Hypoglycemia (Low Blood Sugar) in People Without Diabetes - Topic

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By Caroline Rea, RN, BS, MS MORE ON HYPOGLYCEMIA (LOW BLOOD SUGAR) IN PEOPLE WITHOUT DIABETES
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Overview What is Hypoglycemia (Low Blood Sugar) in eople Without !ia"etes Signs & S !"#$!s Symptoms Dr%gs& Tre'#!en#s & C're #$ams and %ests %reatment &'er'iew Home %reatment HYPOGLYCEMIA (LOW BLOOD SUGAR) IN PEOPLE WITHOUT DIABETES HOME (

"#L$T#D $"T%&L#S Hypoglycemia (Low Blood Sugar) in eople Without !ia"etes ( %reatment &'er'iew Di) $% *in) #+is +e,"*%,Rate this article: Sign in to rate) Sign in to rate) #+%!.s %" #+%!.s )$wn *+, o- users -ound this article help-ul. T$"i/ Overview W+'# is + "$g, /e!i'Hypoglycemia is low "lood sugar. /t occurs when the le'el o- sugar, or glucose, in the "lood drops too low to gi'e the "ody energy. %he medical condition o- low "lood sugar occurs when all 0 o- the -ollowing are present1

Blood sugar is low. Low "lood sugar is causing symptoms. %he symptoms go away when "lood sugar returns to normal. 2asting "lood sugar le'els are measured in mg3dL. 4 -asting "lood sugar le'el o-1

56 to ** mg3dL is normal. +6 to 7* mg3dL is mildly low. Less than +6 mg3dL is 'ery low. %he "loodstream carries glucose8a type o- sugar produced -rom the digestion o- car"ohydrates and other -oods8to pro'ide energy to cells throughout the "ody. 9nused glucose is stored mainly in the li'er as glycogen. /nsulin, glucagon, and other hormone le'els rise and -all to :eep "lood sugar in a normal range. %oo little or too much o- these hormones can cause "lood sugar le'els to -all too low (hypoglycemia) Normally, "lood glucose le'els increase slightly a-ter you eat a meal. When "lood sugar rises, cells in the pancreas release insulin, causing the "ody to a"sor" glucose -rom the "lood, which lowers

the "lood sugar le'el to normal. When "lood sugar drops too low, the le'el o- insulin declines and other cells in the pancreas release glucagon, which causes the li'er to turn stored glycogen "ac: into glucose and release it into the "lood. Low "lood sugar also triggers the release o- hormones "y the pituitary and adrenal glands. %hese hormones also help "ring sugar "ac: to normal. Hypoglycemia is not a disease "ut a condition that results -rom a 'ariety o- causes. W+'# /'%ses + "$g, /e!i'Hypoglycemia is most commonly a complication o- dia"etes treatment, "ut it is otherwise rare. Hypoglycemia may also result -rom1

Medicines, such as monoamine o$idase inhi"itors (M4&/s), ;uinine sul-ate, and salicylates (including aspirin). !rin:ing too much alcohol. !iseases that a--ect the pancreas, li'er, :idneys, adrenal glands, or other organs. /nherited pro"lems with meta"olism. Rapid stomach emptying a-ter a meal. %his may happen a-ter stomach surgery. W+'# 're #+e s !"#$!s%he symptoms can 'ary depending on how low the "lood sugar le'el drops.

Mi,) + "$g, /e!i' can cause nausea, a <ittery or ner'ous -eeling, cold and clammy s:in, sweating, hunger, and a rapid heart"eat. M$)er'#e + "$g, /e!i' o-ten ma:es you -eel irrita"le, an$ious, or con-used. =ou may ha'e "lurred 'ision, -eel unsteady, and ha'e di--iculty wal:ing. Severe + "$g, /e!i' can lead to loss o- consciousness, sei>ures, and coma8and it may "e -atal. Some medicines may mas: symptoms o- low "lood sugar, including "eta("loc:ers, which are o-ten used to treat heart conditions and high "lood pressure. H$w is + "$g, /e!i' )i'gn$se)!octors diagnose hypoglycemia using a medical history, physical e$amination, and tests to chec: "lood sugar le'els. ?enerally, you are diagnosed with the condition i- a "lood test shows you ha'e low "lood sugar and you ha'e symptoms o- hypoglycemia that go away a-ter you eat car"ohydrate such as sugar. !uring a medical history, your doctor will as: a"out your symptoms8when and how o-ten they occur, what "rings them on, and how long they last. =ou also will "e as:ed a"out any medicines you are ta:ing and whether you ha'e recently lost or gained weight. 4 physical e$amination will also help your doctor loo: -or the cause o- your symptoms. !octors rely on la"oratory tests to con-irm low "lood sugar. 4lthough it would "e "est to do these tests when you are ha'ing symptoms, it usually isn@t possi"le. /nstead, tests are done to try to reproduce your symptoms. H$w is + "$g, /e!i' #re'#e)%reatment -or a sudden (acute) episode o- hypoglycemia in'ol'es eating or drin:ing some -orm osugar to restore your "lood sugar to a normal le'el. #pisodes o- hypoglycemia caused "y a long( term (chronic) health condition are treated the same way. But pre'ention o- -uture episodes re;uires treatment or cure o- the long(term condition that is causing the hypoglycemia.

4lthough eating -ood or drin:ing "e'erages that contain sugar is all you need to do to treat many cases o- acute hypoglycemia, you will need help i- the condition is se'ere. 2amily mem"ers, cowor:ers, and -riends should "e aware o- your condition and should /',, *AA $r $#+er e!ergen/ servi/es i- you "ecome sleepy or unconscious. W+'# s+$%,) $% )$ in 'n e!ergen/ /t is important to :now what to do in an emergency when you ha'e low "lood sugar. #mergency care -or low "lood sugar -or people who are not ta:ing insulin includes consuming some :ind o- ;uic:(sugar -ood, such as -ruit <uice, as long as you are a"le to swallow. (9se this in-ormation i- you do not :now whether a person with hypoglycemia ta:es insulin.) /- you are loo:ing -or general in-ormation on dia"etes, see the topics %ype A !ia"etes and %ype B !ia"etes. 0re1%en#, As2e) 3%es#i$ns Le'rning '.$%# + "$g, /e!i'4

What is hypoglycemiaC What causes hypoglycemiaC What are the symptoms o- hypoglycemiaC How does the "ody control "lood sugarC

Being )i'gn$se)4

How is hypoglycemia diagnosedC How is a glucose test doneC

How are imaging tests used to -ind the cause o- hypoglycemiaC Ge##ing #re'#!en#4

How is hypoglycemia treatedC What are ;uic:(sugar -oodsC

What is the emergency treatment -or low "lood sugar -or people who are not ta:ing insulinC

What steps can / ta:e at home to pre'ent low "lood sugarC

4uthor1 Caroline Rea, RN, BS, MS Medical Re'iew1Caroline S. Rhoads, M! ( /nternal Medicine4lan C. !al:in, M! ( #ndocrinology Last 9pdated1 6D3AB3B665 'ore on Hypoglycemia (Low Blood Sugar) in People Without Diabetes HYPOGLYCEMIA (LOW BLOOD SUGAR) IN PEOPLE WITHOUT DIABETES HOME

E5'!s 'n) Tes#s !octors diagnose hypoglycemia using a medical history, physical e$amination, and tests to chec: the "lood sugar le'el. ?enerally, you are diagnosed with hypoglycemia i- you ha'e a low "lood sugar le'el and symptoms that go away a-ter you ha'e ta:en glucose to restore your "lood sugar le'el.A Me)i/', +is#$r =our doctor will as: ;uestions a"out1

What symptoms you e$perience8how long they last, when they occur, how o-ten they occur, and what happens to your symptoms when you eat something. ast medical treatments, any current medical conditions, and whether you are ta:ing medicines ("ring all medicines8"oth prescription and nonprescription8to your appointment -or re'iew) or recei'ing other treatment. !iet and nutrition, such as what and when you eat, and whether you ha'e had recent changes in your eating or "owel ha"its. Whether you ha'e gained or lost weight recently. Because an episode o- hypoglycemia can impair mental -unctioning, your doctor may also want to tal: to -riends or relati'es who ha'e seen your symptoms. P+ si/', e5'!in'#i$n =our doctor also will loo: -or conditions that may cause hypoglycemia, including signs o-1

Li'er disease, such as an enlarged li'er. Eidney disease, such as swelling (edema), and too much urea in the "lood. Malnutrition, such as e$treme weight loss. 4drenal gland disease, such as too much pigment (color) in the s:in and3or low "lood pressure. Pri!'r ,'.$r'#$r #es#s &-ten hypoglycemia is a complication o- dia"etes treatment. /- you are not "eing treated -or dia"etes or another o"'ious cause o- low "lood sugar, you will ha'e la"oratory tests to con-irm hypoglycemia. /deally, your doctor would li:e to do these tests when you are e$periencing symptoms. But "ecause this is usually not possi"le, you pro"a"ly will ha'e tests that attempt to reproduce symptoms. %hese tests are usually done in a clinic or a hospital. /n some cases, home glucose monitors, which are o-ten used "y people who ha'e dia"etes, may "e used to e'aluate possi"le hypoglycemia. But a low "lood sugar reading needs to "e con-irmed "y these -ormal la"oratory tests1

Overnig+# *'s#6 =ou will "e as:ed not to eat o'ernight, and you will ha'e your "lood sugar and insulin le'els chec:ed the -ollowing morning. /n many cases, this test will tell your doctor iyou ha'e -asting hypoglycemia. Pr$,$nge) s%"ervise) *'s#6 %he primary test -or hypoglycemia is a prolonged (DF( to 5B( hour) super'ised -ast. =ou will "e as:ed to -ast until the symptoms o- moderate low "lood sugar de'elop, or until "lood glucose le'els drop "elow D+ mg3dL. /- at the end o- 5B hours you do not ha'e low "lood sugar, you may "e as:ed to e$ercise -or 06 minutes. %his test also can help determine why con-irmed hypoglycemia is occurring. !uring the prolonged super'ised -ast test, your "lood is drawn at regular inter'als to monitor how well your "ody controls "lood sugar le'els. Garious la"oratory tests measure su"stances in the "lood, such as glucose, insulin, and C(peptide. O#+er #es#s 4 urine or "lood test may "e done to loo: -or su"stances called :etones that the "ody produces when it "rea:s down -at -or energy. /nsulin pre'ents the production o- :etones. /- you ha'e low "lood sugar -rom too much insulin, your "ody will not produce :etones. /n people who ha'e normal insulin release, prolonged -asting causes a drop in insulin and an increase in :etone production. %ests also may "e done to loo: -or a tumor o- the pancreas or an endocrine disorder.

/- the suspected cause is rapid emptying o- the stomach a-ter a meal (reacti'e or alimentary hypoglycemia) or a tumor in the pancreas or other part o- the "ody, you may ha'e imaging tests, such as ultrasound C% scan or MR/, to e$amine your stomach, pancreas, or other internal organs. /n some cases pancreatic tumors are ;uite small, so an imaging test in which a dye is in<ected into the "lood 'essels (angiography) may "e used to locate the tumor. &ther imaging tests use radioacti'e proteins that "ind to tumors to locate them. /maging tests may "e needed regularly -or se'eral years, "ecause such tumors can "e hard to locate. W+'# #$ #+in2 '.$%# %he oral glucose tolerance test should not "e used to e'aluate possi"le non-asting (postprandial) hypoglycemia. %his test does not pro'ide consistent and relia"le results when it is used to screen -or hypoglycemia.