Doctor About Your Diabetes Medications

Could my diabetes medication cause hypoglycemia?
When should I take my diabetes medication?
How much should I take?
Should I keep taking my diabetes medication if I am sick?
Should I adjust my medication before exercise?

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