Glucose is the main source of energy for the brain and the other organs of our body. When blood glucose levels fall below normal limits, that is, when the glucose concentration is less than 70 mg / dl, it is said that we are in the presence of hypoglycemia.

When the glucose supply in the body decreases, a series of compensatory mechanisms are activated, which make it possible for the body to recover the energy necessary for the functioning of the organs. These compensatory mechanisms generate symptoms of hypoglycemia.

It is relevant to say that the symptoms of hypoglycemia will depend on the severity of the glucose deficiency. So the lower the blood glucose levels, the more severe the symptoms.

What are the symptoms of hypoglycemia?

The symptoms of hypoglycemia can vary from one person to another, depending on the frequency of their occurrence, the way that appears hypoglycemia and blood sugar levels. In other words, if a person is hypoglycemic on a daily basis, they may tolerate lower blood glucose levels than someone else who is experiencing hypoglycemia for the first time.

The symptoms of hypoglycemia are described in the Whipple triad, characterized by low blood glucose levels, the appearance of symptoms and the disappearance of symptoms as blood glucose levels improve.

In the context of mild hypoglycaemia (glucose levels between 70 to 55 mg / dl), symptoms such as sudden hunger, distal tremor, tingling in the hands and face, anxiety, tachycardia and sweating appear (due to the release of catecholamines as a compensatory response). At this stage, mild neurological symptoms such as tiredness and headache (or headache) may also appear.

Faced with moderate hypoglycemia (between 55 to 40 mg / dl), the symptoms described above are accentuated, associating mucous skin paleness, drowsiness, dizziness, ringing in the ears and blurred vision. The neurological symptoms in this stage are caused by changes in behavior associated with states of irritability, poor expressiveness or slow language (bradylalia).

When the drop in blood glucose continues and hypoglycemia becomes severe (less than 40 mg / dl), neuroglycopenia occurs, the brain being the main affected organ, the patient becomes stuporous, with incoherent language, and may even present seizures and loss of consciousness (fainting and coma) leading to death.

How are compensatory responses to hypoglycemia activated?

By decreasing the concentration of glucose in the blood, the sensor mechanisms at the level of the central and peripheral nervous system are activated, sending signals to the hypothalamus.

These signals activate glucose-regulated neurons which, in turn, send chemical signals that produce a decrease in insulin secretion and an increase in glucagon production in the pancreas, as well as increase the production of adrenaline, which generates an increase in glucose synthesis. in the muscles and the production of fatty acids that are converted into glucose by the liver.

Some of these chemical responses translate into symptoms, for example, the release of adrenaline produces vasodilation (sweating and paleness), tachycardia, tremors, a tingling sensation, among others.

What are the risks of hypoglycemia?

The main risks of hypoglycemia are related to the loss of brain function.

When not enough glucose supply reaches the brain, the synaptic signals necessary for its functioning are not established, so they are lost from the higher mental functions (thought, behavior, memory, attention, etc.) to the temperature-regulating centers ( there may be hypothermia), the respiratory regulating center (there may even be respiratory arrest) and the sleep regulating center (drowsiness, stupor), among others.

When there is a severe drop in blood glucose, seizures can occur (due to the alteration of the excitability of the cerebral cortex) and once extreme levels of glucose in the blood are reached, total loss of consciousness and coma occurs, even this state can be lethal.

Why do hypoglycemia occur?

There are numerous causes of hypoglycemia , the main one being prolonged fasting and the decompensation of diabetes due to infectious or ischemic states. Other causes are: increased insulin levels in hyperinsulinism (for example, in Polycystic Ovarian Syndrome) in an insulinoma or an insulin-secreting tumor, kidney failure (which conditions insulin to circulate for a longer time in the blood because it is not adequately purified at the renal level), diabetic patients with excess doses of insulin or oral hypoglycemic agents, use of alcohol, liver failure, excessive exercise, bariatric surgery, among others.

If you have had any of these symptoms it is important to see your doctor to rule out an underlying cause of hypoglycemia .

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses. He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

Leave a Reply

Your email address will not be published. Required fields are marked *