Hypoglycemia (pronounced HI-po-gli-seem-ee-ah) means low blood sugar. The main fuel used by cells to produce energy is a type of sugar called glucose. Glucose is carried to cells in the bloodstream. In that form, glucose is often referred to as "blood sugar." Cells need a minimum amount of glucose to function properly. When there is not enough glucose in the blood to meet those needs, the condition known as hypoglycemia develops.
An important part of the human diet is carbohydrates—sugars and starches. Carbohydrates are changed in the digestive system to glucose. The bloodstream carries glucose to cells. Cells use glucose to produce the energy needed for walking, talking, and just staying alive.
In some cases, people do not get enough glucose in their regular diet. Or they get enough glucose, but their body does not use it properly. In such cases, the person develops hypoglycemia. Hypoglycemia can develop in several ways.
Hypoglycemia occurs frequently among diabetics (see diabetes mellitus entry). Diabetics are people whose bodies cannot use glucose properly. Their bodies either cannot manufacture or cannot use a compound known as insulin. Insulin (pronounced IN-soo-lin) is needed to convert glucose into a form that cells can use.
Diabetics whose bodies don't manufacture insulin control their disorder by taking insulin shots. Diabetics whose bodies don't recognize insulin can adjust their diet to deal with the condition. Missing a meal or taking too much insulin can cause hypoglycemia. This can cause a severe reaction known as "insulin shock."
Idiopathic hypoglycemia occurs most commonly after a person has eaten. The cause for this type of hypoglycemia is not known. It may occur when an organ, such as the liver or pancreas, is not functioning properly. However, the condition is not related to diabetes.
Idiopathic hypoglycemia also occurs among people who have negative reactions to certain foods and drugs. For example, some children have a negative reaction to aspirin that can cause hypoglycemia. Other children have a negative reaction to natural fruit sugar (fructose) that can produce hypoglycemia.
Strenuous exercise or going without food for long periods of time may also cause hypoglycemia. This form of hypoglycemia is called fasting hypoglycemia.
Other factors can also cause hypoglycemia, including:
The carbohydrates we eat are changed into glucose in the digestive system. The glucose passes into the bloodstream and is carried to cells, where it is used to make energy.
Under normal conditions, blood contains just the right amount of glucose. Cells receive all the glucose they need to function properly. But sometimes, blood contains too much or too little glucose. These conditions are called hyperglycemia ("hyper" means "too much") and hypoglycemia ("hypo" means "too little"). Cells either get more glucose than they can use or do not get enough to function normally.
These conditions are caused by two factors. First, a person may eat a diet that provides too much or too little glucose to the body. For example, people who eat a lot of sugar may develop hypoglycemia.
Second, the cells in a person's body may lack the ability to use glucose normally. The person may have inherited the defect from his or her parents. Or something may have happened in the person's life to cause the defect. In either case, the person's blood contains too much or too little glucose. In the latter case, hypoglycemia results.
There is some debate about the nature of idiopathic hypoglycemia. The condition is being diagnosed much less frequently than it was a few decades ago. Some doctors think the condition is caused by other medical problems and is not a disorder in and of itself. Others think that idiopathic hypoglycemia is actually an early stage of diabetes.
Symptoms differ somewhat depending on the type of hypoglycemia that occurs. In the case of drug-induced hypoglycemia, the symptoms may resemble those of extreme shock. They include:
Idiopathic hypoglycemia is often characterized by milder symptoms, such as:
Hypoglycemia can be difficult to diagnose. Its symptoms may change over time. Patients seldom have all or even most of the symptoms listed above. Also, the symptoms of hypoglycemia are similar to those seen in other disorders.
The first step in diagnosis, therefore, is to rule out other possible causes for a patient's symptoms. Even then, the patient may have two or more problems at the same time, only one of which is hypoglycemia.
Patients with drug-induced hypoglycemia have already been diagnosed with a blood-sugar problem. They may already be taking insulin to control their disorder. Or they may be aware of the need for following a certain diet. These patients can usually diagnose their own episodes of hypoglycemia. They can carry with them a simple machine known as a glucometer. They can take a small sample of their blood and test it in the glucometer. If their blood glucose level is too low, the patient can raise it by eating a small amount of sugar.
A standard test for idiopathic hypoglycemia is called an extended oral glucose tolerance test. The patient is instructed to fast (not eat any food) overnight. The patient then drinks a solution of glucose in water. His or her blood is then tested every hour for five to six hours. The results of this test indicate the patient's ability to metabolize glucose.
The fastest treatment for hypoglycemia is to have the patient eat some sugar. A piece of candy or some fruit juice will usually raise blood sugar quickly. Special glucose tablets or injections (shots) of glucose can also be used.
Long-term treatment of hypoglycemia requires changes in a person's diet. The usual recommendation is for a person to eat small but frequent meals throughout the day. They should avoid simple sugars, alcohol, fats, and fruit juice.
Some homeopathic practitioners believe that hypoglycemia may be caused by a number of factors. They recommend a variety of treatments that may include acupuncture and herbal remedies. One suggested drink is made by boiling gentian (an herb) in water. Some practitioners also recommend adding chromium to the diet. Chromium is thought by some practitioners to help stabilize blood-sugar levels. Chromium is found in whole-grain breads and cereals, cheeses, molasses, lean meats, and brewer's yeast.
All forms of hypoglycemia can usually be controlled by following a well-planned diet. In addition, diabetics can often control drug-induced episodes of hypoglycemia by monitoring their blood glucose levels.
Methods of prevention vary depending on the cause of the hypoglycemia.
The first step in preventing drug-induced hypoglycemia is to maintain a proper diet. Diabetics may also find it necessary to monitor their blood-sugar levels on a regular basis. Low blood-sugar levels indicate that a person should immediately eat candy or some other sweet snack. Insulin pumps are also effective in maintaining the proper level of blood sugar. These pumps can be implanted under the skin and programmed to continuously release the correct amount of insulin.
Idiopathic hypoglycemia can usually be controlled by learning and following certain dietary rules. These rules include the following:
Budd, Martin. Low Blood Sugar: Coping With Low Blood Sugar. London: Thorsons Publications, 1998.
Eades, Michael R., and Mary Dan. Protein Power. New York: Bantam Books, 1995.
Krimmel, Patricia, and Edward Krimmel. The Low Blood Sugar Handbook. Bryn Mawr, PA: Franklin Publishers, 1992.
Ruggiero, Roberta. The Do's and Dont's of Low Blood Sugar. Hollywood, FL: Frederick Fell Publishers, 1988.
Hypoglycemia Association, Inc. 1808 New Hampshire Ave., P.O. Box 165, Ashton, MD 20861–0165.
National Hypoglycemia Association, Inc. PO Box 120, Ridgewood, NJ 07451. (201) 670–1189.