Health Care and Hypoglycemia

Millions of Americans suffer from hypoglycemia--hard to pronounce and even harder to understand. Hypoglycemia, also called low blood sugar according to eDocAmerica, occurs when your glucose (blood sugar) level drops too low. When this happens, characteristic symptoms develop including: hunger, shakiness, dizziness, sweating, blurred vision, and weakness. Many people view hypoglycemia as a distinct disease. In reality, hypoglycemia is usually a manifestation of: 1) an underlying medical condition such as liver disease or a tumor of the pancreas, 2) a side effect of a medication, such as insulin or, 3) a poorly understood condition called "reactive hypoglycemia". Overall, diabetics are the most likely group to experience hypoglycemia, related to taking their glucose-lowering medications. In those without diabetes, reactive hypoglycemia is the most common cause for a low blood sugar. Reactive hypoglycemia is defined as low blood sugar occurring one to three hours after eating.

According to eDocAmerica, some of the causes of reactive hypoglycemia are known, but these represent only a small percentage of the total cases. For example, having stomach surgery can cause food to rapidly pass from the stomach into the small intestine with resulting hypoglycemia. In the majority of cases of reactive hypoglycemia, however, no specific cause is found. Some people may be more sensitive to the body's normal release of the hormone epinephrine, which can produce symptoms of hypoglycemia. A deficiency of a hormone called glucagon, that normally stimulates the release of glucose stores when blood sugar drops or a release of an excess of insulin in response to sugar in the diet are other possible explanations.

According to the National Institute of Health (NIH), Medications, including some used to treat diabetes, are the most common cause of hypoglycemia. Other medications that can cause hypoglycemia include:
--salicylates, including aspirin, when taken in large doses
--sulfa medicines, which are used to treat infections
--pentamidine, which treats a very serious kind of pneumonia
--quinine, which is used to treat malaria

If using any of these medications causes your blood glucose to drop, your doctor may advise you to stop using the drug or change the dosage according to the NIH.
1.) Alcohol drinking: Especially binge drinking, can cause hypoglycemia because your body's breakdown of alcohol interferes with your liver’s efforts to raise blood glucose. Hypoglycemia caused by excessive drinking can be very serious and even fatal.
2.) Critical Illnesses: Some illnesses that affect the liver, heart, or kidneys can cause hypoglycemia. Sepsis (overwhelming infection) and starvation are other causes of hypoglycemia. In these cases, treatment targets the underlying cause.
3.) Hormonal Deficiencies: Hormonal deficiencies may cause hypoglycemia in very young children, but usually not in adults. Shortages of cortisol, growth hormone, glucagon, or epinephrine can lead to fasting hypoglycemia. Laboratory tests for hormone levels will determine a diagnosis and treatment. Hormone replacement therapy may be advised.
4.) Tumors: Insulinomas, insulin-producing tumors, can cause hypoglycemia by raising your insulin levels too high in relation to your blood glucose level. These tumors are very rare and do not normally spread to other parts of the body. Laboratory tests can pinpoint the exact cause. Treatment involves both short-term steps to correct the hypoglycemia and medical or surgical measures to remove the tumor.

Assuming there is no serious underlying cause determined, reactive hypoglycemia can usually be controlled with lifestyle measures according to eDocAmerica. These include eating nutritionally balanced meals, getting regular exercise, and keeping weight under control. Of these, nutritional measures seem to be the most important. Recommendations for managing hypoglycemia are:
--Eat small meals or a snack every 2-3 hours.
--Eat a variety of foods that includes including meat, poultry, fish, or nonmeat sources of protein; starchy foods such as whole-grain bread, rice, and potatoes; fruits; vegetables; and dairy products.
--Eat a source of protein (soy foods, poultry, fish, cheese, eggs, peanut butter or meat) or a source of fat at each meal or snack.
--Eat high fiber foods to help stabilize blood sugar (whole grain breads and cereals, legumes, vegetables and whole fruits).
--Limit simple sugars such as candy, soda, and fruit juice, especially on an empty stomach. Sweet foods are better tolerated if eaten with meal since the other foods at the meal reduce the effects of the sugar.
--Limit consumption of alcohol and caffeine (coffee, tea, soda, chocolate).
--Have non-perishable foods (energy bars, nuts, dried fruits, etc.) available to eat with the first signs of hypoglycemia.
--Consider the Glycemic Index (GI) when considering food choices. Foods with a lower GI are more slowly digested, causing less of a rise in insulin, and possibly preventing hypoglycemia.

According to the National Institute on Health, there are ways to effectively treat hypoglycemia.
If you think your blood glucose is too low, use a blood glucose meter to check your level. If it is 70 mg/dL or below, have one of these "quick fix" foods right away to raise your blood glucose:
2 or 3 glucose tablets
1/2 cup (4 ounces) of any fruit juice
1/2 cup (4 ounces) of a regular (not diet) soft drink
1 cup (8 ounces) of milk
5 or 6 pieces of hard candy
1 or 2 teaspoons of sugar or honey
--After 15 minutes, check your blood glucose again to make sure that it is no longer too low. If it is still too low, have another serving. Repeat these steps until your blood glucose is at least 70.
--Then, if it will be an hour or more before your next meal, have a snack. If you take insulin or a diabetes medication that can cause hypoglycemia, always carry one of the quick-fix foods with you.
--Wearing a medical identification bracelet or necklace is also a good idea.
--Exercise can also cause hypoglycemia. Check your blood glucose before you exercise.
--Severe hypoglycemia can cause you to lose consciousness. In these extreme cases when you lose consciousness and cannot eat, glucagon can be injected to quickly raise your blood glucose level.
--Ask your health care provider if having a glucagon kit at home and at work is appropriate for you. This is particularly important if you have type 1 diabetes. Your family, friends, and co-workers will need to be taught how to give you a glucagon injection in an emergency.
--Prevention of hypoglycemia while you are driving a vehicle is especially important. Checking blood glucose frequently and snacking as needed to keep your blood glucose above 70 mg/dL will help prevent accidents.

Information supplied by MedicineNet.com reports that the body needs fuel to work. One of its major fuel sources is sugars, which the body gets from what is consumed as either simple sugar or complex carbohydrates. For emergency situations (like prolonged fasting), the body stores a stash of sugar in the liver as glycogen. If this store is needed, the body goes through a biochemical process called gluco-neo-genesis (meaning to "make new sugar") and converts these stores of glycogen to sugar. This backup process emphasizes that the fuel source of sugar is important (important enough for human beings to have developed an evolutionary system of storage to avoid a sugar drought). Of all the organs in the body, the brain depends on sugar (which we are now going to refer to as glucose) almost exclusively. Rarely, if absolutely necessary, the brain will use ketones as a fuel source, but this is not preferred. The brain cannot make its own glucose and is 100% dependent on the rest of the body for its supply. If for some reason, the glucose level in the blood falls (or if the brain's requirements increase and demands are not met) there can be effects on the function of the brain. Despite our advances in the treatment of diabetes, hypoglycemic episodes are often the limiting factor in achieving optimal blood sugar control. In large scale studies looking at tight control in both type 1 and type 2 diabetes, low blood sugars occurred more often in the patients who were managed most intensively. This is important for patients and physicians to recognize, especially as the goal for treating patients with diabetes become tighter blood sugar control.

The Mayo Clinic advises that if you have what appear to be symptoms of hypoglycemia, see your doctor. Hypoglycemia, if confirmed, can be an indication of any number of illnesses, all of which can be serious. By seeing your doctor, you can begin the process of having the underlying illness identified and treated. If you have diabetes and early signs of hypoglycemia don't improve with eating or taking glucose tablets, seek immediate help. Also, seek emergency help if someone you know who has diabetes or a history of recurring hypoglycemia loses consciousness. If you have diabetes, carefully follow the diabetes management plan you and your doctor have developed; and if you don't have diabetes but have recurring episodes of hypoglycemia, eating frequent small meals throughout the day may keep your blood sugar levels from getting too low.

If you have symptoms of low blood sugar, you need to eat or drink something with sugar in it according to WebMD. For example, you could eat raisins, graham crackers, or candy. You could also drink skim milk, regular (not diet) soda, or fruit juice. You may also take glucose tablets. It’s a good idea to find out about health problems or situations that can lead to low blood sugar. It’s also important to pay attention to your health and lifestyle. For example, talk to your doctor to see if you can change your diet, change the medicines you take, or change the way you exercise. In some cases, treating the health problem that is causing low blood sugar can prevent future problems.

Take care of yourself. If the problems you are having may be symptomatic of hypoglycemia, get to the doctor. Don't ignore the issue. Proper maintenance of personal health care is a essential to a healthy lifestyle.

Until next time. Let me know what you think.