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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Written by Lin Xiang Dong
Endocrinology
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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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Written by Lin Xiang Dong
Endocrinology
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What to eat for low blood sugar?

For already occurring hypoglycemia, our treatment goal is to quickly alleviate the symptoms of hypoglycemia. The primary method is to provide sugar, either through sugar water, sugary drinks, or sugar-containing fruits, bread, etc. After providing sugar, the symptoms of hypoglycemia can be quickly relieved. At the same time, to prevent hypoglycemia, we need to do the following: first, eat meals regularly every day, avoiding eating too late or not enough. Second, it is not advisable to exercise on an empty stomach; it is appropriate to eat something before exercising. Third, avoid excessive alcohol consumption, as it can inhibit the conversion of liver glycogen into glucose in the body, making it easy to develop hypoglycemia, so avoid excessive drinking. Fourth, once common symptoms such as palpitations, dizziness, sweating, and other symptoms occur, we should quickly provide sugar.

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Written by Lin Xiang Dong
Endocrinology
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How to check for hypoglycemia

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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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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Hypoglycemia emergency treatment procedure

Typically, when we consider a patient might have hypoglycemia, we follow the standard diagnostic procedures. First, we measure the patient's blood sugar level; if it is below 2.8 mmol/L, there is a high likelihood of hypoglycemia. Symptoms may include palpitations, dizziness, pale complexion, lack of concentration, lethargy, or even coma. Immediate action would involve giving the patient oral glucose solution or administrating glucose intravenously, followed by monitoring the patient’s clinical symptoms and blood sugar levels. If the patient's condition significantly improves after glucose provision, we can diagnose them with hypoglycemia. This is also a critical emergency procedure for hypoglycemia, which entails timely glucose supplementation. If the patient has recurrent hypoglycemia episodes, further detailed examinations should be conducted.