How to check for hypoglycemia

Written by Lin Xiang Dong
Endocrinology
Updated on August 31, 2024
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We usually diagnose hypoglycemia based on the following three criteria. The first is the presence of hypoglycemic symptoms, such as palpitations, tremors, sweating, dizziness, etc. If these symptoms are present, we must immediately consider the possibility of hypoglycemia, and then proceed to monitor blood glucose levels. If the blood glucose reading is below 2.8 for non-diabetic patients and below 3.9 for diabetic patients, hypoglycemia can be considered. Subsequently, the patient should consume sugary water, and if the symptoms significantly alleviate after this, a diagnosis of hypoglycemia can be established. Moreover, if the patient does not have a history of diabetes, does not use hypoglycemic drugs, but experiences recurring episodes of hypoglycemia, further testing is required, such as a fasting test, checking C-peptide levels, insulin levels, etc., to rule out insulinoma.

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How is hypoglycemia treated?

For mild hypoglycemia, if the patient is conscious, they can self-treat by orally consuming sugary solutions or foods containing carbohydrates, such as beverages, fruit juices, glucose water, candies, etc. In cases of more severe hypoglycemia accompanied by changes in consciousness, oral sugar intake is not advisable. Instead, intravenous glucose injections should be administered to raise blood sugar levels, typically using about 40-100 ml of 50% concentrated glucose. Blood sugar levels should be monitored repeatedly. If the patient does not regain consciousness, repeated glucose injections may be necessary. For severe cases with other organic pathologies, treatment with corticosteroids may be required, and emergency hospital treatment is necessary.

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Management of Hypoglycemia

The treatment of hypoglycemia mainly includes two aspects: the first is to alleviate the symptoms of hypoglycemia, and the second is to correct various underlying causes that lead to hypoglycemia. For various cases of hypoglycemia that have already occurred, rapid relief can be achieved by administering sugar water, sugary drinks, or consuming candies, cookies, bread, steamed buns, etc. If it is drug-induced hypoglycemia in diabetic patients, the relevant drugs should be discontinued promptly. If hypoglycemia occurs frequently, or even leads to coma, it is possible to investigate the primary disease, conduct a hypoglycemia test, and determine whether an insulinoma exists.

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Is hypoglycemia dangerous?

For diabetic patients, hypoglycemia is defined as glucose levels less than 4 mmol/L, and for non-diabetic individuals, or healthy people, low blood sugar is characterized by levels less than 2.8 mmol/L. Hypoglycemia initially causes metabolic abnormalities in the brain since brain cells in the middle of the brain can't break down fats or proteins; they can only use the simplest sugars, which is the glucose in our blood, as their energy source. When the concentration of sugar in the blood decreases, the brain cells fail to absorb enough energy, which can lead to abnormalities in brain function, resulting in symptoms like fatigue and drowsiness. If glucose is not consumed at this point, the further deficiency in energy for brain cells may lead to coma, making hypoglycemia a very dangerous condition.

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Written by Lin Xiang Dong
Endocrinology
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Standard for Low Blood Sugar

Our diagnostic criteria for hypoglycemia are often based on the "Whipple's triad," which is determined first by the presence of symptoms of hypoglycemia, such as palpitations, dizziness, pale complexion, cold sweats, confusion, mental abnormalities, and so on. Second, after the symptoms appear, we measure blood glucose; in non-diabetic patients, blood glucose below 2.8 mmol/L, and in diabetic patients, blood glucose below 3.9 mmol/L, then it can be judged as possibly hypoglycemia. Third, after measuring blood glucose, we quickly provide sugars, administer oral sugar water, biscuits, etc., and his symptoms of hypoglycemia quickly alleviate. Based on these three points, we can diagnose hypoglycemia.

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Written by Lin Xiang Dong
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How is hypoglycemia treated?

The treatment for hypoglycemia is relatively simple; in most cases, it involves immediate consumption of sugar water to replenish energy, which can significantly alleviate the symptoms of hypoglycemia. If it is an occasional, single occurrence of hypoglycemia, normal status can be restored after replenishing energy. However, if hypoglycemia occurs repeatedly, it is necessary to seek timely medical treatment at a hospital to rule out some common diseases that cause hypoglycemia.