How to Know if You Have Hypoglycemia (low blood sugar levels)

Hypoglycemia is a syndrome with a wide variety of causes. In this condition, low blood glucose concentrations lead to a constellation of signs and symptoms that I will be discussing in this article. This article will also enumerate the laboratory evaluation of patients with hypoglycemia. This article may be more relevant to patients who have diabetes and are on exogenous insulin or oral diabetic medications.

Instructions

Difficulty: Challenging

Things You’ll Need:

• Knowledge
• Observation
• Physician follow up

1. CAUSES:
   
   Drugs:
   
   * Insulin therapy
   * Oral diabetes medications (sulfonylurea)
   * Anti-hypertensive medication (lisinopril)
   * Aspirin
   * Quinine
   * Haloperidol (Haldol)
   
   Alcohol
   Insulinoma (small tumor in pancreas secreting abnormally high insulin)
   Factitious hypoglycemia (by injecting insulin a diabetic drug)
   Intense exercise
2. SYMPTOMS:
   
   Sweating
   Sensation of warmth
   Anxiety
   Tremor or tremulousness
   Nausea
   Palpitations
   Increased heart rate
   Hunger
   Fatigue
   Dizziness
   Headache
   Visual disturbances
   Drowsiness
   Difficulty speaking
   Inability to concentrate
   Abnormal behavior
   Loss of memory
   Confusion
   Seizures
   Ultimately, loss of consciousness or coma
3. Labs:
   
   Blood glucose levels is the gold standard test to diagnose hypoglycemia (generally blood glucose level below 60mg/dl is considered to be hypoglycemia). Blood glucometers that are available in the market for self testing may not be accurate, however.
4. To diagnose insulinoma (pancreatic insulin secreting tumor) more extensive testing may be required. This includes measuring following levels after as 72 hour supervised fast:
   
   Plasma glucose
   Insulin
   C-peptide
   Pro insulin
   Beta-hydroxy butyrate
   Sulfonylurea
   
   High resolution CT of abdomen, MRI or PET scan may also be dome to locate the tumor.

Tips & Warnings

• Diabetics who are on insulin MUST carry sugar pills.
• People who have insulin secreting tumors (insulinomas) MUST also carry sugar pills or candies (not diet sugar).
• Wearing a medical alert bracelet may be life saving for those who have been diagnosed with insulinomas. Then people around would know the most likely cause if you pass out and could give you sugar drinks until the EMS arrives.