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Question: What are the symptoms of hypoglycemia?
I recently went to my doctor with a few symptoms of hypoglycemia. She said that it was a possibility, or it could be pre-diabetes. Please tell me the difference between the two and what I can do to either reverse it, or not experience the symptoms so severely. Thanks! Dr. Bruce Biller responds:
Thanks for your question. Hypoglycemia occurs when the blood glucose falls below a critical level, usually less than 40 milligrams of glucose per deciliter of blood (mg/dL) in an adult. Often symptoms of mild to moderate hypoglycemia include sweating, rapid heart beat, tremors, and anxiety. In more severe hypoglycemia, symptoms may include alterations in consciousness or behavior or even actual loss of consciousness. In patients who are not diabetic and are not taking oral diabetic medication or insulin, a truly low blood glucose of less than 40 may reflect the action of excessive insulin secretion from the pancreas. This is a very rare condition due to a very small benign pancreatic tumor, an "insulinoma." It is, as mentioned, quite rare. In some patients who take oral diabetic medications or who take insulin, the medications themselves may cause true hypoglycemia. In these cases, the medication doses and the timing of doses may need to be adjusted by the doctor. Sometimes there is a need to adjust the diet of diabetic patients, as well, in terms of amount and type of food. If your physician suspects that you have true hypoglycemia, a blood test can be done at the time of maximal symptoms that measures blood sugar (glucose) and insulin level. This test is very helpful in determining the real problem. Occasionally, patients have to fast (no food) for prolonged periods in order to create symptoms that allow blood tests to be done at the time of maximal symptoms. This is usually done under close medical supervision in a hospital. As I mentioned, true hypoglycemia due to severe overproduction of insulin from a tumor is rare. More common is what is now called "pre-diabetes." If you think of diabetes as being a disease caused by your being "resistant" to the action of pancreatic insulin, then in the very early phase of the disease ( called pre-diabetes), this "resistance" creates a situation where the pancreas produces r more insulin in order to try hard to keep the blood glucose normal or near normal. This pattern of excess insulin secretion can be detected by blood tests done in the fasting state (before meals) coupled with tests done after eating a regular meal (post-prandial). The test measures the pattern of glucose and insulin release in the blood to determine if there is evidence of "pre-diabetes." If confirmed, your doctor can recommend either a special diet, weight reduction, exercise, or medication to help your body lose its insulin "resistance" and restore its metabolism to normal. In this way, it may be possible to avoid actual diabetes in the future. If you need more information about either hypoglycemia or pre-diabetes, I would recommend that you contact the local chapter of the American Diabetes Association. You should also certainly speak with your doctor about these issues and see if testing is medically necessary for you. I hope this answer is helpful to you and I wish you good luck!
Bruce Biller, MD -- Dr. Bruce Biller is an internist with subspecialty training in endocrinology and a special interest in diabetes. He is director of the Harvard Business School Health Services and physician to the Harvard University Health Services.
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First published April 24, 2007
Copyright © 2007 Consumer Health Interactive
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