Hypoglycemia
(Low Blood Sugar)

Diabetes and Foot Problems Slideshow

• Hypoglycemia Overview
• Hypoglycemia Causes
• Hypoglycemia Symptoms
• When to Seek Medical Care
• Questions to Ask the Doctor
• Exams and Tests
• Hypoglycemia Treatment
• Self-Care at Home
• Medical Treatment
• Medications
• Surgery
• Next Steps
• Follow-up
• Prevention
• Synonyms and Keywords
• Authors and Editors

Diabetes Emergencies Medical Author: Ruchi Mathur, M.D. Medical Editor: William C. Shiel, Jr., MD, FACP, FACR Viewers have been submitting a number of questions about emergency situations as they pertain to patients with diabetes. While every situation is different and each patient has different needs and demands, we at eMedicineHealth felt that it would be helpful to address some significant issues. Patients with diabetes who require insulin (either type 1 or type 2 diabetes) do pose a challenge when it comes to emergency situations. Let me outline some of the problems and hopefully present some useful options. Air Travel And Diabetes Medications With the changes in regulations in air travel, patients with diabetes are concerned about what they can, and cannot pack in their carry–on luggage. From the TSA website: Notify the Security Officer that you have diabetes and are carrying your supplies with you. The following diabetes–related supplies and equipment are allowed through the checkpoint once they have been screened: Insulin and insulin loaded dispensing products (vials or box of individual vials, jet injectors, biojectors, epipens, infusers, and preloaded syringes; Unlimited number of unused syringes when accompanied by insulin or other injectable medication; lancets, blood glucose meters, blood glucose meter test strips, alcohol swabs, meter–testing solutions; Insulin pump and insulin pump supplies (cleaning agents, batteries, plastic tubing, infusion kit, catheter, and needle); Insulin pumps and supplies must be accompanied by insulin. Glucagon emergency kit; Urine ketone test strips; Unlimited number of used syringes when transported in Sharps disposal container or other similar hard–surface container. Sharps disposal containers or similar hard–surface disposal container for storing used syringes and test strips. Read more about how to manage diabetes emergencies » Top Searched Hypoglycemia Terms: reactive hypoglycemia, diet, symptoms, low blood sugar , treatment , diabetes , hypoglycemia and pregnancy , diabetic shock symptoms , metabolic disorder

Hypoglycemia Overview

Hypoglycemia (low blood sugar) is a commonly perceived problem. In actuality, while some or many of the symptoms may be present, it is rarely confirmed or documented. The presence of true, documented hypoglycemia in the absence of diabetes treatment must be evaluated comprehensively by an endocrinologist. Hypoglycemia most often affects those at the extremes of age, such as infants and the elderly, but may happen at any age. Generally, hypoglycemia is defined as a serum glucose level (the amount of sugar or glucose in your blood) below 70 mg/dL.

As a medical problem, hypoglycemia is diagnosed by the presence of three key features (known as Whipple's triad). Whipple's triad is:

1. symptoms consistent with hypoglycemia,
2. a low plasma glucose concentration, and
3. relief of symptoms after the plasma glucose level is raised.

Symptoms of hypoglycemia typically appear at levels below 60 mg/dL. Some people may feel symptoms above this level. Levels below 50 mg/dL affect brain function.

The body regulates its glucose level—the primary source of energy for the brain, muscles, and other essential cells - by the actions of different hormones. These hormones include insulin (which lowers the blood sugar level) and other chemicals which raise blood sugar (such as glucagon, growth hormone, and epinephrine).

• Both insulin and glucagon are manufactured in the pancreas, an organ near the stomach which assists the digestive tract. Special cells in the pancreas, called beta cells, make insulin. Alpha cells in the pancreas make glucagon.
  
  
• The role of insulin is to help in the absorption of glucose from the blood by causing it to be stored in the liver or be transported into other tissues of the body (for metabolism or storage).
  
  
• Glucagon increases the amount of glucose in the blood by breaking down stored glucose (starch, called glycogen) and releasing it from the liver into the bloodstream.
  
  
• Insulin and glucagon are usually correctly balanced if the liver and pancreas are functioning normally.

Traditionally considered a stress hormone, epinephrine (or adrenalin) is made in the adrenal gland and in certain cells in the central nervous system. Epinephrine also elevates blood glucose levels by making glucose available for the body during a time of stress. When this mechanism is not working properly, hypoglycemia can result. Other hormones also help in raising the level of blood glucose, like cortisol made by the adrenal gland and growth hormone made by the pituitary gland.