Is hypoglycemia dangerous?

Written by Luo Han Ying
Endocrinology
Updated on March 23, 2025
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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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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.

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The harms of hypoglycemia

Hypoglycemia poses significant risks to the human body and mainly includes the following aspects: Firstly, hypoglycemia can lead to brain dysfunction, initially characterized by lack of mental focus, sluggish thinking and speech, dizziness, drowsiness, irritability, and other symptoms. In later stages, seizures, coma, and even death may occur. Secondly, recurrent hypoglycemic episodes can cause irreversible damage to the central nervous system, leading to changes in personality, mental disorders, dementia, etc. Thirdly, hypoglycemia can stimulate the cardiovascular system, trigger arrhythmias, myocardial infarction, and so on. Fourthly, prolonged hypoglycemic coma, if unnoticed, can result in death.

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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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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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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.