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Hypoglycemia

Also listed as: Blood sugar - low; Low blood sugar


Hypoglycemia (low blood sugar) is a condition in which there is an abnormally low level of glucose (sugar) in your blood. Normally your body keeps blood sugar levels within a narrow range through the coordinated work of several organs and glands and their hormones, primarily insulin and glucagon. But factors such as disease or a poor diet can disrupt the mechanisms that regulate your sugar levels. Too much glucose results in hyperglycemia, one of the major symptoms of diabetes. However, hypoglycemia is most common among people with diabetes, as too much insulin can cause blood sugar levels to fall (an insulin reaction).


Signs and Symptoms

Because glucose (sugar) is the brain's primary fuel, your brain feels the effects of hypoglycemia. The effects include the following:


What Causes It?

Hypoglycemia can be caused by the following conditions:


What to Expect at Your Provider's Office

If your symptoms are not severe, your health care provider will order a blood test called a glucose tolerance test (GTT), the same test used to diagnose diabetes. If your levels are only slightly below normal, your provider may recommend diet and lifestyle changes. If your symptoms are severe, your provider will immediately give you glucose in either an oral or injectable form to bring your blood sugar level back to normal as quickly as possible. Additional tests may determine the cause of your low blood sugar.


Treatment Options

It is important to treat low blood sugar immediately to avoid long-term serious effects. Hypoglycemia resulting from exercise several hours after a meal rarely produces serious symptoms. A glass of orange juice and a piece of bread can correct your blood sugar levels within minutes. However, in people with underlying diseases, fluctuating blood sugar levels are more serious and must be treated with oral or injectable forms of glucose. You can take oral glucose if you are able to swallow. If not, your health care provider can give you an injection.

Drug Therapies

Complementary and Alternative Therapies

Long-term treatment is aimed at the cause of the hypoglycemia, but alternative therapies may also be useful in regulating blood sugar in the short term. Nutritional support should be part of treatment.

Nutrition and Supplements

Dietary modification should form the core of any treatment for hypoglycemia. Small frequent meals that are high in fiber and complex carbohydrates are best, preferably five or six a day. Cut down on simple carbohydrates, including sugar, refined foods, juices, and fruit. Foods high in fiber include whole grains, fruits and vegetables, and nuts. Eliminate all caffeine, alcohol, and tobacco.

Some doctors may suggest a high-protein diet, although evidence is mixed on the benefits. A "Zone" style diet, based on the work of Dr. Barry Sears, combines proteins, fats, and carbohydrates in a 30/30/40 ratio and can be very helpful in maintaining stable blood sugar throughout the day.

Soluble fiber, such as flaxseed and pure oat bran, can slow the rate at which dietary sugars enter the blood and help regulate blood sugars throughout the day. Consume 1 - 3 tsp. of either of these fiber sources before meals. Talk to your doctor first if you have a history of digestive disorders.

Vitamins and minerals that are important for regulating glucose levels include the following. If you are diabetic, talk to your health care provider before adding these to your diet:

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). People with a history of alcoholism should not take tinctures. Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted.

Acupuncture

May be beneficial in decreasing stress, increasing coping skills, and regulating hormone function.


Following Up

Any underlying condition that may be causing your hypoglycemia must be aggressively treated so that your episodes do not recur. If you have hypoglycemia when you exercise, carry a healthy snack with you.


Special Considerations

Do not ignore the signs and symptoms of hypoglycemia. Untreated, it can cause irreversible brain damage, coma, or even death.


Supporting Research

Anderson RA, Polansky MM, Bryden NA, Bhathena SJ, Canary JJ. Effects of supplemental chromium on patients with symptoms of reactive hypoglycemia. Metabolism. 1987;36:351-355.

Branch WT Jr. Office Practice of Medicine. 3rd ed. Philadelphia, Pa: WB Saunders Co; 1994:574-575.

Fauci AS, Braunwald E, Isselbacher KJ, et al., eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:2069-2071.

Hofeldt FD. Reactive hypoglycemia. Metabolism . 1975;24:1193-208.

Hopman WP, Houben PG, Speth PA, Lamers CB. Glucomannan prevents postprandial hypoglycemia in patients with previous gastric surgery. Gut . 1988;29:930-4.

Mowry DB. The Scientific Validation of Herbal Medicine. New Canaan, Conn: Keats Publishing; 1986:25.

Stebbing JB, et al. Reactive hypoglycemia and magnesium. Magnesium Bull . 1982;2:131-4.

Tyler VE. Herbs of Choice: The Therapeutic Use of Phytomedicinals. Binghamton, NY: Pharmaceutical Products Press; 1994:141.

Wilson JD, Foster DW. Williams Textbook of Endocrinology. 8th ed. Philadelphia, Pa: WB Saunders Co; 1992:1232-1248.

Wyngaarden JB, Smith LH Jr. Cecil Textbook of Medicine. 17th ed. Philadelphia, Pa: WB Saunders Co; 1985:1342-1348.


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