How to identify Hypoglycemia (Low Blood Sugar)?


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Whenever patient comes to you in complete chaotic behaviour or confusion or brought to EMS in an unconscious state, first thing you have to do is check his blood glucose level. Let’s know more about this condition.



Hypoglycemia, commonly known as low blood sugar, occurs when the glucose levels in the blood drop below normal values. This condition can be concerning, especially for individuals with diabetes, but it can also affect those without diabetes under certain circumstances.

What is Hypoglycemia?

Hypoglycemia is defined as having a blood sugar level below 70 milligrams per deciliter (mg/dL). This condition primarily affects individuals who have diabetes and are taking medications to lower their blood sugar levels. However, it can also occur in people who do not have diabetes due to various reasons such as prolonged fasting, excessive alcohol consumption, certain medications, or underlying health conditions.

what are Signs and Symptoms of hypoglycemia?

  • Confusion: One of the earliest signs of hypoglycemia is confusion or difficulty concentrating. Individuals may find it hard to articulate their thoughts or make decisions.
  • Sweating: Profuse sweating, especially when it’s not associated with physical activity or a hot environment, can indicate low blood sugar levels.
  • Trembling or Shaking: Shakiness or trembling, particularly in the hands, can be a sign that the body is experiencing hypoglycemia.
  • Hunger: Sudden hunger, even shortly after a meal, may signal low blood sugar levels.
  • Irritability: Hypoglycemia can lead to mood changes, such as irritability, anxiety, or agitation.
  • Weakness or Fatigue: Feeling weak or tired, even after adequate rest, can be a symptom of low blood sugar.
  • Dizziness or Lightheadedness: Hypoglycemia can cause dizziness or lightheadedness, potentially leading to fainting in severe cases.
  • Headache: Some individuals may experience headaches as a result of hypoglycemia.
  • Unconsciousness: In severe cases, hypoglycemia can lead to loss of consciousness, where the individual becomes unresponsive and may require immediate medical attention.

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Causes of Hypoglycemia :

1. Diabetes Medications:

One of the primary causes of hypoglycemia is the use of medications to treat diabetes. Insulin, the mainstay of treatment for type 1 diabetes and sometimes used in type 2 diabetes, can lower blood sugar levels too much if the dosage is too high or if not taken as directed. Similarly, certain oral hypoglycemic agents, such as sulfonylureas and meglitinides, stimulate insulin release from the pancreas, increasing the risk of hypoglycemia, especially if not balanced with food intake or adjusted appropriately.

2. Skipping Meals or Delayed Meals:

Not eating regular meals or delaying meals can lead to drops in blood sugar levels, particularly for individuals with diabetes. Without a constant supply of glucose from food, blood sugar levels can plummet, especially if insulin or other diabetes medications are still active in the body. This scenario commonly occurs when individuals skip breakfast or have long gaps between meals.

3. Excessive Alcohol Consumption:

Alcohol can interfere with the liver’s ability to release glucose into the bloodstream. As a result, excessive alcohol consumption, especially on an empty stomach or in combination with medications that lower blood sugar, can lead to hypoglycemia. Alcohol impairs the liver’s normal function, reducing its capacity to maintain blood sugar levels within the normal range.

4. Intense Physical Activity:

Engaging in intense physical activity can deplete glucose stores in the body, leading to hypoglycemia, particularly in individuals with diabetes. During exercise, muscles use glucose for energy, which can lower blood sugar levels. Without sufficient carbohydrate intake or adjustments to insulin doses, hypoglycemia can occur during or after physical activity, especially if it’s prolonged or strenuous.

5. Certain Medical Conditions:

Certain medical conditions can also cause hypoglycemia. For example, adrenal insufficiency (Addison’s disease) can lead to insufficient production of cortisol and adrenaline, hormones that help regulate blood sugar levels. Additionally, pancreatic tumors, such as insulinomas, can produce excessive amounts of insulin, leading to hypoglycemia, even in individuals without diabetes. Other conditions affecting the liver’s ability to regulate glucose, such as liver disease or certain metabolic disorders, can also contribute to hypoglycemia.

Treatment of hypoglycemia

The primary goal of treating hypoglycemia is to raise blood sugar levels quickly to prevent further complications. The following steps can help manage hypoglycemia effectively:

  1. Consume Glucose: Consuming fast-acting carbohydrates, such as fruit juice, glucose tablets, or candy, can rapidly raise blood sugar levels. It’s essential to follow up with a snack or meal containing protein and complex carbohydrates to stabilize blood sugar levels.
  2. Unconscious Patients: In cases where the individual is unconscious or unable to swallow, administering glucagon via injection is the preferred treatment. Glucagon is a hormone that stimulates the liver to release stored glucose into the bloodstream, raising blood sugar levels. The standard dose of glucagon for hypoglycemia is 1 mg injected subcutaneously or intramuscularly. Alternatively, intravenous dextrose 25% (D25) solution may be administered by healthcare professionals to rapidly raise blood sugar levels in unconscious patients. The usual dose is 50 mL of D25 solution administered intravenously.
  3. Glucagon Injection: For severe hypoglycemia, especially if the individual is unconscious or unable to swallow, a hormone called glucagon can be administered via injection. Glucagon stimulates the liver to release stored glucose into the bloodstream, raising blood sugar levels.
  4. Adjust Medications: If hypoglycemia occurs frequently, adjustments to diabetes medications, such as insulin or oral hypoglycemic agents, may be necessary. Consulting a healthcare provider is essential to determine the appropriate dosage and timing of medications.
  5. Regular Monitoring: Monitoring blood sugar levels regularly, especially before and after meals, exercise, and bedtime, can help prevent episodes of hypoglycemia.

Complications of hypoglycemia:

If left untreated, hypoglycemia can lead to serious complications, including:

  • Seizures: Severe hypoglycemia can trigger seizures, which can be life-threatening if not promptly treated.
  • Loss of Consciousness: In extreme cases, hypoglycemia can cause loss of consciousness or coma.
  • Brain Damage: Prolonged or severe hypoglycemia can result in permanent brain damage due to a lack of glucose supply to the brain.
  • Death: Although rare, untreated severe hypoglycemia can be fatal.


Hypoglycemia is a potentially dangerous condition characterized by low blood sugar levels. Recognizing the signs and symptoms of hypoglycemia is crucial for prompt intervention and treatment. By following appropriate management strategies and seeking medical advice when needed, individuals can effectively manage hypoglycemia and reduce the risk of complications.

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