What is hypoglycemia?
Hypoglycemia refers to a condition of low glucose (blood sugar) level in your body. When your blood sugar level falls below 70 mg/dl, it requires immediate attention as it can be fatal if left untreated. Hypoglycemia is most often caused by the medications used to treat diabetes, however, there are other disorders or medications that can lower your blood sugar level.
Symptoms of hypoglycemia
It is important to recognize the symptoms. So that you can properly treat it. If you experience following symptoms, you should check your blood sugar level. If severe hypoglycemia occurs, one can experience seizures or coma.
- Nervous, anxious, irritable
- Sweating, chills, clamminess
- Weakness, lightheadedness, dizziness
- Hunger, nausea
- Blurred or tunnel vision
- Lack of coordination
- Rapid/fast heartbeat
Medications / disorders that can cause hypoglycemia
Some medications that are used to treat diabetes have a higher risk of causing hypoglycemia especially if the medication is taken without food. Below are those medications:
- Glipizide / glimepiride / glyburide
- Nateglinide / repaglinide
Other disorders or medications that can cause hypoglycemia include:
- Excessive alcohol consumption
- Severe hepatitis
- Beta blockers (metoprolol, atenolol, carvedilol, etc): not only beta blockers may cause hypoglycemia, they can also mask certain symptoms such as shakiness, palpitation, and anxiety. Sweating and hunger are not masked.
- Ciprofloxacin / levofloxacin
How to treat hypoglycemia
Rule of 15: Steps to treating hypoglycemia
- Take 15-20 grams of glucose or simple carbohydrates. Do not use chocolate or peanut butter for initial treatment. Added fat will delay
absorptionof sugar and prolong.
- Recheck blood sugar after 15 minutes
- If blood sugar is still less than 70, repeat 15-20 grams of glucose or simple carbohydrates and recheck blood sugar again after 15 minutes
- If blood sugar is greater than 70, eat a small meal or snack that contains some carbohydrates, protein, and fat in order to prevent hypoglycemia from recurring. The fat and protein will help to stabilize the blood sugar.
15 grams of glucose or simple carbohydrates
Glucagon is recommended to be prescribed for all diabetic patients at increased risk of severe hypoglycemia. It is only used when the patient is not conscious enough to treat. Caregivers, school personnel, or family members of these patients should be trained on when and how to administer glucagon. Carbohydrates should be administered as soon as possible after glucagon. It is important to note that glucagon will not work for patients with alcohol-induced due to depleted glycogen stores in those individuals. If no response to glucagon, IV dextrose may need to be administered.
Place patient lying sideways to prevent choking upon return to consciousness. Mix powder for injection by adding 1 mL of manufacturer-supplied sterile diluent or sterile water for injection to a vial containing 1 unit of the drug, to provide solutions containing 1 mg of glucagon/mL. Shake vial gently to dissolve. Use
Episodes of hypoglycemia are dangerous for patients. They decrease
Written By: Eddie Chang and Ellie Sung
- Cryer PE, Davis SN. Hypoglycemia. In: Jameson J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. eds. Harrison’s Principles of Internal Medicine, 20e New York, NY: McGraw-Hill; . http://nv-ezproxy.roseman.edu:2759/content.aspx?bookid=2129§ionid=192288656. Accessed February 25, 2019.
- American Diabetes Association. 6. Glycemic targets: Standards of Medical Care in Diabetes 2019. Diabetes Care 2019;42(Suppl. 1):S61–S70.