Causes of Hypoglycemia

Keeping blood sugar from rising too high is the goal for anyone with any variety of diabetes. But hypoglycemia (high po gly see me uh) is, in a sense, the result of too much success. This term for very low blood sugar is a combination of three Greek words: Hypo = under, glykys = sweet, and haima = blood. Anyone can become hypoglycemic, but for people with diabetes, curbing the threat of nose-diving blood sugar is part of daily life.

When glucose levels drop off, cells throughout much of the body can adjust by living off fat and protein, at least temporarily. But one very important organ -- the one located between your ears -- can't use fat and protein for energy. Since the brain needs glucose to survive, it regards a sugar shortage as a crisis. Early symptoms are no big deal. You feel hungry and a little shaky and nervous, like you had too much coffee. But soon you begin to feel woozy and need to sit down. Your heart thumps, and you break into a cold sweat. Unless you take the proper steps, you may become confused and talk incoherently. Your vision blurs and your head feels ready to burst. In a sense, it is: In extreme cases, hypoglycemia causes convulsions and even comas.

©2007 Publications International, Ltd. Diabetics who need to take medication like insulin are more likely to have hypoglycemia.

What causes a plunge in blood sugar? In a person who does not have diabetes, hypoglycemia is fairly uncommon, since the body comes equipped with an efficient system that keeps blood sugar levels balanced. When blood sugar begins to drop, the pancreas senses trouble and slows down insulin production, so the body doesn't use up glucose so quickly. For an added boost, the pancreas makes the hormone glucagon, which signals the liver to convert some glycogen to glucose, then release the sugary stuff into the blood. It all happens so quickly that a dip in blood sugar is brief and goes unnoticed.

This system can get out of whack if you have diabetes, making it tricky to maintain balanced blood sugar. That's especially true if you inject insulin or take sulfonylureas or meglitinides, two widely used medications that perk up insulin production in the pancreas. Getting the proper dose of these therapies exactly right is something of an art. To avoid frequent bouts of hypoglycemia, you must become expert at tweaking your dosage when necessary and knowledgeable about the steps you can take to help keep your blood sugar from plummeting.

Using insulin or insulin-stimulating medications increases the risk for low blood sugar, but the problem can be triggered by other conditions and circumstances. If you develop symptoms but your glucose levels appear to be safe (and you know your glucose meter is working properly), talk to your doctor. Hypoglycemia can also be caused by:

• Other medications, including aspirin, sulfa drugs (for treating infections), pentamidine (for serious pneumonia), and quinine (for malaria)

• Alcohol, especially if you go on a bender. Heavy doses of booze interfere with the liver's ability to release glucose.

• Other illnesses, including diseases of the heart, kidneys, and liver. Also, rare tumors called insulinomas produce insulin, which would raise levels of the hormone too high, causing blood sugar to drop.

• Hormonal deficiencies. More common in children, a shortage of glucagon, as well as other hormones (including cortisol, growth hormone, and epinephrine) can cause hypoglycemia.

For more information on hypoglycemia, diabetes, and related topics, try the following links:

• For more information about hypoglycemia, including treatment, causes, and diagnosis, visit our main Hypoglycemia page.
• To learn about testing your blood sugar, why you should test your blood sugar, and equipment to measure your glucose levels, go to our main Blood Sugar page.
• For more information on diabetes in general, whether you want to learn about type 1 or type 2, visit the main Diabetes page.
• To learn about hyperglycemia, the other side of the coin from hypoglycemia, visit the main Hyperglycemia page.

ABOUT THE AUTHOR:

Timothy Gower is a freelance writer and the author of several books. His work has appeared in many magazines and newspapers, including Prevention, Health, Reader's Digest, Better Homes and Gardens, Men's Health, Esquire, Fortune, The New York Times, and The Los Angeles Times.

ABOUT THE CONSULTANTS:

Dana Armstrong, R.D., C.D.E., received her degree in nutrition and dietetics from the University of California, Davis, and completed her dietetic internship at the University of Nebraska Medical Center in Omaha. In private practice for 21 years, she has developed educational programs that have benefited more than 5,000 patients with diabetes. She is the cofounder and program director of the Diabetes Care Center in Salinas, California..

Allen Bennett King, M.D., F.A.C.P., F.A.C.E., C.D.E., received his degrees and training at the University of California, Berkeley; Creighton University Medical School; the University of Colorado Medical Center; and Stanford University Medical Center. He is the author of more than 50 papers in medical science and speaks nationally on new advances in diabetes.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.