Hypoglycemia: symptoms, causes, first aid,effects

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
hypoglycemic syndrome.

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

Physiological

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
    normal life.
  • Stress. Emotional stress activates endocrine function.
    system, which leads to the rapid consumption of blood sugar in a short
    period.
  • 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
    pathology.
  • 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
    diabetes).

  • 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
diabetes

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
    blood.
  • 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.

Classification

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
    coma.
  • 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
    unconscious.

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
diabetes mellitus).

Symptoms of hypoglycemia

Neuroglycopenic

Vegetative

Adrenergic Parasympathetic
  • Space disorientation, amnesia
  • Decreased concentration and performance
  • Headache
  • Dizziness
  • Movement Coordination
  • Paresthesia
  • Hemiplegia – unilateral paralysis
  • Diplopia – double vision of objects
  • Aphasia – speech disorders
  • Primitive automatisms, inadequate behavior
  • Focal neurological disorders
  • Disorders of blood circulation and respiration (central
    Genesis)
  • Epileptiform seizures
  • Drowsiness, then impairment of consciousness, leading to fainting and
    coma
  • Increased aggressiveness, unmotivated excitement
  • Fear and anxiety
  • Excessive sweating
  • Tachycardia
  • Hand tremor
  • Muscle hypertension, overstrain individual muscle groups
    of fibers
  • Mydriasis – dilated pupils
  • Hypertension
  • Pale mucous and skin
  • Feeling of hunger
  • General weakness and malaise
  • Nausea
  • Vomiting

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;
  • Sweating;
  • Hand shake;
  • Unmotivated aggression and nervousness;
  • Dizziness;
  • Double eyes, colored circles;
  • Drowsiness;
  • Confusion of speech and understanding of what is happening;
  • Fainting;
  • Coma;
  • Death.

Как не страшно это звучит, но именно such сценарий
unfolds if no time is provided!

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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
    diabetes;
  • unbalanced nutrition;
  • stress;
  • 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,
    drowsiness.

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
by yourself!

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.

Mild degree

You can stop your own condition with the help of
12-15 grams of oral administration of simple, easily digestible carbohydrate from
list below:

  • 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.

Heavy degree

  • 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.

Hypoglycemic coma

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
events.

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
    the signs.
  • 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
    a dream.
  • 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

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