Low blood sugar, also called hypoglycemia, occurs when blood glucose levels drop below normal. Normal blood glucose levels range from 80 to 120 mg/dL (4.4 to 6.6 mmol/L). Common causes of low blood sugar are associated with too much insulin, increased exercise or insufficient food intake. Severe hypoglycemia is a medical emergency that if left untreated can result in seizures, coma or death.
Significance
According to "Sheehy's Manual of Emergency Nursing," hypoglycemia is the most common acute complication of diabetes and the most frequent side effect of insulin and oral hypoglycemic medications. Diabetic patients follow strict therapy regimens to keep their blood glucose in range and even small variations below a normal level can cause problems for the patient.
Hypoglycemia Defined
In "Clinical Practice of Emergency Medicine," hypoglycemia is defined as a glucose level usually less than 55 mg/dL (3.1 mmol/L). In addition to the low blood glucose level, the patient will have symptoms of sweating, shakiness and nervousness. A patient may start to show the symptoms of hypoglycemia before the glucose level gets to 55 mg/dL (3.1 mmol/L).
Signs and Symptoms
Shaking, sweating and nervousness are some of the first signs and symptoms a patient will start to experience with hypoglycemia. In addition, the patient may complain of feeling anxious and restless and have a racing heartbeat. Some patients will say they have a tingling sensation of their lips. Because of the low blood glucose, patients may feel a sense of hunger. Their skin color will look pale. As the hypoglycemia gets worse, people around the patient may notice that he is becoming confused and irritable with slurred speech and staggering. If hypoglycemia is not treated it will result in seizures, coma, permanent brain damage and death.
Causes of Hypoglycemia
Hypoglycemia can be precipitated when a patient misses a meal or eats later than normal. The consumption of alcohol can affect glucose levels and cause them to drop lower than normal. Exercise and increased activity can increase a person's caloric needs. If they do not eat enough to meet the calorie needs during exercise, their blood glucose level will drop. An accidental overdose of insulin will cause a low blood sugar. Overdoses can occur because of poor vision, misunderstanding of instructions, a change in syringe size, a change in insulin concentration or an error by the pharmacy.
Treatment
Treatment for a patient who is awake and still responsive will include giving the patient 15 g of carbohydrates, as noted by "Sheehy's Manual of Emergency Care." Examples of items that contain 15 g of carbohydrates would include three glucose tablets, one small tube of cake frosting or 1/2 cup of orange juice. If the patient is difficult to arouse or is unresponsive, call 911 for medical assistance. If the patient has a blood glucose meter, anyone who is familiar with the procedure should attempt to check the patient's blood glucose level.
References
- "Sheehy's Manual of Emergency Care"; Elsevier Mosby; 2005
- "Clinical Practice of Emergency Medicine"; Lippincott Williams & Wilkins; 2010
