Hypoglycemia

Hypoglycemia is defined as plasma glucose below about 3.9 mmol/L (70 mg/dL), with Whipple triad: symptoms consistent with low glucose, measured low glucose, and relief after glucose. Symptom categories: adrenergic (tremor, sweating, palpitations, hunger) and neuroglycopenic (confusion, behavioral change, seizures, coma). Severe/prolonged hypoglycemia causes irreversible brain injury. Most common in insulin/sulfonylurea-treated diabetes; also causes: fasting, insulinoma, alcohol, hepatic/renal failure, adrenal insufficiency, inborn errors of metabolism, post-bariatric surgery.

Common Symptoms

Tremor; sweating; palpitations; hunger; confusion; blurred vision; weakness; seizures; coma in severe

Causes and Pathogenesis

Glucose supply fails to meet demand: excess insulin/sulfonylurea, fasting, organ failure, insulinoma, counterregulatory hormone deficiency, alcohol-induced impaired gluconeogenesis.

Treatment

Acute: oral fast carbohydrate / IV dextrose / glucagon; identify and treat underlying cause; adjust diabetic regimen; diazoxide/surgery for insulinoma; frequent feeding for reactive hypoglycemia

Preventive Measures

Diabetic patient education; regular meals; monitor glucose; carry fast sugar; avoid excess insulin/alcohol.

Department to Visit

It is recommended to visit the Endocrinology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.