By Dr Ananya Mandal, MD
Hypoglycemia or a below normal blood sugar level is a common complication of diabetes. The condition can also arise due to prolonged starvation, certain hormonal disorders such as hypopituitarism and hypoinsulinism or inborn errors of metabolism such as maple syrup urine disease.
Among individuals with diabetes, the risk for hypoglycemia is increased in cases of missed or poorly timed meals, an unusual amount of physical activity, excessive alcohol consumption or when doses of insulin are too high.
Irrespective of the underlying cause, hypoglycemia should be treated as a matter of urgency. In most cases, an individual can recognize when their blood sugar is falling due to the symptoms that arise such as sweating, palpitations and dizziness.
The brain is particularly vulnerable in cases of falling blood sugar as it has very limited reserves of glucose and depends on its availability in the body. Urgent treatment is therefore required to correct hypoglycemia before any loss of consciousness or permanent brain damage or even death occurs.
If a person's blood sugar falls to below 70 mg/dL, they should consume glucose-rich foods and drinks. Diabetics who know they are prone to hypoglycemia should always ensure they have access to these foods so they can correct their blood sugar levels in the event of a hypoglycemic episode.
Some examples of foods that can correct hypoglycemia include:
1 tablespoon of sugar or honey
5 to 6 pieces of hard candy
3 or 4 glucose tablets
Glucose gel amounting to around 15g of carbohydrate
4 ounces of any fruit juice
4 ounces of non-diet soft drink
8 ounces of milk
One of the above foods should be eaten and the blood sugar level tested again 15 minutes later. If the level is still below above 70 mg/d, another serving should be consumed. A snack is recommended if the next meal is more than an hour away.
Fatty foods such as chocolates are to be avoided since they may contain less sugar and take longer to raise the blood sugar.
In moderate-to-severe hypoglycemia, there may be light headedness and loss of consciousness. In these cases, nothing should be forced into the patient's mouth due to the risk of them choking. Intravenous glucose in the form of 5% dextrose solution may instead be given. The hormone glucagon may also be administered to raise the blood sugar.
Reviewed by Sally Robertson, BSc