HYPOGLYCEMIA: LOW BLOOD GLUCOSE

Blood glucose/ sugar levels are something that people are always worried about. So, blood glucose/ sugar levels to the main sugar found in the blood. It comes from the food one’s eat, and it is the body's main source of energy. The blood carries glucose to all parts of the body's cells to use for energy. 

When there is imbalance ance of this blood glucose/sugar levels it leads to diabetes (high blood glucose/sugar or hyperglycemia) and hypoglycemia (low blood glucose).

So, people know a lot about diabetes or hyperglycemia but today lets discuss hypoglycemia……

What is hypoglycemia/low blood glucose/sugar?

Hypoglycemia refers to low levels of sugar, or glucose, in the blood. So, hypoglycemia is not a disease, but a condition which can indicate health-related problems. 

Hypoglycemia is detected by measuring blood sugar levels with a glucose meter. Any blood glucose level below 4.0 mmol/L indicates that the individual has hypoglycemia. Unlike diabetes, urine tests can’t detect hypoglycemia.

Steps to use glucometer are as follows:

Normal blood sugar levels are as follows:

A blood sugar level less than 140 mg/dL (7.8mmol/L) is normal. 

A reading of more than 200 mg/dL (11.1mmol/L) after two hours indicates diabetes. 

A reading between 140 and 199 mg/dL (7.8mmol/L and 11.0mmol/L) indicates prediabetes.

A blood sugar level below 70 mg/dL (3.9mmol/L) indicates hypoglycemia.

Types of hypoglycemia:

There are two types of hypoglycemia. They are as follows:

● Diabetic Hypoglycemia: It occurs when someone with diabetes doesn't have enough sugar (glucose) in his or her blood. 

●Non-diabetic hypoglycemia:  It is a rare condition, so low blood glucose is seen in people who do not have diabetes. 

Causes of hypoglycemia:

The causes of hypoglycemia are as follows:

(In diabetic hypoglycemia):

If the person has diabetes, so he/she might not make enough insulin (type 1 diabetes) or might be less responsive to it (type 2 diabetes). As a result, glucose tends to build up in the bloodstream and can reach dangerously high levels. To correct this problem, the person might take insulin or other drugs to lower blood sugar levels. But too much insulin or other diabetes medications may cause the blood sugar level to drop too low, causing hypoglycemia.

(In non-diabetic hypoglycemia):

Medications. Taking someone else's oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria.

Excessive Alcohol: Drinking heavily without eating can block the liver from releasing stored glucose into the bloodstream, causing hypoglycemia.

Some critical illnesses: Severe liver illnesses such as severe hepatitis or cirrhosis can cause hypoglycemia. Kidney disorders, which can keep the body from properly excreting medications, can affect glucose levels due to a build-up of those medications.

Long-term starvation, as can occur in the eating disorder anorexia nervosa, can result in too little of substances your body needs to create glucose.

Insulin overproduction: A rare tumour of the pancreas (insulinoma) can cause to produce too much insulin, resulting in hypoglycemia. Other tumours also can result in too much production of insulin-like substances. Enlargement of cells of the pancreas that produce insulin can result in excessive insulin release, causing hypoglycemia.

Hormone deficiencies: Certain adrenal gland and pituitary tumour disorders can result in a deficiency of key hormones that regulate glucose production. Children can have hypoglycemia if they have too little growth hormone.

Symptoms of hypoglycemia:

Foods to eat when blood glucose levels :

● Granola Bars: It gives an immediate boost in the blood sugar levels. They improve energy levels and increase blood sugar. Since many healthy varieties have oats, rice crispies, and nuts; choose them over the less healthy versions.

● Fresh or Dried Fruit: Another great option to have when facing dipping blood sugar levels is fruit. Apples, pears, bananas, apricots, and oranges are good to eat. These provide a healthy dose of glucose to the system with the added benefits of fibre. Strawberries and grapes are also dependable glucose enhancing fruits. One could also munch on some raisins and other nuts like almonds, walnuts, pistachios and dried apricots as a sugar-enhancing snack.

● Cookies: They provide a boost of energy and help you to reach normal sugar levels. Choose the ones that are rich in oats, nuts and have fewer amounts of fats.

● Sugar: If blood sugar has dipped low or if you find no healthy snack nearby, chomp down a tablespoon of sugar or lick a spoonful of honey. Very low glucose levels need immediate action and sugar or liquid carbs like honey or applesauce help to improve the sugar levels rapidly.

● Yoghurt: Eat a bowl of yoghurt with berries and nuts and watch your blood sugar levels improve. Apart from the energy boost, yoghurt will help to get a percentage of a daily dose of calcium, protein and immunity-boosting properties.

● Whole Grain Toast: Another excellent food choice to make when facing low sugar levels is having a whole-grain toast. Since bread is an easily-breakable carbohydrate, it is readily assimilated in the body. The whole-grain toast ensures that the glucose levels stay stable and the subsequent dips in the blood sugar levels are avoided.

● Cheddar Cheese: It provides with instant glucose, protein and high amounts of calcium. When blood glucose levels are dipping, one could have a slice of cheddar cheese to improve them.

● Smoothies: They work as a healthy sugar-increasing option. They are full of protein, vitamins and essential minerals and fibre as well. Blitz, some yoghurt with milk or some juice, oats, nuts, and berries and, have a jarful of healthy goodness that will bring your glucose levels to normal.

General dietary tips for hypoglycemia:

● Eat your meals frequently: When the gap between the meals isn’t too stretched out, the body doesn’t undergo the dips in blood sugar levels. Instead of three hearty meals, shift to six small meals a day. The energy levels will stay on an even keel and help you manage your diabetes better.

● Avoid foods with high sugar content: This includes processed and junk food like sweets, baked goodies, sodas, and fruit juices.

● Choose foods that have a low glycaemic index: Whole-grain foods like oats, quinoa, brown rice are good options. Eat enough protein in every meal as it helps to stabilize blood sugar levels. Lentils, yoghurt, tofu, and soy products are good alternatives to non-vegetarian options.

● Avoid alcohol consumption: If the person is unable to do that, limit it to avoid blood sugar dips. 

Blood glucose is a tricky parameter which causes irreversible changes in the body with moderate to mild symptoms. Hence, it is important to maintain it. So nutrition plays a crucial role in this. People with hypoglycemia must keep all these guidelines before planning or modifying their diet with the help of a good nutritionist/dietitians.

Musharrafa Asad

References:

○ American Diabetes Association. (2020a). 5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes—2020. Diabetes Care, 43(Supplement 1), S48–S65. https://doi.org/10.2337/dc20-S005

○ American Diabetes Association. (2020b). 7. Diabetes Technology: Standards of Medical Care in Diabetes—2020. Diabetes Care, 43(Supplement 1), S77–S88. 

https://doi.org/10.2337/dc20-S007

○ American Diabetes Association. (2020c). 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2020. Diabetes Care, 43(Supplement 1), S98–S110. https://doi.org/10.2337/dc20-S009

○ Cryer, P. E., Davis, S. N., & Shamoon, H. (2003). Hypoglycemia in Diabetes. Diabetes Care, 26(6), 1902–1912. https://doi.org/10.2337/diacare.26.6.1902

○ Diabetes Diet: 14 Foods to Control Low Blood Sugar Levels - PharmEasy. (2018, November 14). PharmEasy Blog. https://blog-prod.pharmeasy.in/blog/low-blood-sugar-symptoms-and-foods-that-control-blood-sugar/

○ Diabetic hypoglycemia—Symptoms and causes. Mayo Clinic. Retrieved January 8, 2021, from https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525

○ Editor. (2019, January 15). Hypoglycemia occurs when blood glucose levels fall below 4 mmol/L. Knowing the symptoms and causes of hypoglycemia can help you avoid a hypo. Diabetes. https://www.diabetes.co.uk/Diabetes-and-Hypoglycaemia.html

○ Hypoglycemia (low blood sugar): Symptoms, Causes, and treatment. (2019, March 11). https://www.medicalnewstoday.com/articles/166815

○ Non-DNon-Diabeticglycemia | Hormone Health Network.  Retrieved January 8, 2021, from https://www.hormone.org/diseases-and-conditions/diabetes/non-diabetic-hypoglycemia