Management of Hypoglycemia

Written by Lin Xiang Dong
Endocrinology
Updated on September 02, 2024
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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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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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What is hypoglycemia?

Hypoglycemia is a condition characterized by abnormally low plasma glucose levels, caused by various etiologies, and clinically presents as a syndrome mainly featuring sympathetic nervous excitement and brain cell glucose deficiency. For healthy individuals, hypoglycemia is diagnosed when blood glucose levels fall below 2.8 mmol/L. For diabetic patients, hypoglycemia is diagnosed when blood glucose levels are below 3.8 mmol/L. Hypoglycemia can be categorized into fasting hypoglycemia and postprandial hypoglycemia based on its causes. Common symptoms of hypoglycemia include palpitations, fatigue, trembling hands, accelerated heart rate, sweating, mental distraction, dizziness, drowsiness, unstable gait, irritability, and even odd behaviors. In severe cases, it can lead to coma or even death.

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Causes of Hypoglycemia in Pregnant Women

Hypoglycemia is a relatively common clinical phenomenon in pregnant women during pregnancy, mainly manifesting as dizziness, blurred vision, and even fainting. This occurs because the metabolism of pregnant women accelerates during pregnancy, while the secretion of the islets is not correspondingly increased. This results in the physiological function of the islets being very active, which can easily lead to low blood sugar in expectant mothers, causing symptoms such as dizziness and fatigue due to hypoglycemia. Additionally, hormonal changes during pregnancy can lead to decreased appetite, nausea, vomiting, irregular eating habits, and malnutrition in pregnant women. Despite this, energy consumption still occurs, which can also lead to hypoglycemia.

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Hypoglycemia complications

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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How to regulate hypoglycemia

If hypoglycemia occurs repeatedly, it is necessary to go to the hospital for an examination to rule out some diseases that may cause hypoglycemia. If no apparent diseases are found after the examination, self-regulation can be considered. The methods for self-regulation include the following: Firstly, pay attention to a reasonable diet, eat regularly, balance meat and vegetables, and develop good eating habits without excessive dieting. Secondly, persist in exercising to strengthen the body, enhance physical fitness, improve immunity, and reduce the occurrence of hypoglycemia. Lastly, develop good living habits, ensure adequate sleep, avoid staying up late, avoid excessive fatigue, and balance work and rest.