Insulin is a hormone that allows a variety of cells in the body to take up sugars. Diabetes mellitus is a disease caused by a lack of insulin in the body or lack of effectiveness of the hormone. Insulin therapy may be needed in diabetics to lower their blood sugar. Hypoglycemia is a state in which the blood sugars fall to low levels. Insulin does not treat hypoglycemia. Indeed, the opposite is true -- insulin therapy is the most common cause of hypoglycemia. Sugars are essential for body activity; the brain, especially, is entirely dependent on sugars for its energy. Hypoglycemia is thus a serious problem that should be treated promptly to prevent complications.
Causes of Hypoglycemia
By far, the most common cause of hypoglycemia is an excessive insulin injection. This usually occurs in diabetics, when they inject insulin and forget a meal, have a diarrheal condition that prevents absorption of food, exercise excessively or consume larges amounts of alcohol. Insulin also may be injected excessively in some cases of suicide attempts. Hypoglycemia also can occur as a complication of sulfonylurea therapy, an oral drug taken for type 2 Diabetes. Some rare tumors, including pancreatic and liver tumors, can cause hypoglycemia by producing excessive insulin that is released into the bloodstream.
Symptoms of Hypoglycemia
The symptoms of hypoglycemia are varied and depend on the individual. Hypoglycemia can cause sweating, trembling, a pounding heartbeat, hunger and anxiety. Other symptoms may be due to the effects of poor sugar supply to the brain and include confusion, tiredness, drowsiness, headache, speech difficulties, lack of concentration and loss of coordination. Though the symptoms can be irritating, they serve as a useful warning to individuals that their blood sugar is dropping; this warning lets them take measures to treat it. In individuals being treated with insulin for long periods of time, however, some of these symptoms may be blunted. This can set the stage for more serious complications.
Complications
Untreated hypoglycemia can slowly progress. As sugar levels fall, individuals can have seizures, faint and lose consciousness. Untreated, severe hypoglycemia can eventually be fatal unless emergency treatment is initiated.
Treatment
Diabetics being treated with insulin should carry some kind of simple carbohydrate with them at all times. Simple carbohydrates include items such as biscuits, energy bars or glucose tablets. These should be taken promptly when warning symptoms occur. This treatment can cause a rise in blood sugar within minutes. If a person loses consciousness, the individual will be unable to consume anything orally. In this case, intravenous glucose or glucagon should be given. Individuals who have repeated episodes of hypoglycemia should talk to their family doctor to get a more suitable insulin dosing regimen. People with an insulin-producing tumor should consider surgical treatment to excise it.
References
- "Davidson's Principles and Practice of Medicine"; Nicholas A. Book, et al.; 2006
- MayoClinic.com; Hypoglycemia; Jan. 12, 2010
