The Truth About Hypoglycemia
I’ve received this question a number of times over the years: “I have episodes of hypoglycemia that make me really tired, foggy, and shaky. My doctor says to drink a glass of orange juice or eat some candy immediately and it works. But what should I do on the Wheat Belly lifestyle?” First of all, let’s put aside hypoglycemia–low blood sugars, generally 70 mg/dl (3.8 mmol/L) or less–that occurs in people with diabetes. In diabetics, it is a matter of making adjustments in insulin or other medications, or avoiding blood sugar drops during exercise, sleep, or prolonged periods of not eating. I’m not talking about this kind of hypoglycemia. I’m also not talking about very rare causes of hypoglycemia, such as insulinoma (a form of pancreatic cancer), binge drinking, antibodies against insulin or the insulin receptor in people with lupus, people who have undergone gastric bypass surgery, or have rare inherited carbohydrate metabolism defects such as glycogen storage diseases. Put all of that aside. I’m talking about the common, everyday form of hypoglycemia that plagues non-diabetic people and is responsible for symptoms such as fatigue, mental “fogginess,” confusion, slurred speech, trembling, rapid heart beat, irritability, and sweating. This form of hypoglycemia–“reactive hypoglycemia”–typically occurs about 90 minutes to 3 hours after eating (varying depending on the composition of the meal and the vigor of your insulin response). The conventional “solution,” as in the question above, is to consume some source of sugar, usually 15 to 25 grams worth. Once you understand why hypoglycemia develops, however, you will understand how knuckleheaded that solution is. Outside of diabetes, some diabetes drugs, and the rare causes of hypoglycemia me Continue reading >>
Recurrent Hypoglycemia: When Diabetes Is Not The Cause
Diabetes, Nutritional And Metabolic Diseases, Diabetes Type 2 ABSTRACT: Most episodes of recurrent hypoglycemia occur in patients with diabetes mellitus and can be prevented by changes in medication, diet, or activity. However, persistent, unexplained hypoglycemia can indicate a potentially grave, often treatable, underlying disorder, such as insulinoma, or adrenal or pituitary insufficiency. Medication errors are another cause of unexplained hypoglycemia. A focused laboratory workup is essential; obtain a plasma or serum glucose level and serum insulin and C-peptide levels. Insulin levels should be suppressed (less than 6 μIU/mL) when the glucose level is below 60 mg/dL. “Normal” or high insulin and C-peptide levels suggest excessive endogenous insulin production. Hypoglycemia is a common event that typically occurs in persons with diabetes mellitus. In this context, hypoglycemia usually results from an imbalance among diabetic therapy, level of activity, and dietary intake. Therefore, management of hypoglycemia has become “scripted”: glucose administration, followed by adjustments in insulin or oral medications or diet. The simplicity of this approach can be deceptive, however. Practitioners may underestimate the impact of other hypoglycemic disorders that are not the direct result of diabetes or its treatment regimen. In this setting, hypoglycemia can indicate a serious disturbance in glucose regulation and can recur with devastating consequences. Determining the cause of hypoglycemic “outliers,” therefore, is critical. The potentially life-threatening consequences of sudden, unexpected hypoglycemia may endanger not only the affected person but others as well (eg, hypoglycemia in a driver of a motor vehicle). Here are 4 cases of hypoglycemia that occurre Continue reading >>
Go to: ABSTRACT Objective: To describe the evaluation and management of hypoglycemia in patients without diabetes. Methods: Review of literature for the evaluation and management of non-diabetic hypoglycemia using Medline and PubMed. Results: Hypoglycemia (glucose <55 mg/dL) is uncommon in people without diabetes. Whipple’s triad (low plasma glucose concentration, clinical signs/symptoms consistent with hypoglycemia, and resolution of signs or symptoms when the plasma glucose concentration increases) should be documented in patients prior to embarking on evaluation. Medications should be reviewed. Critical illnesses, malnutrition, hormone deficiencies especially adrenal insufficiency, and nonislet cell tumors secreting IGF-II need be considered in those who are ill. Hypoglycemia can also follow bariatric surgery. In apparently healthy individuals, endogenous hyperinsulinism due to insulinoma, functional β-cell disorders, or the insulin autoimmune syndrome are possible, as are accidental, surreptitious or factitious causes of hypoglycemia. Tests performed during hypoglycemia can establish the cause in those whom illness or medications are not the cause. Testing may be done at the time of spontaneous development of symptoms. If this is not possible, it can be done in the setting of a prolonged supervised fast or during a mixed meal test. Endogenous hyperinsulinism is supported by insulin ≥3 uU/mL, c-peptide ≥0.2 nmol/L, proinsulin ≥5 pmol/L, β-hydroxybutyrate ≤2.7 mmol/L and undetectable sulfonylurea/meglitinide in the setting of hypoglycemia. Use of glucagon tolerance tests, c-peptide suppression tests, anti-insulin antibody testing and continuous glucose monitoring are discussed. Congenital causes of hypoglycemia, diagnosed primarily in neonates and children Continue reading >>
Hypoglycemia Without Diabetes
Normally, hypoglycemia, also referred to as low blood sugar, is found in diabetic patients who take too much insulin or too much of their diabetic medications. Both type 1 diabetics and type 2 diabetics can suffer from hypoglycemia; however, it is seen more commonly in type 1 diabetics who use insulin. Hypoglycemia can be found in non-diabetics, however, and is due to many reasons. The Definition of Low Blood Sugar Low blood sugar is defined as a blood sugar level below a certain level, usually about 60-70 mg/dL. You may have experienced it by feeling extremely hungry or weak. It can occur after exercising a lot without having eaten something to sustain you prior to exercise. This type of hypoglycemia is common and has probably been experienced by everyone at some time in their lives. Low blood sugar can also be a medical problem unrelated to exercise. This type of hypoglycemia results when the level of blood glucose in the bloodstream is too low to provide energy to the body. Causes of Hypoglycemia in the absence of Diabetes You can have hypoglycemia even if you aren’t diabetic and aren’t taking insulin. Common causes of hypoglycemia without diabetes include the following: Surgery on the stomach Use of alcohol Metabolic disorders Problems with the pancreas Problems with the kidneys Problems with the liver Certain medications Symptoms of Hypoglycemia in the absence of Diabetes The symptoms you experience from low blood sugar levels depend on how low the blood glucose level decreases. There are a few different types of hypoglycemia, including these: Mild hypoglycemia. When you have mild hypoglycemia, you can feel hungry or perhaps nauseous. You may have a rapid heart rate and may feel nervous or jittery. You may develop sweatiness and your skin might turn clammy and Continue reading >>
- Abnormally High Blood Sugar]. Hypoglycemia Is A Common
What Is Hypoglycemia? Hypoglycemia is a condition that occurs when a person's blood sugar (glucose) levels are too low. [Compare with hyperglycemia - abnormally high blood sugar]. Hypoglycemia is a common complication of diabetes. It can cause headaches, loss of concentration and in severe cases, convulsions and coma. A blood sugar count of 80 mg/dl is considered low but you may not experience symptoms until you hit 60 mg/dl. Fortunately most cases of hypoglycemia are mild and can be easily corrected by taking a few sugar cubes, 2 or 3 glucose tablets or drinking a sugary drink. FACTS Type 1 diabetics are, on average, hypoglycemic 10 percent of the time. It causes symptoms about twice a week and a severe 'attack' once a year. Type 2 diabetics in comparison have severe episodes only one-tenth as often. The main reason for this difference is the difference in medication taken. 3 Foods to Throw Out Cut a bit of belly bloat each day, by avoiding these 3 foods nucific.com What Are The Symptoms? Your brain needs glucose to run the rest of your body, if levels drop too low, your intellectual function suffers. You can develop what doctors medically term neuroglycopenic symptoms. These include: • Headache • Blurry vision or double vision • Loss of concentration • Feeling cranky or aggressive • Confusion • Tiredness In prolonged, extreme cases: • Convulsions (seizures) • Fainting • Coma The muscles in your body need glucose for energy, rather like a car needs gas to run on. If your blood glucose drop too low, the body panics and sends out a group of hormones to rapidly increase your levels again. The main hormone it sends out is adrenaline. This response can result in a second category of symptoms called adrenergic symptoms (adrenaline comes from the adrenal gla Continue reading >>
How To Treat Low Blood Sugar: 7 Tricks Every Diabetic Should Know
What causes hypoglycemia? iStock/Erna Vader Taking certain diabetes medications, skipping meals, not consuming enough carbs, and even too much exercise can throw your blood sugar off balance and cause low blood sugar. Insomnia and excessive alcohol consumption have also been linked to low glucose levels. When blood sugar dips to a level that's too low to sustain normal functioning—in most people, that's below 70 mg/dl—it results in a hypo attack with varying symptoms depending on its severity. People who have recurring bouts of low blood sugar may have no warning signs at all, explains Michael Bergman, MD, endocrinologist and clinical professor of medicine at NYU Langone Medical Center. This is known as hypoglycemic unawareness; the longer you’ve had diabetes, the more common it is. On the milder end of the low blood sugar spectrum, you may feel hungry, nauseated, jittery, nervous, and have cold and clammy-feeling skin. Many people also describe the feeling that their heart is racing or pounding. Low blood sugar can happen at night, too, causing nightmares and night sweats. Moderate low blood sugar can cause behavioral changes, making you fearful, confused, or angry. It can also trigger blurry vision, slurred speech, and problems with balance and walking. A layperson may even mistake you for being drunk. If left untreated, severe low blood sugar can cause loss of consciousness, seizures, irreversible brain or heart damage, coma, or even death. Here are first aid tips to handle a diabetic emergency. iStock/Geber86 It goes like this: If your blood sugar reading is low (below 70 mg/dl), eat or drink something equal to 15 grams of fast-acting carbohydrate (4 ounces of juice). Even if you feel okay, don't wait for the symptoms of hypoglycemia to kick in. Rest for 15 mi Continue reading >>
Can Low Blood Sugar Or High Blood Sugar Cause Nightmares?
Both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) can cause any of a list of reactions in the body. Among these are sleep disturbances, which may manifest as nightmares. Hypoglycemia Hypoglycemia has many causes. We all require certain levels of glucose in our systems to maintain energy levels. For the non-diabetic, in the absence of certain disorders, this is generally not an issue, as the metabolic process automatically balances the levels of glucose and insulin in our bodies. For the diabetic, particularly one who is using insulin and/or other medications to manage their glucose levels, continuing balance might be more difficult to achieve. Some causes of hypoglycemia include an overdose of insulin; a dose of insulin combined with a skipped meal; a reaction to a combination of diabetic medications; exercise that isn’t factored into insulin dosing; or any of a number of other medical problems, including tumors and hormonal disorders. Once blood sugar drops below certain levels, the body releases epinephrine, signaling an emergency to the body. This in turn causes the symptoms experienced by those who have hypoglycemia. Hypoglycemia does not only occur during the day. In fact, the onset of hypoglycemia during the nighttime hours is not at all uncommon. While it might be easy to spot the symptoms of a serious drop in blood sugar levels while awake (shakiness, sweating, confusion, blurred vision, tingling or numbness of the tongue or lips, lightheadedness or dizziness, among other symptoms), recognizing the problem during the night is more difficult, and potentially more critical. Nighttime onset of hypoglycemia can manifest as nightmares or crying out during sleep, excessive sweating, and confusion and irritability upon waking. It is critical to Continue reading >>
WHAT IS NON-DIABETIC HYPOGLYCEMIA? Hypoglycemia is the condition when your blood glucose (sugar) levels are too low. It happens to people with diabetes when they have a mismatch of medicine, food, and/or exercise. Non-diabetic hypoglycemia, a rare condition, is low blood glucose in people who do not have diabetes. There are two kinds of non-diabetic hypoglycemia: Reactive hypoglycemia, which happens within a few hours of eating a meal Fasting hypoglycemia, which may be related to a disease Glucose is the main source of energy for your body and brain. It comes from what we eat and drink. Insulin, a hormone, helps keep blood glucose at normal levels so your body can work properly. Insulin's job is to help glucose enter your cells where it's used for energy. If your glucose level is too low, you might not feel well. You can have symptoms of hypoglycemia, but unless your blood glucose level is actually low when you have symptoms, you don't have hypoglycemia. WHAT CAUSES NON-DIABETIC HYPOGLYCEMIA? The two kinds of non-diabetic hypoglycemia have different causes. Researchers are still studying the causes of reactive hypoglycemia. They know, however, that it comes from having too much insulin in the blood, leading to low blood glucose levels. Type of Non-diabetic Hypoglycemia Possible Causes Reactive hypoglycemia Having pre-diabetes or being at risk for diabetes, which can lead to trouble making the right amount of insulin Stomach surgery, which can make food pass too quickly into your small intestine Rare enzyme deficiencies that make it hard for your body to break down food Fasting hypoglycemia Medicines, such as - salicylates (a type of pain reliever) - sulfa drugs (an antibiotic) - pentamidine (to treat a serious kind of pneumonia) - quinine (to treat malaria) Alcohol, esp Continue reading >>
When the blood-glucose drop to below normal levels, hypoglycemia is the result. Though uncommon, people who do not have diabetes can have hypoglycemia, caused by medication, diseases, tumours, or hormone/enzyme deficiencies. The symptoms are similar to diabetes-related hypoglycemia, which may include hunger, shakiness, sweating, light-headedness, sleepiness, dizziness, confusion, anxiety, speaking difficulties, and weakness. There are two types of non-diabetic hypoglycemia: Reactive hypoglycemia - also called postprandial hypoglycemia, occurs within four hours after meals. Fasting hypoglycemia - also called postabsorptive hypoglycemia, often related to an underlying disease. Reactive Hypoglycemia Diagnosis Laboratory blood plasma analysis from a blood sample taken while having symptoms. A personal blood glucose meter cannot be used to diagnose reactive hypoglycemia. The doctor may ask about the signs and symptoms. See if the symptoms ease when the blood sugar returns to above 70 mg/dL after eating. The oral glucose test is no longer used, as it can actually trigger hypoglycemic symptoms. Relief from the symptoms after eating and a blood-glucose level below 70 mg/dL at the time of the symptoms constitutes a confirmation of reactive hypoglycemia. Causes Debatable causes Sensitivity to the hormone epinephrine. Deficiencies in glucagon secretion. Certain causes, though uncommon Gastric surgery - causing the rapid passage of food into the small intestine. Rare enzyme deficiencies such as hereditary fructose intolerance. Treatment Small meals every three hours. Being physically active. Eating foods high in fiber. Avoiding foods high in sugar, especially on an empty stomach. A low-carbohydrate diet. Fasting Hypoglycemia Diagnosis Fasting hypoglycemia is diagnosed when the bloo Continue reading >>
Hypoglycemia, also known as low blood sugar, is when blood sugar decreases to below normal levels. This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness, seizures, or death. A feeling of hunger, sweating, shakiness, and weakness may also be present. Symptoms typically come on quickly. The most common cause of hypoglycemia is medications used to treat diabetes mellitus such as insulin and sulfonylureas. Risk is greater in diabetics who have eaten less than usual, exercised more than usual, or have drunk alcohol. Other causes of hypoglycemia include kidney failure, certain tumors, such as insulinoma, liver disease, hypothyroidism, starvation, inborn error of metabolism, severe infections, reactive hypoglycemia, and a number of drugs including alcohol. Low blood sugar may occur in otherwise healthy babies who have not eaten for a few hours. The glucose level that defines hypoglycemia is variable. In people with diabetes levels below 3.9 mmol/L (70 mg/dL) is diagnostic. In adults without diabetes, symptoms related to low blood sugar, low blood sugar at the time of symptoms, and improvement when blood sugar is restored to normal confirm the diagnosis. Otherwise a level below 2.8 mmol/L (50 mg/dL) after not eating or following exercise may be used. In newborns a level below 2.2 mmol/L (40 mg/dL) or less than 3.3 mmol/L (60 mg/dL) if symptoms are present indicates hypoglycemia. Other tests that may be useful in determining the cause include insulin and C peptide levels in the blood. Hyperglycemia (high blood sugar) is the opposite condition. Among people with diabetes, prevention is by matching the foods eaten with the amount of exercise and the medications used. When Continue reading >>
Print Overview Hypoglycemia is a condition characterized by an abnormally low level of blood sugar (glucose), your body's main energy source. Hypoglycemia is commonly associated with the treatment of diabetes. However, a variety of conditions, many of them rare, can cause low blood sugar in people without diabetes. Like fever, hypoglycemia isn't a disease itself — it's an indicator of a health problem. Immediate treatment of hypoglycemia involves quick steps to get your blood sugar level back into a normal range — about 70 to 110 milligrams per deciliter, or mg/dL (3.9 to 6.1 millimoles per liter, or mmol/L) — either with high-sugar foods or medications. Long-term treatment requires identifying and treating the underlying cause of hypoglycemia. Symptoms Similar to the way a car needs gas to run, your body and brain need a constant supply of sugar (glucose) to function properly. If glucose levels become too low, as occurs with hypoglycemia, it can cause these signs and symptoms: Heart palpitations Fatigue Pale skin Shakiness Anxiety Sweating Hunger Irritability Tingling sensation around the mouth Crying out during sleep As hypoglycemia worsens, signs and symptoms may include: Confusion, abnormal behavior or both, such as the inability to complete routine tasks Visual disturbances, such as blurred vision Seizures Loss of consciousness People with severe hypoglycemia may appear as if they're intoxicated. They may slur their words and move clumsily. Many conditions other than hypoglycemia may cause these signs and symptoms. A blood sample to test your blood sugar level at the time of these signs and symptoms is how to know for sure that hypoglycemia is the cause. When to see a doctor Seek a doctor's help immediately if: You have what may be symptoms of hypoglycemia an Continue reading >>
Low Blood Sugar (hypoglycaemia)
A low blood sugar, 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 you take insulin. A low blood sugar can be dangerous if it's not treated promptly, but you can usually treat it easily yourself. Symptoms of low blood sugar A low blood sugar causes different symptoms for everybody. You'll learn how it makes you feel if you keep getting it, although your symptoms may change over time. Early signs of a low blood sugar include: feeling hungry sweating tingling lips feeling shaky or trembling feeling tired becoming easily irritated, tearful, stroppy or moody turning pale If not treated, you may then get other symptoms, such as: weakness blurred vision difficulty concentrating unusual behaviour, slurred speech or clumsiness (like being drunk) feeling sleepy seizures (fits) collapsing or passing out Hypos can also occur while sleeping, which may wake you up during the night or cause headaches, tiredness or damp sheets (from sweat) in the morning. If you have a device to check your blood sugar level, a reading of less than 4mmol/L is too low and should be treated. Treatment for low blood sugar Treating a low blood sugar yourself Follow these steps if your blood sugar is less than 4mmol/L or you have hypo symptoms: Have a sugary drink or snack – try something like a small glass of non-diet fizzy drink or fruit juice, a small handful of sweets, or four or five dextrose tablets. Test your blood sugar after 10-15 minutes – if it's 4mmol or above and you feel better, move on to step 3. If it's still below 4mmol, treat again with a sugary drink or snack and take another reading in 10-15 minutes. Eat your main meal (containing carbohydrate) if you're about to have it or Continue reading >>
Can You Have Hypoglycemia Without Diabetes?
A low blood sugar episode is frightening enough for most people to wonder if they can have hypoglycemia without diabetes. The short answer to that question is “yes”. Low blood sugar episodes can happen to anyone. But certain types of low blood sugar episodes may indicate that you do have diabetes or another significant medical condition. Hypoglycemia Symptoms Hypoglycemia is a condition where blood sugar levelsdrop below normal. During the day, a healthy person’s blood sugar fluctuates slightly depending on when their last period of exercise or last meal was. When your blood sugar dips slightly you may feel hungry, grouchy, nauseous, or even nervous. Hypoglycemia is a more severe drop in blood pressure. Medically, hypoglycemia is defined as a drop in blood sugar below 70. When your blood sugar levels drop this far, you may feel shaky, sweaty or unsteady on your feet. Your vision may blur and your heart may race. If your blood sugar dips low enough, you may pass out or have a seizure — even if you have low blood sugar without diabetes. Hypoglycemia without Diabetes Low blood sugar dips — even those low enough to be defined as hypoglycemia — can happen to normal healthy people who do not have diabetes. These low dips in blood sugar are called reactive hypoglycemia. The symptoms are the same, but the cause is more easily identifiable and in reaction to a state of being. Meal skipping is a common cause for hypoglycemia without diabetes. As your body burns its sugar reserves, they continue to get lower if you don’t refuel with a meal or a snack. Go without eating for long enough, and your blood sugar will get low enough to cause a hypoglycemic episode. Vigorous exercise — especially on an empty stomach — is another way to burn through your blood sugar reser Continue reading >>
WHAT YOU NEED TO KNOW: What is non-diabetic hypoglycemia? Non-diabetic hypoglycemia is a condition that causes the sugar (glucose) in your blood to drop too low. This can happen in people who do not have diabetes. The 2 types of non-diabetic hypoglycemia are fasting hypoglycemia and reactive hypoglycemia. Fasting hypoglycemia often happens after the person goes without food for 8 hours or longer. Reactive hypoglycemia usually happens about 2 to 4 hours after a meal. When your blood sugar level is low, your muscles and brain cells do not have enough energy to work well. What causes non-diabetic hypoglycemia? Fasting hypoglycemia: Certain medicines or herbal supplements such as fenugreek, ginseng, or cinnamon Alcohol Exercise Medical conditions such as liver disease, hypothyroidism, and tumors Eating disorders or malnutrition Stomach surgery or hemodialysis Reactive hypoglycemia: The causes of reactive hypoglycemia may be unknown. Hyperinsulinism Meals high in refined carbohydrates such as white bread or foods high in sugar Prediabetes Any surgery of the digestive system What are the signs and symptoms of non-diabetic hypoglycemia? Blurred vision or changes in vision Dizziness, lightheadedness, or shakiness Fatigue and weakness Fast or pounding heartbeat Sweating more than usual Headache Nausea or hunger Anxiety, Irritability, or confusion How is non-diabetic hypoglycemia diagnosed? Blood tests are done to measure your blood sugar levels. These tests may also be done to find the cause of your hypoglycemia. Fasting tests may be done. You may have an overnight fasting test or a 72-hour fasting test. After you have fasted overnight, your blood sugar levels will be tested 2 times. For a 72-hour fasting test, you will not be given food for a period of up to 72 hours. During th Continue reading >>
Can You Have Low Blood Sugar With Type 2 Diabetes?
back to Overview Know-how Type 2 A tag-team approach on low blood sugar with type 2 diabetes. Markus recently wrote an article on our German language blog talking about low blood sugar with type 2 diabetes. The question (“can I have low blood sugar with type 2 diabetes?”) is very common, and it’s easy to see why it’s of concern. So I’ve helped Markus bring his German post to life here in English. I hope it helps! Here’s Markus: Low blood sugar In 2014, results from the DAWN2 study were announced. It was the largest study of its kind (15,000 participants) on the “fears & needs of people with diabetes and their families.” One result stood out: The gravest fears are related to low blood sugars, especially at night. Up to 69% of the participants share this fear! So! Can you have low blood sugar with type 2 diabetes? Yes! Of course! But let’s think about who exactly is at risk – and why. It’s common to think: Type 1 diabetes = at risk for lows Type 2 diabetes = not at risk for lows But that isn’t correct at all, so we should wipe it from our mind. So… what do I need to know? Maybe it’s more accurate to say that people with type 2 diabetes who take certain types of medication are more at risk for lows. We’re getting closer! But to get to the truth, we should take a look at someone without diabetes. Is it possible for them to have lows, too? Theoretically yes, especially if doing long-lasting physical activities without proper food intake. Additionally, extreme stress and binge drinking are also common causes of low blood sugar for people without diabetes. However, it’s pretty rare because as soon as BG’s drop below 80 mg/dl (4.4 mmol/L), the natural counterregulatory system kicks in, raising blood sugar back to normal levels. I’ve never exp Continue reading >>