Hypoglycemia means low blood glucose level. Different individuals may experience signs and symptoms of hypoglycemia at different blood glucose levels (i.e. some individuals may experience symptoms at 70 mg/dl and some may experience at 65 mg/dl). Hypoglycemia is an emergency condition and need prompt raising of blood glucose level, either by injecting intravenous glucose, or 5% dextrose or by ingesting glucose powder. If treatment is delayed and blood glucose level remain low for long, brain function becomes abnormal and there is risk of serious consequences, such as unconsciousness, seizure, coma, permanent brain damage (because glucose is the only fuel for brain to function) and even death.

What is hypoglycemia?

For diabetes patients, under treatment with oral anti-diabetic medications or with insulin, simple demonstration of low level of blood glucose define hypoglycemia. But, for non-diabetic individuals, the diagnosis of hypoglycemia can be made if Whipple’s triad is satisfied, which include symptoms of hypoglycemia, a low blood glucose level and correction of symptoms of hypoglycemia after administration of glucose in any form.

It is not easy to define what blood glucose level constitute hypoglycemia. Normally blood glucose level remains 70-140 mg/dl throughout the days 24 hour. Some experts believe the lower limit of blood glucose level to be 60 mg/dl. Hence, it is not easy to clearly define what constitute hypoglycemia. Majority of individuals develop symptoms of hypoglycemia, when blood glucose level is below 55 mg/dl. Hence, blood glucose level below 50-55 mg/dl can be safely considered to be hypoglycemia. The variations of blood glucose level that produce symptoms, may be due to different methods used to measure blood glucose level, age and various other factors. The need to define hypoglycemia arises, for deciding when (at what blood glucose level) to start medical intervention.

Prevention of hypoglycemia:

Prevention of hypoglycemia, depends on the cause of hypoglycemia.

• If there is a definite cause (such as anti-diabetic drug, insulin overdose etc.) it should be addressed, after immediate management with adequate glucose administration. If hypoglycemia is due to drug overdose, it should be corrected. If it is due to short and rapid acting insulin preparation, the change of insulin preparation may be considered. If hypoglycemia is due to hormone deficiency such as hypopituitarism or adrenal insufficiency, hormone replacement should be done. Anti-diabetic medications such as sulfonylureas may cause hypoglycemia, which should be replaced with other available oral anti-diabetic medications.