Update: October 2018
Hypoglycemia refers to the pathological conditions of the temporary
character at which the level of peripheral blood glucose
drops below the minimum limit of 3.5 mmol / l. With this
deviation forms a special symptom complex, which is called
The condition is especially dangerous for patients with diabetes mellitus,
since in the absence of emergency compensation of blood glucose
develop hypoglycemic coma.
Causes of hypoglycemia
That is, symptoms of hypoglycemia can occur in a healthy
human under the following conditions and provoking factors:
- Fasting, malnutrition, diet (deficient
minerals, fiber, vitamins). This is the most common cause of development.
symptoms of hypoglycemia in a relatively healthy person. If a
for a long time to refrain from normal nutrition, and then
eat carbohydrate foods, blood sugar rises quickly, but
also quickly and consumed to a level lower than normal.
- Insufficient drinking regime. Lack of water in the body
leads to a compensatory consumption of blood sugar to maintain
- Stress. Emotional stress activates endocrine function.
system, which leads to the rapid consumption of blood sugar in a short
- Abuse in the diet of refined carbohydrates.
The pancreas on the background of a constant excess of sweet gets used
produce large amounts of insulin. With a constant excess
insulin blood glucose tends to decrease.
- Strong physical exertion. The body increases consumption
stored glycogen and blood sugar consumption at intense
training or hard physical labor leading to
physiological drop in blood glucose.
- Period of menstruation. A drop in sugar levels may occur on
the background of a sharp drop in the production of estrogen and progesterone, which are
normal concentrations increase (estrogen) and normalize
(progesterone) blood sugar.
- Physiological hypoglycemia of newborns of the first day of life.
Immediately after birth, the baby’s energy needs are covered
maternal glucose, a small amount of which is stored in
umbilical vein. But the rapid depletion of glycogen stores leads to
drop in glucose at 1-2 hours of life. Gradually, with
improving nutrition in healthy children
is being restored. However, congenital
- The introduction of a large amount of saline (NaCl) intravenously,
leading to artificial lowering of blood sugar.
Causes of hypoglycemia in diabetics
Symptoms of hypoglycemia
Skip eating diabetic. Needing energy, the body
starts to consume glucose from the depot – glycogen or more simply
starch, the stock of which in people with diabetes is small and not
compensates for glucose requirements (see sugar symptoms
- An overdose of insulin or glucose-lowering drugs that
may increase insulin levels in the blood. This leads to an imbalance.
(there is more insulin in the blood than glucose), the liver begins to break down
glycogen – glucose depot. Synthesized sugar enters the blood,
to cope with high insulin levels. Those. such
compensatory mechanism saves the body from hypoglycemia, only
patients with diabetes glycogen store is small, which is automatically
increases the risk of lowering blood sugar levels.
Pathological causes in people who do not suffer from sugar
The following reasons can also be realized in
diabetic, only hypoglycemia will always flow brighter and
come faster than people without diabetes.
- Dehydration. When dehydrated in peripheral blood
there is a deficiency of vitamins, trace elements and blood sugar,
because they leave the body with sweat and urine and are not compensated
from the outside (see symptoms and causes of dehydration).
- Exhaustion. When depleted glycogen reserve fall to
critical level, respectively, glucose does not come from outside and
can not be compensated by the internal reserves of the body.
- Liver diseases (cirrhosis, necrosis, hepatic
failure) in which the process of formation is disturbed
glucose (see liver disease symptoms).
- Hormone deficiency: cortisol (may occur on the background
cancellation of corticosteroid drugs, chronic insufficiency
adrenal cortex), growth hormone, adrenaline and glucagon,
stimulating the mobilization of glucose in the liver, hypopituitarism
(insufficiency of pituitary function)
- Violation of carbohydrate absorption – gastrointestinal diseases (colitis,
enteritis, dumping syndrome).
- Meningitis, encephalitis, sarcoidosis
- Alcoholism, alcohol overdose. Ethanol metabolism
occurs in the liver with the help of the enzyme alcohol dehydrogenase.
The cofactor launching this process is NAD – a special
a substance that is involved in the synthesis of glucose. The more
alcohol enters the body, the more consumption is exposed
OVER, simultaneously inhibiting the process of gluconeogenesis and leading to a fall
glucose in blood.
- Critical failure of vital organs: heart,
liver, kidney (see symptoms of kidney disease) – leading to
dysfunction of the body as a whole and dysregulation of sugar
- Sepsis. Increased glucose uptake with large
the number of macrophages, parallel increases production
инсулина и значительно уменьшается синтез glucose in печени.
- Pancreatic insulinoma (benign or
malignant neoplasms of beta-islands), against which
excessive glucose utilization occurs.
- Congenital malformations: autoimmune hypoglycemia,
5-cell hypersecretion, 7-ectopic insulin secretion, with
which there is insufficient production of glucose.
The mechanism of formation of blood glucose
After eating carbohydrate food, the body gets glucose,
which is carried by blood to all cells. As soon as glucose
begins to enter the blood (absorbed from the gastrointestinal tract), pancreas
the gland begins to secrete the hormone insulin, which helps the cells
use incoming sugar as an energy source. Have
healthy people the amount of glucose received and the response share
insulin is always equal to each other.
Have больных инсулинозависимым diabetes поджелудочная железа не
capable of producing the required amount of insulin, and they must
enter it from the outside, and in the correct dose.
According to the severity of the state of lack of blood glucose
divided into 3 degrees:
- Легкая (2,7-3,3 ммоль/л, см. норма glucose in крови) –
a person is conscious, can stop himself
lack of glucose. With дальнейшем не поступлении glucose in кровь,
within 20-30 minutes a severe degree can develop and even
- Heavy (2-2,6 mmol / l) – a man in the mind, but can not
help yourself without help.
- Hypoglycemic coma (<2 ммоль/л) – человек находится в
Symptomatic hypoglycemia is taken into a separate category,
которая наблюдается у пациентов с сахарным diabetes при резком
a drop in blood glucose from high to normal and not
requires correction. At the same time observed typical for the state
symptomatology. To avoid sudden surges in sugar levels, sick
сахарным diabetes следует постоянно соблюдать диету (см. диета при
Symptoms of hypoglycemia
Люди, страдающие diabetes давно, умеют распознавать данное
state of 2-3 signs. The rest must remember a certain
a sequence of symptoms that occur one after the other, and
pretty fast. Unfortunately, not everyone has a classic
symptoms, so the best assistant in this situation is the device
to measure blood sugar!
Signs of hypoglycemia by frequency of appearance:
- Sudden general weakness;
- Feeling of hunger;
- Nausea, vomiting;
- Haveчащенное сердцебиение;
- Hand shake;
- Unmotivated aggression and nervousness;
- Double eyes, colored circles;
- Confusion of speech and understanding of what is happening;
Как не страшно это звучит, но именно such сценарий
unfolds if no time is provided!
Hypoglycemia in a dream
A drop in blood sugar can happen in a dream. Main symptoms
– sharp waking up from nightmares, in sweat, right up to
wet sheets. If a человек не проснулся среди ночи, то утренние
The symptoms of the condition are fatigue and weakness.
Hypoglycemia in children
The causes of this condition in children are:
- diseases of the nervous and endocrine systems, including sugar
- unbalanced nutrition;
- physical overload.
In addition to the above, there are 2 fundamental reasons
development of pediatric hypoglycemia:
- Haveвеличение содержания кетоновых тел в blood. Have таких детей
there is a peculiar acetone smell from the mouth, constant
dizziness, vomiting, fainting, due to
the toxic effect of acetone.
- Leukin intolerance of congenital nature – amino acids,
part of the protein, requiring compliance with a special diet.
Main symptoms: вялость, потливость, бледность кожи,
Frequent hypoglycemic seizures adversely affect
intellectual and physical development of children. Cropping
hypoglycemia in children is carried out as in adults. With
leucine intolerances are excluded foods such as eggs, fish,
nuts, milk and others containing leucine.
Help with hypoglycemia – pre-medical and stationary
For quick help the body produces tablets containing
d-glucose (dextrose) or glucagon. Instructions for these drugs
must know all diabetics and people living with them. Patients
prone to hypoglycemia, you should always wear such drugs with
Being in a state of sugar shortage is dangerous as a lack of compensation,
and surplus of glucose. An overdose of glucose inevitably leads
subsequent hyperglycemia, no less dangerous for a diabetic.
Assistance should begin with measuring household blood sugar
измерителем, дабы подтвердить недостаток глюкозы blood. Blood sugar
should be measured and with the provision of assistance. If a such возможности
No, you should immediately begin to stop the condition.
You can stop your own condition with the help of
12-15 grams of oral administration of simple, easily digestible carbohydrate from
- d-glucose (in tablets). The most preferred method with
predictable scenario of a turn of events, i.e. smooth rise
глюкозы blood. 1 gram of glucose increases blood sugar by 0.22
mmol / l. Knowing the original numbers of blood sugar, easy to calculate
the required dose of tablets;
- 150 grams of sweet fruit juice or sweet drink;
- warm tea with 2 teaspoons of sugar;
- 1 banana;
- 5-6 slices of dried apricots;
- a couple of slices of milk chocolate or 1 candy;
- 2 teaspoons of honey or sugar (dissolve);
- 2 pieces of refined sugar.
Attention!!! Eat or drink one of the suggested foods.
options! Cannot exceed specified quantity.
If a через 15-20 минут сахар крови не повысился, а состояние
remains unsatisfactory, you should again take 15-20 grams
simple carbohydrate. A person’s condition improves within an hour.
after taking light carbohydrates, i.e. do not wait for instant
relief after taking a glucose tablet.
- Quickly give a person 12-15-20 grams of easily digestible carbohydrate.
After 20 minutes, the person should eat another 15-20 grams of complex carbohydrate
(bread, cracker biscuits, bread, porridge).
- If a человек сильно расторможен, может глотать, но уже не
able to chew, glucose should be given in the form of a solution, dissolving
The required number of tablets in a small amount of water. Or
just offer sweet water.
- Abroad sold glucose in a gel state, which
You can lubricate the mouth, where the sugar begins to quickly absorb
into the blood.
If a человек находится в бессознательном состоянии либо сознание
his confused oral liquids and other products
excluded! You should call an ambulance.
The first aid is intramuscular injection of 1 ml.
Glucagon – express kits with 1 syringe and drug are sold in
pharmacies. In the hospital, hypoglycemia treatment is carried out
intravenous glucose 40%. If a состояние не купируется,
have resorted to the subcutaneous injection of adrenaline and other intensive care
Consequences of hypoglycemia
Frequent bouts of condition can trigger angiopathy.
leg and eye vessels, increase the risk of heart disease,
vessels and the brain. Death of a man who fell into
hypoglycemic coma, is due to the death of the cells of the head
brain that feed on glucose. This is an extreme case, but quite
real, if time does not help a person.
How to prevent hypoglycemia in type 1 and 2 diabetes
- By heart know how to stop this condition and its
- Know your insulin dose and not exceed it.
- Follow the diet and the schedule of injections.
- Measure fasting blood sugar in the morning, before each meal and before
- Stop drinking alcohol.
- Always carry special glucose tablets.
or any product with simple carbohydrates (sweet caramel,
chocolate, dried apricots).
- With необходимости приема каких-либо лекарств внимательно
read how they affect insulin and blood sugar
(enhance the action of insulin aspirin, allopurinol, warfarin,
probenecid and other drugs).
Автор: врач-гигиенист, эпидемиолог