Hypoglycemia complications

Written by Lin Xiang Dong
Endocrinology
Updated on September 23, 2024
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Complications of hypoglycemia encompass aspects of both the central nervous system and the heart. Firstly, the central nervous system, due to hypoglycemic episodes, can lead to brain cells lacking energy, which may then cause cerebral edema. This results in severe neuroglycopenic syndrome. Common symptoms include confusion, apathy, and abnormal mental and behavioral actions. If hypoglycemia persists or recurs, it can lead to coma and death. Secondly, cardiac complications arise during hypoglycemic episodes because excitement of the sympathetic nervous system leads to an increased heart rate or sinus tachycardia. Very few patients may experience bradycardia. Additionally, other arrhythmias, including premature atrial contractions, supraventricular tachycardia, ventricular premature beats, and short episodes of ventricular tachycardia, can occur.

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What does hypoglycemia lack?

Hypoglycemia refers to a decrease in the concentration of glucose in the blood, known as hypoglycemia. Generally, for the normal healthy population, a blood glucose concentration below 2.8 mmol/L is considered hypoglycemia. For diabetic patients, a blood glucose concentration below 3.9 mmol/L is considered hypoglycemia. Of course, this can also be due to some endocrine diseases, such as pituitary insufficiency, adrenal cortex insufficiency, and hypothyroidism leading to hypoglycemia. In addition to the low concentration of glucose in the blood, there may also be a decrease in some hormone levels related to pituitary, adrenal, and thyroid functions, such as decreased cortisol and thyroid hormone levels, which are also deficiencies in the body.

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How to Treat Hypoglycemia

If the patient is experiencing symptoms such as dizziness, palpitations, cold sweats, and feelings of hunger, but is mentally clear, it is suggested to promptly eat foods like candy or chocolate that can rapidly increase blood sugar levels. However, if the patient's hypoglycemia isn’t fully corrected and leads to unconsciousness, then it is critical to immediately call emergency services (dial 120). Upon their arrival, a micro blood sugar test should be conducted. Secondly, an injection of 50% glucose can be administered intravenously to correct the hypoglycemia. Thus, preventing hypoglycemia is very important.

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Does low blood sugar cause confusion?

When hypoglycemia occurs, it is possible to experience confusion. This is because, under normal conditions, the glucose level in our brain tissue is only about 25% of that in our blood. After hypoglycemia occurs, the glucose concentration in our brain tissue will further decrease, leading to a state of sugar and oxygen deprivation in the brain. Severe cases can exhibit a range of neuropsychiatric symptoms such as behavioral changes and confusion, cognitive dysfunction, or even epileptic seizures. Some patients may also experience coma and permanent brain damage, typically seen in those with severe and prolonged hypoglycemia. Similarly, patients who repeatedly experience hypoglycemia often also suffer from brain atrophy. Therefore, confusion can occur during hypoglycemia.

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Hypoglycemia is caused by what?

Hypoglycemia is most commonly seen in patients with type 2 diabetes. During the treatment of diabetes, hypoglycemia can occur due to excessive use of medication or insulin, failure to eat on time after exercise, or decreased appetite without appropriately reducing the medication. Another common cause is insulinoma, a type of tumor that secretes excessive insulin, resulting in lowered blood glucose levels. A third cause relates to the early stage of type 2 diabetes, where insulin resistance and delayed insulin peak times often lead to pre-meal hypoglycemia, especially before lunch and dinner. Lastly, hypoglycemia is also commonly observed in some young women with specific coloring, potentially due to gastrointestinal motility issues or other reasons leading to pre-meal hypoglycemia. It is also common in patients with hepatitis or cirrhosis, where the liver's ability to output glucose is diminished, increasing the risk of hypoglycemia when fasting.

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What are the symptoms of hypoglycemia?

Hypoglycemia, in fact, is diagnosed in healthy individuals when blood glucose levels are less than or equal to 2.8 mmol/L, and in diabetic patients when levels are less than or equal to 3.9 mmol/L. Common symptoms of mild hypoglycemia typically involve sympathetic nervous system activation, such as dizziness, palpitations, cold sweats, trembling hands, and a feeling of hunger. It is recommended that food be consumed promptly when these symptoms occur. If hypoglycemia is not immediately addressed, severe outcomes can occur, including altered mental status, coma, and unresponsiveness. In some cases, hypoglycemia may trigger seizures or abnormal cerebral vascular accidents, such as stroke or cardiac ischemia, leading to a heart attack. Therefore, preventing hypoglycemia is of utmost importance.