Demystifying Hypoglycemia: A Comprehensive Explanation of Low Blood Sugar Levels

Hypoglycemia, or low blood sugar, is a significant concern for individuals with diabetes, as well as for those without the condition. In non-diabetic individuals, blood sugar levels below 2.8 mmol/L are considered hypoglycemic, while diabetic patients are typically considered hypoglycemic when their levels drop below 3.9 mmol/L. Hypoglycemia can lead to various symptoms, including palpitations, weakness, tremors, sweating, and elevated heart rate.

Causes of Hypoglycemia:

1. Medication-Related Factors:

   • Insulin: Overdosing on insulin or engaging in vigorous activity after insulin injection can lead to acute hypoglycemia.
   • Sulfonylureas: These drugs can cause hypoglycemia, especially in cases of reduced food intake, liver or kidney disease, or adrenal insufficiency.
   • Other Oral Hypoglycemics: These medications are potent at lowering blood sugar and can induce hypoglycemia.

2. Disease-Related Factors:

   • Liver Disease: Severe liver conditions can impair the liver's ability to regulate blood sugar, leading to hypoglycemia.
   • Endocrine Disorders: Diseases affecting the adrenal glands, thyroid, or pituitary gland can cause hypoglycemia.

3. Lifestyle Factors:

   • Undereating and Overexertion: Long-term undereating, anorexia nervosa, chronic malabsorption, or conditions like renal glycosuria can lead to low blood sugar.
   • Alcohol Consumption: Drinking on an empty stomach can trigger the release of large amounts of insulin, leading to hypoglycemia.
   • Intense Exercise: Prolonged strenuous activity, especially in patients with high fever or diabetes, can consume large amounts of glucose  and cause hypoglycemia.

4. Functional Causes:

   • Functional Hypoglycemia: This type often occurs in obese middle-aged women, typically a few hours after a meal, and is thought to be related to the release of polypeptide hormones in the intestines that stimulate excessive insulin secretion.

Prevention Strategies for Hypoglycemia:

• Proper Medication Use: Start with low doses of insulin or secretagogues and adjust carefully.
• Regular and Balanced Meals: If meals are skipped or reduced, adjust hypoglycemic medication doses accordingly.
• Appropriate Exercise: Engage in mild to moderate physical activity to enhance metabolism and cardiovascular function without overexerting.
• Close Blood Sugar Monitoring: Regular monitoring is crucial, especially before bedtime and after adjusting medication doses. Carry a source of glucose, such as biscuits or candy, to quickly address hypoglycemia.

In conclusion, diabetic individuals should be vigilant about the risk of hypoglycemia and take preventive measures to avoid it. Carrying a "first aid card" with essential information and a source of glucose can be lifesaving in the event of severe hypoglycemia. Proper management of diabetes, including medication, diet, and exercise, is key to preventing both hypoglycemia and hyperglycemia.