hypoglycemia Hypoglycemia refers to a decrease in the plasma glucose level, with blood glucose levels dropping to <2.8mmol/L (50mg/dL) in adults and <4mmol/L (72mg/dL) in diabetic patients. Symptoms often include palpitations, profuse sweating, and even alterations in consciousness.

Hypoglycemia refers to a decrease in plasma glucose levels, with adult blood glucose levels dropping to <2.8 mmol/L (50 mg/dL), and in diabetic patients dropping to <4 mmol/L (72 mg/dL). Symptoms of hypoglycemia often include palpitations, profuse sweating, and even changes in consciousness.

Fasting Hypoglycemia

Also known as post-absorptive hypoglycemia, it mainly refers to hypoglycemic symptoms occurring in a fasting state. The main causes include severe diseases (such as liver failure, renal failure, etc.), use of hypoglycemic drugs, alcohol consumption, and insufficient secretion of glucose-regulating hormones.

Insulinoma

A neuroendocrine tumor that secretes insulin within the pancreas. Patients with this condition often experience hypoglycemia on an empty stomach and may require surgical resection for treatment.

Diabetic Hypoglycemia

The main external causes of diabetic hypoglycemia include improper use of insulin, reduced or delayed food intake after insulin injection, and improper use of insulin secretagogues. Internal causes are mainly due to impairment of the body's counterregulatory mechanisms against hypoglycemia.

Postprandial Hypoglycemia

Hypoglycemia often occurs 1.5 to 3 hours after breakfast, does not occur on an empty stomach in the morning, and occurs around lunch and dinner, approximately every 15 to 20 minutes. This is mainly seen in early-stage type 2 diabetes patients, patients receiving parenteral nutrition support, and patients with psychological or emotional instability.

Neonatal Hypoglycemia: Pallor, dyspnea, daze, easy irritability, intermittent twitching, feeding difficulties, etc.

Adults commonly experience symptoms such as palpitations, sweating (often profuse), tremors, hunger, and in severe cases, altered consciousness.

Hypoglycemia in children: Similar to adults, but may present as grand mal seizures.

Hypoglycemia in pregnant women: Similar to adults, manifesting as dizziness, palpitations, fatigue, tremors, and sweating.

Hypoglycemia in the elderly: Symptoms of sympathetic nervous system activation (profuse sweating, palpitations, nausea, pallor) may not be obvious, but may manifest as changes in personality, insomnia, vivid dreams, and may even lead to myocardial infarction or stroke.

For individuals experiencing acute hypoglycemia, immediately administer 15g of glucose orally (at home, sugary drinks such as fruit juice are acceptable, with a sugar content preferably exceeding 15g). If symptoms do not improve after 15 minutes, repeat the sugar intake. If recurrent episodes occur, immediately seek emergency medical attention and administer glucose intravenously.

For individuals in hypoglycemic coma, promptly seek emergency medical attention, administer glucose intravenously, and if necessary, use hydrocortisone and/or glucagon. It is important to avoid feeding comatose patients to prevent respiratory obstruction.

In Traditional Chinese Medicine, hypoglycemia falls into categories such as "fainting" and "deficient wind," with various differentiation of symptoms. Common Chinese herbal medicines for raising blood sugar include astragalus, prepared rehmannia, salvia miltiorrhiza, codonopsis, safflower, and kudzu root with licorice.

If a patient exhibits symptoms of hypoglycemia (pallor, tremors, sweating, palpitations, hunger), the following assistance can be provided:

If the patient is conscious, immediately provide a rapidly absorbable carbohydrate, such as a bottle of fruit juice or a cup of sugar water (100-150 ml, approximately 15g of sugar), and wait for 15 minutes to observe any improvement in symptoms. If hypoglycemic symptoms persist, provide additional sugar water or fruit juice. If a blood glucose meter is available, the patient can self-monitor their blood glucose levels.

If the patient loses consciousness, or experiences choking or coughing while drinking, do not force-feed or give water, as this may lead to choking. Immediately call for emergency medical assistance and await the arrival of emergency responders.

Diet: It is important to maintain regular meal times and eat three meals each day.

Dietary Recommendations: Individuals with a history of hypoglycemia, those preparing for high-intensity exercise, or those undergoing diabetes medication treatment are advised to carry some high-sugar foods with them, such as fruit candy, sugar cubes, toffees, chocolates, fruit juice, honey, and biscuits, for potential needs.

Hypoglycemic symptoms in newborns, pregnant women, the elderly, and diabetic patients may not be typical but pose significant risks and require close attention and timely medical care.

Effects of Hypoglycemia During Pregnancy: Mild decrease in maternal blood sugar (2.8-3.3 mmol/L) requires timely sugar supplementation and has minimal impact on the fetus. However, severe hypoglycemia (<1.5 mmol/L) or the occurrence of coma and generalized seizures can cause hypoglycemia in the fetus and should be promptly addressed in a hospital. If left untreated for more than 6 hours, the fetal brain can suffer severe damage or even death.

Harm of Neonatal Hypoglycemia: The earlier and lower the blood sugar level at the onset of hypoglycemia and the longer the duration, the greater the damage to the newborn. This can manifest as decreased responsiveness, feeding difficulties, drowsiness, apnea, tremors, and seizures. Repeated or prolonged hypoglycemia not only affects growth and development, leading to low height, low weight, and delayed intellectual development, but can also cause permanent neurological damage such as epilepsy and cerebral palsy.

General Population

Eat three regular meals and avoid skipping meals.

Avoid engaging in vigorous exercise on an empty stomach, such as running or stair climbing.

During physical exams or prenatal check-ups, pay attention to fasting blood sugar levels. If they are too low (<4 mmol/L), seek medical attention from an endocrinologist.

Diabetic Patients

Maintain a regular lifestyle, eat meals at fixed times, and eat promptly after taking antidiabetic medications or insulin injections.

Monitor blood sugar levels closely, especially after adjusting antidiabetic medications, to promptly understand the status of blood sugar control.

Avoid excessive physical activity, maintain a consistent level of daily exercise, and carry candies when engaging in outdoor activities.

Adhere to medical advice and avoid adjusting medication dosages on your own. Double-check the medication and its dosage before each administration, especially for insulin.

Prevention of Neonatal Hypoglycemia

Mothers in labor can consume easily digestible food in small quantities during labor, and mothers undergoing cesarean section can receive intravenous glucose supplementation.

Feed the newborn as soon as possible within 30 minutes after delivery.

Pay close attention to the blood sugar of high-risk newborns, such as premature and low birth weight infants. For those unable to be fed orally, administer 10% glucose intravenously.