Fainting from hypoglycemia: Hypoglycemia (Low Blood Sugar) in People Without Diabetes
Hypoglycemia (Low Blood Sugar) in People Without Diabetes
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Hypoglycemia, or low blood sugar, is most common in people who have diabetes. If you have already been diagnosed with diabetes and need more information about low blood sugar, see the topics:
What is low blood sugar?
You may have briefly felt the effects of low blood sugar when you’ve gotten really hungry or exercised hard without eating enough. This happens to nearly everyone from time to time. It’s easy to correct and usually nothing to worry about.
But low blood sugar, or hypoglycemia, can also be an ongoing problem. It occurs when the level of sugar in your blood drops too low to give your body energy.
What causes hypoglycemia in people who don’t have diabetes?
Ongoing problems with low blood sugar can be caused by:
- Diseases of the liver, kidneys, or pancreas.
- Metabolic problems.
- Alcohol use.
- Stomach surgery.
What are the symptoms?
Symptoms can be different depending on how low your blood sugar level drops.
- Mild hypoglycemia can make you feel hungry or like you want to vomit. You could also feel jittery or nervous. Your heart may beat fast. You may sweat. Or your skin might turn cold and clammy.
- Moderate hypoglycemia often makes people feel short-tempered, nervous, afraid, or confused. Your vision may blur. You could also feel unsteady or have trouble walking.
- Severe hypoglycemia can cause you to pass out. You could have seizures. It could even cause a coma or death.
If you’ve had hypoglycemia during the night, you may wake up tired or with a headache. And you may have nightmares. Or you may sweat so much during the night that your pajamas or sheets are damp when you wake up.
How is hypoglycemia diagnosed?
To diagnose hypoglycemia, your doctor will do a physical exam and ask you questions about your health and any medicines you take. You will need blood tests to check your blood sugar levels. Some tests might include not eating (fasting) and watching for symptoms. Other tests might involve eating a meal that could cause symptoms of low blood sugar several hours later. The results of these types of tests can help diagnose the cause.
You may also need tests to look for or rule out health problems that could be affecting your blood sugar levels.
How is it treated?
You can treat a sudden episode of low blood sugar by eating or drinking something with sugar in it. Some examples of “quick-sugar foods” are fruit juice, soda, milk, raisins, and hard candy. You may also take glucose tablets. This is usually all that’s needed to get your blood sugar level back up in the short term.
If your hypoglycemia is caused by a health condition, you may need treatment for that condition. There also may be steps you can take to avoid low blood sugar. For example, talk to your doctor about whether changes in your diet, medicines, or exercise habits might help.
What should you do in an emergency?
If mild or moderate hypoglycemia isn’t treated right away, it can turn into severe hypoglycemia. People with severe hypoglycemia usually pass out. If you pass out, someone should call 911 right away.
If you have a health problem that tends to cause low blood sugar, it’s a good idea to teach your family, friends, and coworkers about what symptoms to watch for and what to do. You may also want to wear a medical alert bracelet or necklace.
Low blood sugar (hypoglycaemia) – NHS
A low blood sugar level, also called hypoglycaemia or a “hypo”, is where the level of sugar (glucose) in your blood drops too low.
It mainly affects people with diabetes, especially if they take insulin.
A low blood sugar level can be dangerous if it’s not treated quickly, but you can usually treat it easily yourself.
Symptoms of a low blood sugar level
A low blood sugar level can affect everyone differently. You’ll learn how it makes you feel, although your symptoms may change over time.
Early signs of a low blood sugar level include:
- feeling tired
- feeling hungry
- tingling lips
- feeling shaky or trembling
- a fast or pounding heartbeat (palpitations)
- becoming easily irritated, tearful, anxious or moody
- turning pale
If a low blood sugar level is not treated, you may get other symptoms, such as:
- blurred vision
- confusion or difficulty concentrating
- unusual behaviour, slurred speech or clumsiness (like being drunk)
- feeling sleepy
- seizures or fits
- collapsing or passing out
A low blood sugar level, or hypo, can also happen while you’re sleeping. This may cause you to wake up during the night or cause headaches, tiredness or damp sheets (from sweat) in the morning.
How to treat a low blood sugar level yourself
Follow these steps if your blood sugar level is less than 4mmol/L or you have hypo symptoms:
- Have a sugary drink or snack – like a small glass of fizzy drink (not a diet variety) or fruit juice, a small handful of sweets, 3 or 6 glucose tablets or 1 to 2 tubes of glucose gel.
- Test your blood sugar after 10 to 15 minutes – if it’s improved and you feel better, move on to step 3. If there’s little or no change, treat again with a sugary drink or snack and take another reading after 10 to 15 minutes.
- You may need to eat your main meal (containing a slow-release carbohydrate) if it’s the right time to have it. Or, have a snack that contains a slow-release carbohydrate, such as a slice of bread or toast, a couple of biscuits, or a glass of cows’ milk.
You do not usually need to get medical help once you’re feeling better if you only have a few hypos.
But tell your diabetes team if you keep having hypos or if you stop having symptoms when your blood sugar level is low.
How to treat someone who’s unconscious or very sleepy (drowsy)
Follow these steps:
- Put the person in the recovery position and do not put anything in their mouth – so they do not choke.
- Call 999 for an ambulance if an injection of glucagon is not available, you do not know how to use it, or the person had alcohol before their hypo.
- If an injection of glucagon is available and you know how to use it, give it to them immediately.
- If they wake up within 10 minutes of getting the injection and feel better, move on to step 5. If they do not improve within 10 minutes, call 999 for an ambulance.
- If they’re fully awake and able to eat and drink safely, give them a carbohydrate snack.
They may need to go to hospital if they’re being sick (vomiting), or their blood sugar level drops again.
Tell your diabetes care team if you ever have a severe hypo that caused you to lose consciousness.
How to treat someone who’s having a seizure or fit
Follow these steps if someone has a seizure or fit caused by a low blood sugar level:
- Stay with them and stop them hurting themselves – lie them down on something soft and move them away from anything dangerous (like a road or hot radiator).
- Call 999 for an ambulance if the seizure or fit lasts more than 5 minutes.
- After the seizure or fit stops, give them a sugary snack.
Tell your diabetes care team if you ever have a severe hypo that caused you to have a seizure or fit.
What causes a low blood sugar level
In people with diabetes, the main causes of a low blood sugar level are:
- the effects of medicine – especially taking too much insulin, medicines called sulfonylureas (such as glibenclamide and gliclazide), medicines called glinides (such as repaglinide and nateglinide), or some antiviral medicines to treat hepatitis C
- skipping or delaying a meal
- not eating enough carbohydrate foods in your last meal, such as bread, cereals, pasta, potatoes and fruit
- exercise, especially if it’s intense or unplanned
- drinking alcohol
Sometimes there’s no obvious reason why a low blood sugar level happens.
Very occasionally, it can happen in people who do not have diabetes.
Preventing a low blood sugar level
If you have diabetes, you can reduce your chance of getting a low blood sugar level if you:
- Check your blood sugar level regularly and be aware of the symptoms of a low blood sugar level so you can treat it quickly.
- Always carry a sugary snack or drink with you, such as glucose tablets, a carton of fruit juice or some sweets. If you have a glucagon injection kit, always keep it with you.
- Do not skip meals.
- Be careful when drinking alcohol. Do not drink large amounts, check your blood sugar level regularly, and eat a carbohydrate snack afterwards.
- Be careful when exercising; eating a carbohydrate snack before exercise can help to reduce the risk of a hypo. If you take some types of diabetes medicine, your doctor may recommend you take a lower dose before or after doing intense exercise.
- Have a carbohydrate snack, such as toast, if your blood sugar level drops too low while you’re asleep (nocturnal hypoglycaemia)
If you keep getting a low blood sugar level, talk to your diabetes care team about things you can do to help prevent it.
A low blood sugar level without diabetes
A low blood sugar level is uncommon in people who do not have diabetes.
Possible causes include:
- your body releasing too much insulin after eating, (called reactive hypoglycaemia or postprandial hypoglycaemia)
- not eating (fasting) or malnutrition
- a complication of pregnancy
- a gastric bypass (a type of weight loss surgery)
- other medical conditions, such as problems with your hormone levels, pancreas, liver, kidneys, adrenal glands or heart
- some medicines, including quinine (taken for malaria)
See a GP if you think you keep getting symptoms of a low blood sugar level. They can arrange some simple tests to check if your blood sugar level is low and try to find out what’s causing it.
A low blood sugar level and driving
You may still be allowed to drive if you have diabetes or you’re at risk of a low blood sugar level for another reason, but you’ll need to do things to reduce the chance of this happening while you’re driving.
You also need to tell the Driver and Vehicle Licensing Agency (DVLA) and your car insurance company about your condition.
For more information, see:
Page last reviewed: 24 September 2020
Next review due: 24 September 2023
human biology – By what mechanism can hypoglycemia induce fainting?
There are regulatory mechanisms that may prevent moderate hypoglycemia to progress to a more severe state, however these mechanisms act before lack of conciousness sets in. The progression of hypoglycemia may depend on overall health and medical status and vary between healthy and diabetic persons, for example.
Rosenthal et al. (1) write that
The brain is normally dependent on glucose for oxidative metabolism
and function. Acute iatrogenic hypoglycemia, occurring as a result of
insulin excess during the treatment of type 1 diabetes, can cause
clinically significant cognitive impairment. In health, such
hypoglycemic cognitive dysfunction does not occur. Endogenous
counterregulatory mechanisms are activated in response to a small
reduction in circulating glucose, preventing more profound
hypoglycemia. In diabetes, the inability to reduce circulating insulin
levels (1), the failure of glucagon responses (2), sometimes
accompanied by defective autonomic and adrenergic responses (3), can
allow plasma glucose levels to fall low enough to result in detectable
disturbance of cognitive function, ranging from a subtle slowing of
reaction times (3) to coma (4).
In short, the brain malfunctions due to lack of glucose (the sole energy source for the brain). Note that cognitive impairment and unconciousness can also occur in otherwise healthy persons, for example in the case of prolonged exercise combined with lack of nutrition. The exact cause of cortical dysfunction is not known:
Impairment of brain function is a recognized consequence of acute
hypoglycemia. It is known that different brain functions have
different susceptibilities to acute hypoglycemia; for example, the
triggering of autonomic activation, a hypothalamic function, occurs in
response to quite modest decrements in circulating glucose
concentrations (5,6,7), whereas significant cortical dysfunction
requires more profound glucose deprivation (3). Even within different
cortical functions, there is variation in hypoglycemia susceptibility
(26). The mechanisms of cortical dysfunction during hypoglycemia are
Hypoglycemia (for Parents) – Nemours Kidshealth
No matter what we’re doing, even during sleep, our brains depend on glucose to function. Glucose is a sugar that comes from food, and it’s also formed and stored inside the body. It’s the main source of energy for the body’s cells and is carried to them through the bloodstream.
When blood glucose levels (also called blood sugar levels) drop too low, it’s called hypoglycemia. Very low blood sugar levels can cause severe symptoms that need immediate medical treatment.
Blood sugar levels in someone with diabetes are considered low when they fall below the target range. A blood sugar level slightly lower than the target range might not cause symptoms, but repeated low levels could require a change in the treatment plan to help avoid problems.
The diabetes health care team will find a child’s target blood sugar levels based on things like the child’s age, ability to recognize hypoglycemia symptoms, and the goals of the diabetes treatment plan.
Causes of Low Blood Sugar Levels
Low blood sugar levels are fairly common in people with diabetes. A major goal of diabetes care is to keep blood sugar levels from getting or staying too high to prevent both short- and long-term health problems. To do this, people with diabetes may use insulin and/or pills, depending on the type of diabetes they have. These medicines usually help keep blood sugar levels in a healthy range, but in certain situations, might make them drop too low.
Hypoglycemia can happen at any time in people taking blood sugar-lowering medicines, but is more likely if someone:
- skips or delays meals or snacks or doesn’t eat as much carbohydrate-containing food as expected when taking the diabetes medicine. This is common in kids who develop an illness (such as a stomach virus) that causes loss of appetite, nausea, or vomiting.
- takes too much insulin, takes the wrong type of insulin, or takes insulin at the wrong time
- exercises more than usual without eating additional snacks or adjusting the dosage of diabetes medicines to help prevent drops in blood sugar level
A low blood glucose level also can happen:
- during sleep, known as nocturnal hypoglycemia
- several hours after exercise, known as delayed postexercise hypoglycemia
- after someone drinks alcohol or uses drugs. Alcohol hurts the body’s ability to keep blood glucose in a normal range, which can cause a sudden drop in blood sugar. Drug or alcohol use also can make it hard for someone to sense low blood sugar levels. Talk to your child or teen about the health risks of alcohol and drug use.
Certain conditions also can increase how quickly insulin is absorbed into the bloodstream and make hypoglycemia more likely. For example, taking a hot shower or bath right after having an insulin injection increases blood flow through the blood vessels in the skin, which can cause the insulin to be absorbed more quickly than usual.
Insulin also can be absorbed more quickly when it’s injected into a muscle instead of into the fatty layer under the skin. And giving a shot in a part of the body most used in a particular sport (like injecting in the leg right before soccer practice) can make the insulin be absorbed more quickly. All of these situations increase the likelihood of hypoglycemia.
Signs and Symptoms of Low Blood Sugar
The signs and symptoms of low blood sugar can vary depending on the person and how quickly the level falls. Also, problems other than hypoglycemia or diabetes can cause similar symptoms.
Warning signs of low blood sugar include:
- extreme hunger (some kids complain of a gnawing stomachache or “hunger pain”)
- shakiness or tremors
- rapid heart rate
- cold sweat
- a pale, gray skin color
- moodiness or crankiness/irritability
- unsteadiness/staggering when walking
- blurred or double vision
- seizures or convulsions
- loss of consciousness
Kids who have nocturnal hypoglycemia may have bouts of crying, nightmares, or night sweats (with damp sheets and/or pajamas), and might wake up groggy or with a headache.
Checking for Low Blood Sugar Levels
When blood sugar levels fall too low, the body releases the hormone adrenaline, which helps get stored glucose into the bloodstream quickly. Paleness, sweating, shakiness, and increased heart rate are early warning signs of this adrenaline release.
More severe symptoms — such as confusion, drowsiness, seizures, and loss of consciousness — may happen if the hypoglycemia isn’t treated and the brain doesn’t get enough glucose to work properly.
The only way to know for sure if your child has low blood sugar levels is to test them. Blood sugar levels can be tested with a glucose meter, a computerized device that measures and displays the amount of glucose in a blood sample. However, if the situation makes it impossible or inconvenient to quickly check the blood sugar, it’s important to treat your child for hypoglycemia immediately to prevent symptoms from getting worse.
Sometimes a child with diabetes may have symptoms of low blood sugar, but the levels are not actually low. This is a called a false reaction. Adrenaline also can be released when blood sugar levels fall rapidly from a high level to a normal level. Testing blood sugar levels before giving treatment for hypoglycemia can help you identify false reactions.
Also, some kids may learn to fake symptoms of low blood sugar to get a sugary treat or avoid something unpleasant. Again, checking the blood sugar level can confirm the presence of hypoglycemia.
It’s important to discuss the signs and symptoms of low blood sugar with your child. Even younger kids who can’t verbalize symptoms should learn how to alert their parents when they don’t feel well. This will help kids make the connection between how they feel and the need for treatment. Kids also should know when and how to find an adult for help.
Some people with diabetes don’t have or can’t sense the early warning signs of low blood sugar, a condition known as hypoglycemic unawareness. They’re at greater risk for not recognizing the need to get treatment for hypoglycemia promptly. This could lead to more serious symptoms, such as loss of consciousness or seizures, as their blood sugar falls.
If you think your child is having trouble sensing low blood sugar, be sure to let the diabetes health care team know.
Treating Low Blood Sugar Levels
The diabetes health care team will give you clear guidelines about how to treat hypoglycemia, depending on the severity of the symptoms.
If it’s convenient, test the blood sugar levels before treating your child to confirm that the symptoms are due to hypoglycemia. If blood sugar can’t be checked immediately, don’t delay treating your child’s symptoms — you can always do a test after getting the blood sugar back into the normal range.
When blood sugar levels are low, the goal is to get them back up quickly. To do that, give your child sugar or sugary foods that raise the blood glucose level quickly. In general, treatment for hypoglycemia involves:
- having your child eat or drink a form of glucose that works fast, like regular soda, orange juice, or cake frosting
having your child take special tablets or gels that contain glucose. Generally, symptoms will stop about 10 minutes after your child takes sugar.
- rechecking your child’s blood sugar to make sure that the level is no longer low and giving your child food to help prevent the blood sugar from dropping again
- giving glucagon (see below), if symptoms are severe or get worse after your child is given sugar by mouth
For more severe cases of hypoglycemia in which seizures or loss of consciousness happen, giving sugar by mouth may be very difficult or even dangerous. In that case, a glucagon injection should be given.
Glucagon is a hormone that helps raise blood sugar levels quickly. Treatment with glucagon should be given as soon as severe hypoglycemia is suspected and not delayed to call a doctor or ambulance.
After receiving glucagon, a child should wake up within about 10 to 15 minutes and be able to take sugar or food by mouth to help prevent the blood sugar from falling again. Call 911 if your care team has advised you to do so at this point.
Call the doctor after any severe low blood sugar reaction requiring glucagon treatment — it could be a sign that the diabetes management plan needs to be changed to help prevent future hypoglycemia episodes.
When possible, adult family members and your child’s caregivers and school staff should know:
- the signs of hypoglycemia
- when and how to give glucagon shots
- when to get emergency medical care
Your doctor can prescribe a glucagon kit, which should be kept where you and your child’s caregivers can easily find it.
Preventing Low Blood Sugar Levels
By knowing what causes low blood sugar levels and being prepared, you and your child can make them less likely and help prevent severe symptoms.
Remember: You can’t turn off the action of insulin once it’s been injected. So to avoid low blood sugar episodes, insulin doses need to be matched to your child’s needs each day — taking meals, exercise, and other things into consideration.
More tips to help avoid low blood sugar levels:
- Give your child the correct dose and type of insulin at the right time in the appropriate injection site.
- Check your child’s blood sugar regularly and whenever necessary to confirm that symptoms are due to hypoglycemia.
- Your child shouldn’t take baths or hot showers right after an insulin shot.
- Check blood glucose levels before and during exercise and make sure your child eats snacks as needed to keep or bring blood sugar levels into target range.
- Make sure your child follows the suggested timing of meals, injections, and exercise, based on the diabetes management plan.
- Your child should keep something containing sugar with him or her at all times and take it right away if symptoms of low blood sugar appear.
No matter how careful parents and children are, kids with diabetes at some point will have episodes of low blood sugar. So they should always wear and/or carry some sort of medical identification (like a bracelet or necklace). Besides identifying your child as having diabetes, this can provide emergency contact information.
If you have any questions about how to prevent or treat low blood sugar levels, call your child’s doctor or diabetes health care team.
Living with Hypoglycemia & Vasovagal Syncope
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Something that I struggle with but don’t ever discuss is living with hypoglycemia and vasovagal syncope. It’s not something that comes to mind for me to talk about yet it has a huge impact on my life. Being a fitness competitor is extremely difficult for me (towards the end of prep) because of it. Hypoglycemia can be best and easily described as having periods of low blood glucose (low blood sugar). Vasovagal Syncope can be best described as fainting due to over-reaction to certain things such as the sight of blood/needles, etc.
LIVING WITH HYPOGLYCEMIA – MY HEALTH JOURNEY
When I was in college I didn’t know the best ways to eat healthy. I knew how to work out but this was still before my heavy lifting days. I could often be caught running the treadmill for 45 minutes and doing maybe 30 minutes of light weights. I would count calories and thought fat was the enemy. I never considered how much protein, carbs or fat I was getting because I was so stuck on the number of calories.
Towards the end of college I had a few episodes where I would become really shaky, light-headed and dizzy. A few times I passed out. I thought it was a fluke thing the first few times but as the episodes increased getting worse each time, I knew something was wrong.
I remember getting ready for one of my first post-graduation interviews. I was blow-drying my hair and started to become extremely weak. I got nauseous, I felt clammy and I started to shake. I would blow-dry for a minute, take a break, blow-dry for a minute, take a break. Not wanting to miss my interview I kept telling myself it would pass. I got in my car and started to drive to my interview, making it to one of the busiest roads in town. Before I knew it I was in a full-blown sweat and I was starting to lose my vision. Luckily, I was able to get to the side of the ride before I lost complete vision. I couldn’t see a thing. By some grace of god, I didn’t pass out and lose control of my car. It took me a few minutes to get my vision back and when I woke up I was COVERED in sweat and shaking uncontrollably.
Over the next few years I had many random occurrences of passing out. I usually got a small window of time where I could feel it coming on and I could call for help. No one could ever keep it from happening but at least I knew if someone was there I wouldn’t get hurt. It wasn’t until me and my husband decided to have kids that I was ever diagnosed.
One day we visited a Reproductive Endocrinologist Dr. who sees patients for endometriosis, PCOS and many other issues. I was there for a possible endometriosis evaluation which had nothing to do with my fainting episodes. During the sit-down in the Dr.’s actual office I started to become weak. I was sweating, felt light-headed and couldn’t put my words together. Me and my husband were sitting directly across from the Dr. and I told them both (as I was sitting down) “I’m going to pass out”. Sure enough right in front of the Dr., I passed out cold. I’m sure it would be embarrassing for some but to me I was happy it happened in front of him. Looking at the circumstances and knowing my blood sugar, he pretty much diagnosed me on the spot (with some further testing after).
My Dr. gave me some advice on how to control living with hypoglycemia and my blood sugar. To this day I find them all imperative to keeping my healthy. I have not had an episode since taking these steps. I’ve listed some below.
- Eat meals that have carbs/protein/fat. A great snack bar if you have hypoglycemia: Kashi Bars
- Make sure you are getting enough CARBS
- Do not drink alcohol without a sufficient amount of food
- Do not skip meals
- Eat when you are hungry, don’t let yourself go too long between meals or become famished
- Check your blood sugar (there are lots of devices you can put right in your pocket)
Fast forward a few months from THAT Dr. appt. and I was also given an appt. at my cardiologist office. I was given a tracking device that I had to wear for a week or so (can’t remember exactly, it was awhile ago) to evaluate my heart. All turned out ok but he did say that I was definitely suffering from vasovagal syncope episodes as well. Not only did I pass out for unforeseen reasons often but I also passed out whenever I would have blood taken or get HIGHLY anxious.
With these 2 issues combined he gave me a pretty serious possible outcome: losing my license. I think my jaw was on the floor when he said this. Luckily, with the help and advice of my Dr.’s and support of my husband (taking me to Dr. appts., supporting my constant need to eat lol) I was able to avoid this. My cardiologists instructions for me to help avoid these vasovagal episodes:
- Eat a TON of salt. People are amazed at how much salt I put on ALL my meals!
- Stay well hydrated – The Nalgene Water Bottle is marked with ounces and milliliters making it easy for you to track your water throughout the day.
- Don’t drink much alcohol
- Try to have a high-fiber diet
- If you ever feel symptoms, lay on the floor and lift your legs straight up. Drawing the blood back down makes it almost impossible for you to pass out. (seriously a life-saver although you may look coo-koo doing this in the mall HA!)
As I’m sure you can imagine, prepping for a fitness competition while living with hypoglycemia l is EXTREMELY difficult. A very strict diet is imperative if you want to do well in a competition. There is no point in entering if you cannot follow the diet. You cannot out-train a poor diet. I push myself as much as I can in terms of diet but my health always comes first. If I ever feel like I’m starting to feel “not right” I let my coach know and we adjust accordingly. You just have to listen to your body.
Here is an example of one of my fitness competition prep meals. It works for me because there is enough protein, carbs and fat.
If you have any symptoms like mine or feel like you may have either of these conditions, go get checked! It’s better to know and learn how to manage it then to struggle with the unknown.
Lauren is a wife, mom of 3, and personal trainer with a passion for fitness, fashion, and blogging. She shares affordable fashion finds, fitness tips, and helps you learn how to make money with YOUR blog!
Hypoglycemia Symptoms, Causes, Diagnosis and Treatments
With Elena Christofides and Jennifer Shine Dyer MD, MPH
When you’re diabetic, a severe drop in blood sugar can strike even when you’re doing everything right. Glucose is your body’s main source of energy and fuels your brain, so it’s critical to recognize the early signs of an episode before it becomes severe enough to cause you to pass out or worse. We’re here to empower you with clear answers to all your pressing Qs.
Definition | Causes | Symptoms | Diagnosis | Treatments | Complications | Fast Facts | Support
What is hypoglycemia?
Hypoglycemia is the medical term for low blood sugar, or glucose. Sounds simple enough, right? Well, the condition can be surprisingly difficult to diagnose and manage. Despite the fact that low blood sugar is most commonly associated with diabetes, you don’t have to be diabetic to experience episodes of hypoglycemia. Learning how to spot and treat it yourself before it progresses to an emergency is the most important step to prevent complications.
Infographic by Lauren Hunter
What are the signs and symptoms of hypoglycemia?
Hypoglycemia tends to present as a cluster of symptoms, and they often occur together. The most common signs of dangerously low blood sugar include:
- Dizziness, disorientation, light-headedness, and an inability to think clearly
- Hunger, especially if you’ve just eaten
- Heightened irritability, confusion, and anxiety
- Clamminess and sweating, with cold hands and feet
- Drastic mood swings
If you have one or more of these symptoms contact your doctor.
What causes hypoglycemia?
If you have diabetes, there are common triggers to avoid. If you’re diabetic and experience any of the above low blood sugar symptoms after any the following behaviors, it’s important to alert your physician to see whether you have dangerously low blood sugar.
- Too few carbohydrates. As carbohydrates are your body’s main source of glucose, not having enough of them can cause a drop in blood sugar.
- Skipping meals. Just like consuming too few carbohydrates, skipping meals can prevent your body from receiving the energy it needs from glucose.
- Strenuous physical activity. Exercising more than usual, especially if you haven’t eaten enough carbohydrates at a meal, can cause a hypoglycemic episode.
- Excessive drinking. Alcohol can interfere with your body’s ability to metabolize glucose.
- Not eating soon enough after insulin treatment. If you take insulin as prescribed during mealtimes, but delay eating, this can cause hypoglycemia.
- Too much insulin. If you take too much insulin, this can cause your blood sugar to crash.
How is hypoglycemia diagnosed?
Hypoglycemia displays differently from person to person. Glucose maintenance is like a thermostat and may require adjustment based on how you’re feeling. A blood glucose reading will determine whether you’re experiencing hypoglycemia, and your doctor can recommend a home blood glucose meter to self-monitor your own blood sugar levels.
Low blood sugar is typically defined as 70 milligrams per deciliter, though it varies depending on your body composition. Dangerous levels of low blood sugar are anything below that. Getting into the habit of monitoring your own blood sugar levels with the help of your doctor is the first step in diagnosing and managing your hypoglycemia.
“If a person is acting a bit goofy or boisterous (often described as seeming “drunk” while perfectly sober) but they deny symptoms of hypoglycemia, then ask them to check their blood glucose level with a blood glucose monitor,” explains diabetes specialist David Klonoff MD. “The result might be surprisingly low. In that case, the person can be rescued with oral sugar before their condition worsens to where they are at risk of brain damage associated with going into a hypoglycemic coma.”
“Management means that fine line diabetes patients walk between normal blood sugar and abnormal blood sugar,” explains Dr. Elena Christofides. “Simple avoidance of hypoglycemic episodes isn’t the correct way to think about it. The most important thing that people need to appreciate is that avoidance of hypoglycemia by maintaining their blood sugar artificially high is not saving them, as high blood sugar presents its own risks.”
If you frequently have low glucose levels, it’s important to work with your physician in order to determine root causes rather than just raising your blood sugar, which, as Dr. Christofides explains, can exacerbate risks of diabetic complications. Remember, even though hypoglycemic episodes increase anxiety and can cause symptoms like spiking blood pressure and a racing heart, the condition is usually not life-threatening. An episode is sometimes referred to as a hypoglycemic attack, but nothing’s actually attacking your body—it’s just alerting you to what it needs (more glucose in your blood).
“Most people are afraid they’re going to die because they have a single episode of hypoglycemia, which simply isn’t true,” says Dr. Christofides.
What are the treatments for hypoglycemia?
Make an appointment with an endocrinologist if you feel like you’re having episodes of hypoglycemia, even if you’re not diabetic. They’ll talk you through treatment strategies, including:
- Adjusting your medications. You may need to change how often you take insulin or other medications, which medications you’re on, how much you take, and when you take them.
- Working with a registered dietitian on a personalized meal plan that stabilizes blood sugar levels. There’s no one-size-fits-all hypoglycemia diet, but a nutritionist can help you figure out a consistent meal plan tailored to you, and teach you how to count carbohydrate grams to go along with your health and routine.
- Increasing and improving self-monitoring of your blood glucose levels. Knowing your blood glucose level throughout the day—when you get up, before meals, and after meals etc.—can help you keep it from getting too low.
- Limiting consumption of alcoholic beverages. Alcohol interferes with the way your body metabolizes glucose. If you’re prone to hypoglycemia, consider decreasing how much alcohol you consume.
- Glucose tablets (dextrose). Make sure you always have glucose tablets on hand, whether at home, school, the office, or the gym. After taking the tablet, check your blood sugar. If it’s still low, take another tablet. If that doesn’t help, check with your doctor.
How can I stop my blood sugar from crashing?
Here are a few ways to avoid hypoglycemic episodes:
- Get in the habit of self-monitoring your blood glucose. Keeping track of when your blood sugar drops can help you recognize aspects of your routine that may be contributing to your hypoglycemia. Dr. Klonoff recommends a continuous glucose monitor. “It’s the best tool for automatically checking your blood glucose levels around the clock,” he says.
- Change your meal plan. When, what, how much, and how often you eat all play a big part in your blood glucose levels. A dietitian can teach you about healthy, well-balanced food choices that will make it easier for you to maintain an acceptable blood sugar range.
- Keep a stash of glucose tablets on hand. With your doctor’s recommendation, make sure you always have glucose tablets with you. You can stick them in your briefcase, purse, car, desk, school locker, etc. You may also want to keep snacks nearby—for example, cheese or peanut butter crackers, although doctors suggest over-the-counter glucose tablets for more accurate dosage. “Do not eat a ‘healthy’ sugar-free candy bar during hypoglycemia,” warns Dr. Klonoff. “Its lack of sugar means that it will not raise your blood glucose level sufficiently when you want it to. ”
- Certain drinks can help get your blood sugar up as well. Try 8 oz. of fruit juice, a soft drink (not sugar-free), or a cup of milk.
What complications can be caused by hypoglycemia?
Passing out from low blood sugar because you have not recognized the early signs and symptoms is called hypoglycemia unawareness, and can be quite dangerous depending on where you are, explains Dr. Klonoff. As doctors are required to report such incidents to the Department of Motor Vehicles, it can also mean a suspended driver’s license.
If this is something you’re worried about, “Wearing a continuous glucose monitor with an alarm for hypoglycemia can alert a person who is prone to developing low blood sugar levels that their blood glucose concentration is becoming dangerously low, so appropriate preventive action can be taken before they lose consciousness,” explains Dr. Klonoff.
What if I’m experiencing hypoglycemic episodes even though my doctor has confirmed that I’m not diabetic or prediabetic?
If you have low blood sugar and don’t have diabetes or prediabetes, it can be a sign of another serious health issue such as a tumor, hormone deficiency, kidney disorder, anorexia, or other eating disorder, all of which can cause dangerously low blood sugar.
Anorexia has the highest mortality of any psychiatric disorder, and the cause of death can be hypoglycemia, so take your illness seriously and seek help if you suspect your eating disorder may be progressing to the point where it is causing you to faint or experience other signs and symptoms of dangerously low blood sugar. The National Eating Disorders Association (NEDA) has resources on how to identify the signs that you may have an eating disorder, a hotline for help, as well as easily accessible information on everything from how to know when you need help to how to find quality treatment options in your zip code.
“People who are not diabetic don’t spontaneously have hypoglycemia for no reason,” explains Dr. Christofides. “It’s often an indication of another underlying issue, such as a hormone deficiency or eating disorder, so it’s important to schedule an appointment with your doctor to determine the cause in order to prevent complications.”
Common causes of hypoglycemia in people without diabetes include:
- Pancreatic tumor
- Medication that inhibits the proper production of insulin
- Hepatitis or kidney disorders
- Hormone deficiencies
- Anorexia and other eating disorders
Work with your doctor to find out what’s triggering your low blood sugar levels in order to come up with the right treatment plan for the root cause of your hypoglycemia.
What extreme conditions can occur if hypoglycemia is left untreated?
Although severe episodes (you may have heard the terms “diabetic shock,” “hypoglycemic shock” or “insulin shock”) which can trigger potentially life-threatening comas are rare, they require immediate emergency room care, so it’s best to make sure you are tracking your blood sugar so that you never have to worry about getting to that point. A drop in blood sugar means less fuel for your brain, so it’s critical for your body to receive enough glucose. “Hypoglycemia that leads to extended, reduced brain function is the biggest concern, as this can lead to seizures and loss of basic bodily functions controlled by the brain, which can ultimately lead to death,” explains Dr. Dyer.
Where can I find support?
The Hypoglycemia Support Foundation, established nearly 40 years ago, is a national group that offers many resources, including advocacy. They offer salons so that you can personally connect with people like you who are also dealing with bouts of low blood sugar.
Occasionally blood sugar crashes are so extreme they require emergency room care for an immediate dextrose IV treatment. If you have diabetes, wear a medical bracelet that does TK thing? What will this bracelet have on it? A number of one of your contacts? Can you answer and smooth out with this line? have a circle of people who serve as close contacts and are aware of your condition and how to help.
FAQ: Frequently Asked Questions
Who is most at risk for hypoglycemia?
Aside from diabetics, Dr. Jennifer Shine Dyer notes that children are more prone to
experience episodes of hypoglycemia because of their smaller body size, as well as having less fat to burn to maintain energy when glucose levels are low. “Eating meals every 4 to 6 hours should maintain glucose levels if this is the only cause of hypoglycemia,” she says.
How do I know it’s low blood sugar?
To know if you’re suffering from hypoglycemia, you’ll need to begin tracking your glucose levels under the supervision of your doctor. Drugstores and pharmacies carry test strips, as well as glucose meters, which will help. You can even see the effect that different foods have on your body by checking your blood sugar after eating.
Does fasting affect my blood sugar levels?
Yes, going without food can trigger hypoglycemia. If you have diabetes and are concerned about hypoglycemia, aim to eat smaller, more frequent meals and snacks that are low in processed sugars every three hours or so.
Does alcohol consumption trigger low blood sugar?
Excessive alcohol consumption, defined as more than one drink per day for women and more than two drinks per day for men, especially with little food, can keep your liver from releasing glucose, which can lead to hypoglycemia.
Updated on: 07/15/21
Causes, Symptoms and Treatment Options
Medically reviewed by Drugs.com. Last updated on March 1, 2021.
What is Hypoglycemia?
Hypoglycemia is an abnormally low level of blood sugar (blood glucose). Because the brain depends on blood sugar as its primary source of energy, hypoglycemia interferes with the brain’s ability to function properly. This can cause dizziness, headache, blurred vision, difficulty concentrating and other neurological symptoms.
Hypoglycemia also triggers the release of body hormones, such as epinephrine and norepinephrine. Your brain relies on these hormones to raise blood sugar levels. The release of these hormones causes additional symptoms of tremor, sweating, rapid heartbeat, anxiety and hunger.
Hypoglycemia is most common in people with diabetes. For a person with diabetes, hypoglycemia occurs because of too high a dose of diabetic medication, especially insulin, or a change in diet or exercise. Insulin and exercise both lower blood sugar and food raises it. Hypoglycemia is common in people who are taking insulin or oral medications that lower blood glucose, especially drugs in the sulfonylurea group (Glyburide and others).
True hypoglycemia with laboratory reports of low blood sugar rarely occurs in people who do not have diabetes. When it does occur outside of diabetes, hypoglycemia can be caused by many different medical problems. A partial list includes:
- Gastrointestinal surgery, usually involving removal of some part of the stomach. Surgery that removes part of the stomach can alter the normal relationships between digestion and insulin release. “Nissen” surgeries for treatment of gastroesophageal reflux can also result in episodes of hypoglycemia.
- A pancreatic tumor, called an insulinoma, that secretes insulin
- A deficiency of growth hormone from the pituitary gland or of cortisol from the adrenal glands. Both of these hormones help to keep blood sugars normal
- Overdose of aspirin
- Severe liver disease
- Use of insulin by someone who does not have diabetes
- Cancers, such as cancer of the liver
- Rarely, an enzyme defect. Examples of enzymes that help keep blood sugar normal are glucose-6-phosphatase, liver phosphorylase, and pyruvate carboxylase
Hypoglycemia can cause:
- Symptoms related to the brain “starving” for sugar — Headache, dizziness, blurred vision, difficulty concentrating, poor coordination, confusion, weakness or fainting, tingling sensations in the lips or hands, confused speech, abnormal behavior, convulsions, loss of consciousness, coma
- Symptoms related to the release of epinephrine and norepinephrine — Sweating, tremors (feeling shaky), rapid heartbeat, anxiety, hunger
If a person with diabetes has severe hypoglycemia, he or she may not be able to answer the doctor’s questions because of confusion or unconsciousness. In this case, a family member or close friend will need to describe the patient’s medical history and insulin regimen.
To help ensure effective emergency treatment, all people with diabetes should consider wearing a medical alert bracelet or necklace. This potentially lifesaving jewelry will identify the patient as having diabetes, even if the patient is far from home and traveling alone.
Family members or friends of a person with diabetes should learn how to bring a patient out of severe hypoglycemia by giving the person orange juice or another carbohydrate, or by giving an injection of the drug glucagon, which can raise blood sugar.
If a person with diabetes can answer questions appropriately, the doctor will want to know the names and doses of all medications, as well as recent food intake and exercise schedule. If the patient has been self-monitoring blood sugar with a glucometer (a hand-held device to measure glucose levels in blood from a finger prick), the doctor will review the most recent glucometer readings to confirm low blood sugar and to check for a pattern of hypoglycemia related to diet or exercise.
In people who do not have diabetes, the doctor will review current medications and ask about any history of gastrointestinal surgery (especially involving the stomach), liver disease and an enzyme deficit. Patients should describe their symptoms and when the symptoms occur — whether they occur before or after meals, during sleeping or after exercise.
In a person with diabetes, the diagnosis of hypoglycemia is based on symptoms and blood sugar readings. In most cases, no further testing is necessary.
In a person who is not diabetic, the ideal time for diagnostic testing is during an episode of symptoms. At that time, blood can be drawn to measure levels of glucose, and the patient’s reactions to glucose intake can be tested. If these measures confirm the diagnosis of hypoglycemia, blood can be sent to a laboratory to measure insulin levels.
If the patient has no symptoms at the time of evaluation, the doctor may ask him or her to measure his or her blood glucose when hypoglycemic symptoms occur. In non-diabetics, a blood sample can be tested to measure liver function and cortisol levels.
If an insulinoma is suspected, the doctor may order a supervised 48-hour fast. During that period, blood levels of glucose and insulin will be measured whenever symptoms occur or once every six hours, whichever comes first. A blood glucose level of less than 40 milligrams per deciliter with a high level of insulin strongly suggests the person has an insulinoma or has taken insulin or another diabetic drug in secret.
If a person develops symptoms of hypoglycemia only after eating, the doctor may ask him or her to self-monitor blood sugar with a glucometer at the time the symptoms occur.
An episode of hypoglycemia caused by exercise or by too much short-acting insulin usually can be stopped within minutes by eating or drinking a food or beverage that contains sugar (sugar tablets, candy, orange juice, non-diet soda). Hypoglycemia caused by sulfonylurea or long-acting insulin can take one to two days to go away.
People with diabetes remain at risk for episodes of hypoglycemia throughout life because they need medications that lower blood sugar. Hypoglycemic episodes at night are particularly dangerous because the person often sleeps through part of the time that their blood sugar is low, treating the sugar level less quickly. Over time, repeated episodes can lead to impaired brain function.
About 85% of patients with an insulinoma will be cured of hypoglycemia once the insulin-secreting tumor is removed.
Many people without diabetes who have symptoms that seem like signs of low blood sugar do not truly have low sugar levels. Instead, the symptoms are caused by something other than low blood glucose.
In people taking insulin or other diabetic medicine, drinking alcohol can lead to an episode of hypoglycemia. Patients with diabetes should discuss with their doctors how much alcohol, if any, they can drink safely. Alcohol can cause serious episodes of hypoglycemia even when insulin was taken hours before. People with diabetes should be very aware of this possible problem if they drink.
People with diabetes should always have ready access to emergency supplies for treating unexpected episodes of hypoglycemia. These supplies may include candy, sugar tablets, sugar paste in a tube and/or a glucagon injection kit. A glucagon injection may be given by a knowledgeable family member or friend if a hypoglycemic patient is unconscious and cannot take sugar by mouth. For diabetic children, emergency supplies can be kept in the school nurse’s office.
Any person at risk of hypoglycemic episodes can help to avoid delays in treating attacks by learning about his or her condition and sharing this knowledge with friends and family members. The risk for hypoglycemia is lower if you eat at regular times during the day, never skip meals and maintain a consistent exercise level.
Like people with diabetes, nondiabetic people with hypoglycemia should always have ready access to a source of sugar. In rare circumstances, a doctor may prescribe a glucagon emergency kit for nondiabetic people who have a history of becoming disoriented or losing consciousness from hypoglycemia.
If a conscious person is having symptoms of hypoglycemia, the symptoms usually go away if the person eats or drinks something sweet (sugar tablets, candy, juice, non-diet soda). An unconscious patient can be treated with an immediate injection of glucagon or with intravenous glucose infusions in a hospital.
People with diabetes who have hypoglycemic episodes may need to adjust their medications, especially the insulin dose, change their diet or their exercise habits.
If you recognize that your symptoms are caused by hypoglycemia, you should treat yourself or seek treatment, and not try to just “tough it out.” People with long-standing diabetes may stop experiencing the usual early warning symptoms of hypoglycemia. This is called hypoglycemic unawareness. It can be very serious because the person may not know to seek treatment.
If you and your doctor identify that you are unaware when you have low blood sugars, your dose of insulin or other diabetes medicines will probably will need to be reduced. You will need to check your blood sugar more often. Your insulin dose will likely need frequent adjustments to maintain reasonable blood sugars (but not “perfect” sugars) with less risk of hypoglycemia.
An insulinoma is treated with surgery to remove the tumor. Hypoglycemia caused by problems with the adrenal or pituitary glands is treated by replacing the missing hormones with medication.
Nondiabetic people with hypoglycemic symptoms following meals are treated by modifying their diet. They usually need to eat frequent, small meals and avoid fasting.
When To Call A Professional
Call for emergency medical assistance whenever anyone is unconscious or obviously disoriented. Severe insulin reactions can be fatal, so it is important to seek treatment immediately.
People with diabetes should contact their doctors promptly if they experience frequent episodes of hypoglycemia. They may need to adjust their daily doses of medications, meal plans and/or exercise program.
Nondiabetic people who experience symptoms of hypoglycemia should contact their doctors for evaluation of the problem.
Call for emergency medical assistance whenever anyone is unconscious or obviously disoriented. Severe insulin reactions can be fatal, so it is important to seek treatment immediately.
People with diabetes should contact their doctors promptly if they experience frequent episodes of hypoglycemia. They may need to adjust their daily doses of medications, meal plans and/or exercise program.
Nondiabetic people who experience symptoms of hypoglycemia should contact their doctors for evaluation of the problem.
Learn more about Hypoglycemia
Mayo Clinic Reference
National Institute of Diabetes & Digestive & Kidney Disorders
American Diabetes Association
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
90,000 Fainting in diabetes mellitus: causes, first aid
Fainting in a person with diabetes mellitus can be triggered by too much insulin, which is caused by a high concentration of glucose in the blood serum. It is also a symptom of a hypoglycemic crisis – a condition caused by a rapid decrease in sugar content. Loss of consciousness often precedes hypoglycemic coma, which poses a threat to human health and life.
Fainting with hypoglycemia
Loss of consciousness with low sugar in a diabetic can be caused by a number of reasons, including non-observance of dietary rules:
- skipping the next meal;
- forced prolonged fasting;
- eating food rich in carbohydrates;
- alcohol abuse during insulin therapy.
In addition, the incorrect technique of insulin injections or the incorrectly selected dose of drugs can provoke fainting in diabetes mellitus, as a result of which an overdose occurs.
Endocrine diseases or dysfunctions of the kidneys, liver, pituitary gland and adrenal glands can often cause loss of consciousness caused by a decrease in serum glucose concentration.
A sharp decrease in the sugar content is often evidence of the development of a hypoglycemic attack.In this case, it is necessary to urgently seek medical help, since this pathological condition often leads to impaired cerebral circulation, damage to the nervous and cardiovascular systems, heart attacks and strokes.
Hypoglycemia can be recognized by the following symptoms:
- Sharp sudden drop in blood glucose concentration.
- Great feeling of hunger accompanied by nausea, turning into vomiting.
- Drowsiness, muscle weakness, trembling in the arms and legs.
- High blood pressure, headache, dizziness.
- Rapid heartbeat, dilated pupil.
- Numbness of tongue and lips.
- Increased sweating.
- Auditory and visual hallucinations.
- Distracted attention, confusion.
All these signs are characteristic of patients suffering from both types 1 and 2 diabetes mellitus. However, they do not always manifest themselves in full and with a certain sequence, but they are expressed the more vividly, the more rapidly the blood sugar level falls.
A hypoglycemic crisis develops with lightning speed and many diabetics are unable to recognize it at the very beginning, until fainting appears, which often precedes a hypoglycemic coma. Therefore, even with the slightest deterioration in well-being, it is necessary to measure the blood sugar level with a glucometer.
Fainting with hyperglycemia
In some cases, high blood sugar or hyperglycemia can cause fainting in diabetes. This pathological condition of a diabetic is usually caused by a long interval between meals, eating a large amount of carbohydrates or skipping the next intake of antidiabetic drugs, as well as an incorrectly calculated dose of insulin that does not correspond to the required value.
The main symptoms of hyperglycemia are unquenchable thirst and dry mouth; increased urination; decreased visual acuity and frequent headaches. In addition, when exhaling, the patient will smell acetone. This is due to an increase in the concentration of ketone bodies.
Increased sugar levels for a long time lead to the following complications:
- Vaginal infections.
- Dermatitis of various localization.
- Feeling of chills, tingling, goose bumps due to damage to small blood vessels.
- Disorder of defecation.
- Reduced tissue regeneration, as a result of which wounds, cuts and scrapes do not heal for a long time.
Loss of consciousness in a person with diabetes mellitus with hyperglycemia often precedes a diabetic coma.
In the presence of signs of hyperglycemia, it is necessary to act quickly, since any delay is fraught with the development of a coma. In case of fainting in a patient with diabetes mellitus, an urgent need to inject insulin, lay the person on his side and call an ambulance.
You also need to act urgently at the first signs of an impending hypoglycemic attack. So if the patient is conscious, he needs to consume simple carbohydrates: a glucose tablet, sugar, candy, a glass of juice or sweet tea. After a while, you need to eat cookies, bread or sweet pastries, while not forgetting to constantly measure your glucose level with a glucometer.
In case of loss of consciousness in a patient with diabetes mellitus caused by a hypoglycemic crisis, it is impossible to give him anything from food or drinks – this can cause asphyxia.An urgent need to inject glycogen and call an ambulance.
Hypoglycemia in type 1 and type 2 diabetes: signs and symptoms
In a healthy person, when the glucose level approaches the lower limit of the norm – 3.3 mmol / l – two protective mechanisms immediately work: the production of insulin by the pancreas decreases and the production of glucose by the liver increases … That is why hypoglycemia in healthy people is extremely rare and they are not dangerous – a decrease in sugar levels to the level at which hypoglycemic coma may develop will not occur.
In diabetes mellitus, it is impossible to instantly reduce the level of insulin in the blood (the exception is the introduction of insulin using an insulin pump, the action of which can be suspended), and glucose emitted by the liver is not always enough – that is why hypoglycemia in diabetes mellitus requires urgent measures.
Indicators of hypoglycemia
In patients with diabetes mellitus, hypoglycemia is understood as a decrease in glucose levels below 3.9 mmol / l.
Patients occasionally experience symptoms of mild hypoglycemia with normal blood glucose levels.Such hypoglycemias are called false and they occur if the patient has lived with high blood glucose levels for a long time. False hypoglycemia is not dangerous and does not require any measures. In other situations, the patient may not experience symptoms of hypoglycemia, while the blood glucose level will be below normal – this is true hypoglycemia, requiring immediate action.
Causes of hypoglycemia
Causes associated with hypoglycemic therapy:
- Insulin overdose in the event of an error in dialing the insulin dose or inadequate increase in the insulin dose in the event of a malfunctioning syringe pen or when injecting insulin with a concentration of 100 U / ml with a syringe designed to inject insulin with a concentration of 40 U / ml.
- Overdose of tableted glucose-lowering drugs: additional drug intake or inadequate increase in the dose of drugs.
- Violation of the insulin injection technique: change in depth or incorrect change of the injection site, massage of the injection site, exposure to high temperatures (for example, when taking a hot shower).
- Increase in insulin sensitivity during exercise.
- Skipping meals or not eating enough carbohydrates.
- Increase in the interval between insulin injection and food.
- Short-term unplanned physical activity without carbohydrate intake before and after exercise.
- Drinking alcohol.
- Intentional weight loss or fasting without reducing the dose of antihyperglycemic drugs or fasting.
- Slowing down the evacuation of food from the stomach.
Symptoms of hypoglycemia
Hypoglycemia is multifaceted, but each patient has its own “set” of symptoms, and most patients feel the approach of hypoglycemia well:
- First of all: palpitations, tremors, pallor, nervousness and anxiety, nightmares, sweating, hunger, paresthesia.
- They join as the glucose level continues to decrease: weakness, fatigue, decreased concentration, dizziness, visual and speech disorders, changes in behavior, seizures, loss of consciousness (hypoglycemic coma).
Is hypoglycemia dangerous?
According to the severity (or danger to health and life), hypoglycemia is divided into lungs – the patient himself is able to restore the blood glucose level to normal, and severe – to restore the blood glucose level to normal values, outside help is needed.
Mild hypoglycemia is not dangerous. Moreover, the closer to normal the patient’s blood glucose level, the greater the likelihood of an increase in the frequency of mild hypoglycemia.
Severe hypoglycemia causes significant damage to brain cells and is life-threatening.
What you need to know before using Dinga
Special instructions and precautions
Please strictly follow the doctor’s prescription for dosage, monitoring (blood and / or urine tests), diet and physical activity (physical work and exercise).
Be sure to tell your doctor or pharmacist before taking this drug if you are recovering from injury, surgery, febrile infections, or other stressful situations because you need to change your treatment temporarily.
Important information about lactic acidosis
Lactic acidosis – an increase in the content of lactic acid in the blood. This is a rare but very dangerous complication of metformin that requires urgent medical attention and hospital treatment.It is very common in people with severe kidney disease. You should refrain from drinking too much alcohol, both once and repeatedly while taking this drug, as alcohol potentiates the effects of metformin.
Symptoms of lactic acidosis include: rapid breathing, abdominal pain, nausea, vomiting, feeling cold.
If you experience any of these symptoms, stop taking Dinga and contact your healthcare professional immediately .
Important information about hypoglycemia (low blood sugar)
When using Dinga, hypoglycemia may develop. Listed below is additional information about hypoglycemia, its symptoms, and treatment.
The following factors may increase the risk of hypoglycemia:
- malnutrition, irregular, skipped or delayed meals or periods of fasting,
- if you increase physical activity and at the same time do not eat enough food or the food contains less carbohydrates than necessary,
- change in diet mode,
- drinking alcohol, especially if you skipped a meal,
- decreased kidney function,
- serious liver disease,
- if you suffer from certain decompensated hormonal disorders: dysfunction of the thyroid, pituitary or adrenal glands,
- taking certain medications (see.Other medicines and Dinga),
- Dinga’s intake is more than recommended.
If any of these predisposing factors to hypoglycemia are present, talk to your doctor or pharmacist as a dose adjustment is necessary in this situation. This also applies in cases where the patient is ill during the course of treatment or when changing lifestyle.
Symptoms of hypoglycemia:
Symptoms of hypoglycemia may be mild or absent in situations where hypoglycemia develops gradually, in the elderly, patients with autonomic neuropathy, or in those who are simultaneously prescribed treatment with other drugs, such as beta-blockers, clonidine, reserpine, guanethidine or other sympathomimetics.
Treatment of hypoglycemia:
In many cases, the symptoms of hypoglycemia disappear very quickly when you consume something that contains sugar, such as sugar cubes, sweet juice or tea. You should always carry something that contains sugar with you (such as sugar lumps). Remember that artificial sweeteners are ineffective.
Please contact your doctor or go to the hospital if sugar intake does not help or symptoms recur.
Blood or urine glucose levels should be checked regularly. Your healthcare provider will also need to have periodic blood tests to check your blood cell count and liver function.
Low hemoglobin levels and breakdown of red blood cells (hemolytic anemia) may occur in patients with deficiency of the enzyme glucose-6-phosphate dehydrogenase.
Before starting treatment, kidney function should be assessed and monitored regularly:
- at least once a year in patients with normal renal function,
- at least 2 to 4 times a year in patients with kidney disease and in the elderly.
Pay special attention to when kidney function may be impaired, for example, when taking new drugs to lower blood pressure, relieve swelling, or treat pain and inflammation (nonsteroidal anti-inflammatory drugs).
Surgery or administration of iodine-containing contrast agents for examination
If you are scheduled for surgery or need to undergo an examination with the introduction of iodine-containing contrast agents, for example, during an X-ray examination or CT scan, you must stop taking Dinga for a certain period of time before and after the examination or surgery.Your healthcare provider will determine if you need replacement therapy at this time. It is important that you follow your doctor’s instructions exactly.
Children and adolescents
Dinga has not been studied for use in children and adolescents under 18 years of age.
Other medicines and Dinga
Tell your doctor or pharmacist if you are using, have recently taken or must take any other drugs.Your doctor may change the dosage of Dinga if you are taking other medications that can weaken or increase the therapeutic effect of Dinga.
The following medications may increase the hypoglycemic effect of Dinga. This can put you at risk of developing hypoglycemia (low blood sugar):
- other drugs for the treatment of diabetes mellitus (insulin or other antidiabetic drugs),
- drugs for the treatment of pain and inflammation (phenylbutazone, azopropazone, oxyphenylbutazone, aspirin and similar drugs),
- medicines for the treatment of urinary tract infections (for example, some long-acting sulfonamides),
- medicines for the treatment of bacterial or fungal infections (tetracycline, chloramphenicol, fluconazole, miconazole, quinolones, clarithromycin),
- anticoagulants (coumarin derivatives such as warfarin),
- drugs for muscle growth (anabolic steroids),
- drugs used for hormone replacement therapy in men,
- drugs for the treatment of depression (fluoxetine, MAO inhibitors),
- medicines for lowering high blood cholesterol levels (fibrates),
- medicines for lowering high blood pressure (ACE inhibitors),
- antiarrhythmic drugs (disopyramide),
- drugs for the treatment of gout (allopurinol, probenecid, sulfinpyrazone),
- medicines for the treatment of oncological diseases (cyclophosphamide, ifosfamide, trophosphamide),
- drugs for weight loss (fenfluramine),
- drugs that improve blood circulation, when administered as intravenous infusions in high doses (pentoxifylline),
- medicines for the treatment of hay fever (tritoqualin),
- sympatholytics used to treat high blood pressure, heart failure, or symptoms of prostate dysfunction.
The following drugs may reduce the hypoglycemic effect of Dinga. This can put you at risk of developing hyperglycemia (high blood sugar):
- Medicines containing female sex hormones (estrogens, progestogens),
- diuretics that increase the rate of formation and excretion of urine (thiazide diuretics),
- medicines to increase the function of the thyroid gland (levothyroxine),
- medicines for the treatment of allergies and inflammation (glucocorticoids),
- medicines for the treatment of severe mental disorders (chlorpromazine and other phenothiazine derivatives),
- medicines used to improve heart rate, treat bronchial asthma or nasal congestion, coughs and colds, weight loss or life-threatening emergencies (epinephrine and sympathomimetics),
- drugs for lowering high blood cholesterol (nicotinic acid),
- laxatives used to treat constipation when used for a long time,
- drugs used to treat seizures (phenytoin),
- medicines for the treatment of excessive nervousness and sleep disturbances (barbiturates),
- medicines for the treatment of high eye pressure (acetazolamide),
- medicines for the treatment of high blood pressure or lowering blood sugar (diazoxide),
- medicines for the treatment of infections, tuberculosis (rifampicin),
- drugs for the treatment of acute hypoglycemia (glucagon),
- medicines for the treatment of bronchial asthma (beta-2 agonists such as salbutamol).
The following drugs can increase or decrease the hypoglycemic effect of Dinga:
- Medicines used for the treatment of gastric and duodenal ulcers (H 2 – blockers),
- Medicines for the treatment of high blood pressure or heart failure, such as beta blockers, clonidine, guanethidine and reserpine. They can also mask the symptoms of hypoglycemia, so special monitoring is necessary when using these drugs.
Dinga can either enhance or weaken the effects of the following drugs:
- Anticoagulants (coumarin derivatives, e.g. warfarin),
- wheelievelam, used to lower blood cholesterol levels, also has an effect on the absorption of Dinga. To avoid this interaction, you need to take Dinga at least 4 hours before taking the wheelchair.
Iodine-containing contrast agents
Lactic acid build-up in the blood (lactic acidosis) may occur if you use iodine-containing contrast media for examinations such as x-rays or CT scans.You must stop taking Dinga before and after the test (see Table: Special Instructions and Precautions).
Dinga with alcohol
You should avoid alcohol and preparations containing ethyl alcohol. Drinking alcohol in unpredictable ways can increase or decrease the hypoglycemic effect of Dinga, and can also increase the risk of developing lactic acidosis.
90,000 Why do we faint?
Speaking fainting, or, scientifically, syncope, we mean a sudden, unexpected loss of consciousness that lasts no more than a few minutes, and more often lasts literally a second.
Loss of consciousness occurs due to insufficient blood supply to the brain. This is mainly due to a drop in blood pressure.
Usually we feel the threat of loss of consciousness.
The following signs precede fainting:
- a sharp development of pallor,
- general weakness, dizziness, weakness in the legs,
- darkening before the eyes, the presence of noise in the ears, sweating
Mechanisms of syncope
Neurotransmitter syncope develops as a result of impaired functioning of the autonomic nervous system. Due to various reasons, the vascular tone changes, the heart rhythm slows down, and the pressure decreases. As a result, insufficient blood supply to the brain occurs. Fainting is often of a neurotransmitter nature (exposure to heat, stuffiness, stress, fear, etc.).
Arrhythmogenic syncope develops in the event of a sharp violation of the heart rhythm.This type of fainting is inherent in heart disease.
Orthostatic syncope develops with a sudden rise from a lying position. The vessels do not have time to respond to the new position of the body, and blood flows from the head.
Cerebrovascular syncope is caused by impaired blood circulation in the brain due to pathology of the cerebral vessels.
Causes of fainting and loss of consciousness
The reasons are varied – from ordinary (situational, caused by unfavorable factors) to serious pathologies requiring immediate treatment.
- heat, stuffiness, heatstroke are the most common causes of fainting, especially in people with hypotension (low blood pressure),
- hunger, thirst, the development of which can also contribute to severe dehydration (vomiting , diarrhea, profuse sweating),
- excessively tight, oppressive, with a tight corset, clothes that were a common cause of fainting in women in the past,
- strong emotional and emotional upheavals: bad news, fear, panic,
- overwork, mental and physical,
- abrupt change in body position after a long stay in one position (abrupt getting out of bed, from a chair),
- severe pain.
Sometimes fainting occurs in pregnant women, which is often the result of a drop in blood pressure. In addition, the blood supply is disrupted due to the pressure of the uterus on the blood vessels.
Fainting can be caused by:
- anemia due to large blood loss during bleeding,
- hypotension: people with low blood pressure are sometimes prone to fainting,
- vegetative-vascular dystonia, which is a pathological condition characterized by a violation activity of the autonomic nervous system, responsible for the coordination of the work of blood vessels and internal organs (adolescents often suffer from vegetative-vascular dystonia),
- panic attacks,
- decrease in blood glucose levels (hypoglycemia), which happens not only in patients with diabetes due to physical overload, alcohol intoxication, prolonged fasting.
Fainting can be dangerous if it is a symptom of the following diseases:
- vascular diseases and pathologies: vascular stenosis (narrowing), atherosclerosis, cervical osteochondrosis,
- cardiac pathologies: heart failure, arrhythmia, cardiomyopathy ,
- endocrine disorders,
- brain tumor, traumatic brain injury,
How to avoid fainting?
So-called situational syncope is not a health hazard.You just need to strive not to get into situations where there is a risk of loss of consciousness, especially if the person is elderly or suffers from hypotonic illness. If possible, you should avoid prolonged exposure to the sun, stuffy rooms, crowded transport passengers, abruptly not get up from a chair or bed, try not to stay hungry for a long time, etc.
With the development of fainting during pregnancy, there is no need to worry, but it is still necessary to notify the doctor, especially if they become more frequent.
With arterial hypotension and vegetative-vascular dystonia, fainting is quite common, but it is not life-threatening. These fainting spells can be prevented with vascular training. For this purpose, physiotherapy exercises, water procedures (douches, contrast showers), yoga classes, etc.
Osteochondrosis of the cervical spine, in addition to fainting, is accompanied by headaches, numbness of the arms and legs, pain in the arms, neck and shoulders. This disease is unpleasant and debilitating.Without a doubt, you need to see a doctor, be examined and receive treatment.
When is fainting really dangerous?
The cause of concern and the reason for seeking medical attention is cardiac (arrhythmogenic) syncope, which occurs during cardiovascular diseases.
Unlike other forms, arrhythmogenic syncope occurs regardless of the presence of adverse factors. In this case, the patient can be in any position, including lying.
Occasionally, heart rhythm disturbances or palpitations may occur before fainting occurs.
Heart fainting cannot be ignored. It is necessary to contact a specialist and be examined.
90,000 About the danger of heat for diabetics
Abnormally hot weather can have a negative impact on patients with diabetes mellitus. At high temperatures, the vessels of the skin dilate in order to better give off excess heat with sweat. Together with sweat, the body loses salts and trace elements.Their deficiency affects the cardiovascular system. “
Overheating in hot weather must be distinguished from hypoglycemia. Overheating may cause clouding of consciousness, fainting, convulsions. The same symptoms sometimes occur with hypoglycemia. In such situations, a diabetic patient needs to determine the blood sugar level.
In summer, high air temperatures play a major role in worsening the course of the disease. Because of this, the blood thickens, sweating increases with an increase in fluid loss, the body’s energy reserves are spent more intensively, increasing nutritional requirements, and the risk of sunstroke increases.
In hot weather, appetite decreases, as a result of which a patient with diabetes can skip meals or eat much less. This can cause a hypoglycemic reaction, especially during treatment with insulin or sulfonylureas. “
On hot days, it is recommended to drink two to three liters of liquid during the day. This is especially important for diabetic patients taking NGLT-2 inhibitors, diuretics. It is advisable to always have a bottle of drinking water with you.It is also recommended to monitor blood sugar and blood pressure more often. And don’t forget to take the recommended medications. For patients receiving insulin, adjust the dose if necessary. Refrain from physical activity during the hottest hours. On the street, wear a hat and not walk without shoes on hot surfaces, for example, on sand, asphalt, “- said Antsiferov.
Insulin should not be left in a hot room or in the sun, as it must be stored at temperatures up to 30 degrees.When transporting insulin, you should use a special container bag. And if the condition worsens, the appearance of incomprehensible complaints, you should consult a doctor.
In hot weather, appetite decreases, as a result of which a patient with diabetes can skip meals or eat much less. This can cause a hypoglycemic reaction, especially during treatment with insulin or sulfonylureas, “he emphasized.
The interlocutor of the agency noted that on hot days it is recommended to drink two to three liters of liquid during the day.This is especially important for diabetic patients taking NGLT-2 inhibitors, diuretics. It is advisable to always have a bottle of drinking water with you.
“It is also recommended to monitor blood sugar and blood pressure more often. And do not forget to take the recommended medications. For patients receiving insulin, adjust its dose if necessary. Refrain from physical activity during the hottest hours. Wear a hat and do not walk outside. without shoes on a hot surface, for example, on sand, asphalt, “Antsiferov said.
The doctor clarified that insulin should also not be left in a hot room and in the sun, as it must be stored at temperatures up to 30 degrees. When transporting insulin, you should use a special container bag. And if the condition worsens, the appearance of incomprehensible complaints, you should consult a doctor.
Doctor-endocrinologist of the health care institution “Zelva CRH” R.S. Slauta
Fainting – a directory of diseases – HealthInfo
Fainting can occur whenever the body is unable to quickly compensate for a decrease in blood pressure.For example, when the heart rhythm is abnormal, the heart is not always able to increase the release of blood in order to reverse the decrease in blood pressure. At the same time, people may feel normal at rest, but feel weak during exercise, because the body’s need for oxygen suddenly increases. Such fainting is called effort or exertion fainting. It often occurs after exercise. The reason is that when physical activity stops, the heart rate begins to fall, and the blood vessels of the muscles remain still dilated – this is necessary to remove waste products.The combination of decreased cardiac output and increased vascular capacity causes blood pressure to drop and the person faints.
It is obvious that the blood volume decreases with bleeding. But it can also decrease when dehydration develops due to diarrhea, increased sweating, and excessive urination, which often occurs with untreated diabetes or Addison’s disease.
Fainting is possible when the compensatory mechanisms are affected by nerve signals coming from other parts of the body.For example, with abdominal pain, signals are sent to the heart through the vagus nerve, which slows down the heart rate. This is enough to cause fainting, which is called vasovagal. Many other factors, including pain of various origins, fear, and the sight of blood, can lead to this type of fainting.
Fainting during coughing and urination usually occurs because the amount of blood flowing back to the heart is reduced by exertion. Fainting caused by urination is especially common in old age.Fainting associated with swallowing can occur with diseases of the esophagus.
Fainting is the result of a decrease in the number of red blood cells (anemia), sugar content (hypoglycemia) or carbon dioxide in the blood (hypocapnia) with increased breathing (hyperventilation). Sometimes anxiety leads to hyperventilation. When carbon dioxide levels decrease, the blood vessels in the brain narrow and the person may feel faint and dizzy, but without losing consciousness. Weightlifters have known to faint as a result of hyperventilation before lifting the bar.
In rare cases, usually in old age, fainting occurs as a manifestation of mild stroke, in which the blood supply to a part of the brain is suddenly reduced.
Who to contact in case of hypoglycemia
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