Hypoglycemia (Reactive Hypoglycemia)

Hypoglycemia is a general term used to describe an abnormally low level of glucose, or blood sugar. This is defined as a glucose level of less than 60 milligrams per deciliter of blood (mg/dl). The normal range of blood sugar levels, taken while fasting, is between 80 and 120 mg/dl.

Symptoms include hunger, weakness, nervousness, difficulty concentrating, and mood swings. A more severe reaction is characterized by excessive sweating, a pounding heartbeat, and cold and clammy skin, along with growing weakness, difficulty in walking, and increasing confusion. If uncorrected, a severe hypoglycemic reaction can progress to convulsions, loss of consciousness, coma, and even death.

Hypoglycemia most often occurs in people who have diabetes, and results from taking too much insulin or too high a dose of a hypoglycemic drug, a medication prescribed for type II, or adult-onset, diabetes, in which the body still produces some insulin. Despite a popular belief that hypoglycemia is a common and frequently unrecognized condition responsible for a whole host of vague symptoms, it is rare in people who do not have diabetes. However, the condition sometimes occurs during a prolonged fast, and some people develop it in response to alcohol or as a side effect of certain medications.

Diagnostic Studies and Procedures

Hypoglycemia is readily identified by a check of blood sugar levels. This can be done with a self-monitoring kit that analyzes a drop of blood obtained with a simple finger prick. Anyone with diabetes should know how to perform this self-test, and do it regularly at home, usually several times a day.

In a patient who does not have diabetes, laboratory studies of blood sugar levels will be performed. The most frequently used test is an oral glucose tolerance test, or OGTT. in which blood sugar levels are measured after the patient has fasted and then re-measured hourly for the next several hours, after the person consumes a sugar drink.

Medical Treatments

Hypoglycemia usually does not require special medical treatment, other than adjusting the medication regimen in people who use insulin or oral agents for diabetes. The proper balance of medication, diet, and exercise is the key to its control. A person who is experiencing a mild hypoglycemic reaction is helped by eating a simple sugar, such as honey, orange juice, or hard candy. A severe hypoglycemic reaction is a medical emergency that must be treated with intravenous glucose and other measures to raise blood glucose levels.

Alternative Therapies

Anyone with diabetes should be under the care of a medical specialist and use alternative therapies only with the approval of a physician.

Exercise Conditioning. Regular aerobic exercise is an important aspect of stabilizing blood glucose levels. Exercise also contributes to general feelings of well-being, and thus may control some of the vague symptoms, such as fatigue and depression, that are often attributed to hypoglycemia.

Naturopathy and Nutrition Therapy. A diet of five or six small meals a day is recommended, with emphasis on low-fat sources of protein, including fish, skinless white meat of chicken or turkey, and skim milk and other low-fat dairy products. Candy and other sugary foods should be avoided. Alcohol and caffeine should be minimized.

Yoga and Meditation. These and other relaxation techniques can be useful in reducing stress, which may contribute to nervousness and other symptoms attributed to hypoglycemia.

Self-Treatment

Self-treatment is the key to controlling hypoglycemia. Symptoms can be relieved within 10 to 15 minutes if the proper action is taken. At the first signs of a hypoglycemic reaction, eat six or seven hard candies, or two teaspoons of honey, syrup, or sugar. Alternatively, drink a cup of orange juice or any sugary soft drink. Wait for 10 to 15 minutes, measure your blood sugar, and repeat the process if necessary.

When symptoms are more severe, eat or drink something sugary and then eat a high-carbohydrate food, such as an apple or banana, a slice of bread, a few crackers, or a bowl of cereal. These foods supply both simple and complex carbohydrates, and help to stabilize blood glucose levels.

Avoid alcohol if it is clearly the cause of hypoglycemia. If your medication brings on a hypoglycemic reaction, discuss alternatives with your doctor.

Other Causes of Hypoglycemia Symptoms

Faintness, weakness, and dizziness can also be signs of a heart condition. Excessive sweating may be due to anxiety, menopause, hyperthyroidism, or even a heart attack. Increasing confusion could indicate the onset of a stroke, a transient ischemic attack (TIA), excessive drinking, or an adverse reaction to a drug. Emotional problems, including depression and anxiety, can also lead to symptoms similar to those of hypoglycemia.