Hypoglycemia is defined as blood glucose concentration below 2.77mmol/l (50mg/dl), and is a common complication of diabetic patients treated with oral hypoglycemic drugs or insulin. The early symptoms of hypoglycemia are dominated by the excitation of the vegetative nerves, especially the sympathetic nerves, manifested as palpitations, weakness, sweating, hunger, pallor, tremor, nausea and vomiting, etc. More serious hypoglycemia often has the manifestation of central nervous system sugar deficiency, such as blurred consciousness, mental disorder, limb paralysis, incontinence, lethargy, coma, etc. It is worth noting that the manifestation of hypoglycemia can be different for each patient, but for the patient Therefore, diabetic patients and their family members should pay attention to identifying the symptoms of hypoglycemia in order to take timely measures.
Hypoglycemia is harmful to human body, especially to elderly patients, the harm of hypoglycemia is more than that of hyperglycemia. The hazards of hypoglycemia are mainly as follows
1.When hypoglycemia, the body’s adrenaline, glucocorticoid, glucagon and growth hormone and other glucose-raising hormones increase, resulting in reaction to sexual intercourse blood glucose (Sumuje effect), causing blood glucose fluctuations and aggravation of the disease.
2, long-term repeated severe hypoglycemic episodes can lead to irreversible damage to the central nervous system, causing the patient’s personality variation, mental disorder, dementia, etc.
3, hypoglycemia can also stimulate the cardiovascular system, promoting arrhythmia, myocardial infarction, stroke, etc.
4. Hypoglycemic coma for too long undetected can cause death.
Hypoglycemia is one of the emergencies of diabetes mellitus and should be actively dealt with.
1.In the early stage of hypoglycemia, there are only symptoms such as sweating, panic, weakness, hunger, etc. When the patient is sober, he can drink sugar water or eat cookies or snacks containing more sugar.
2.If the patient’s consciousness has changed, he should use 50% glucose 40-60ml intravenously, and in more serious cases, 10% glucose can be used for continuous intravenous drip.
3.Application of glucagon Glucagon 1mg intramuscular injection can be used when available, but the price of glucagon is higher.
It should be noted that if hypoglycemia occurs in patients treated with Bystolic, they need to be treated with oral or intravenous application of glucose.
Hypoglycemia is a biochemical abnormality and not a disease. Whenever the blood sugar drops below the normal value for some reason, causing a group of clinical manifestations highlighted by sympathetic excitation and central nervous system dysfunction, it is called hypoglycemia. This disease can lead to coma when it is serious.
There are many causes of hypoglycemia, which can be roughly divided into the following categories.
1. Excessive insulin: insulinoma, islet cell hyperplasia, islet cell carcinoma, ectopic insulin-secreting tumor, and hypoglycemic drugs. Clinically endogenous or external insulin-induced hypoglycemia is the most common.
2.Responsive hypoglycemia: early diabetes, functional hypoglycemia, nutritional hypoglycemia.
3.Oversensitivity to insulin.
4.Liver disease.
5.Toxicity: drug poisoning.
6.Sugar deficiency.
What are the symptoms of hypoglycemic coma
Hypoglycemia is a strong stress for the organism, and the patient shows sympathetic excitement; hypoglycemia makes the central nervous system lack energy source, and many dysfunctions occur. Patients feel dizziness, headache, hunger, weakness and cold limbs at the beginning of the disease, followed by hazy consciousness, disorientation, convulsions and even coma, which can also be manifested as mental confusion and hemiparesis.
How to treat
1, general treatment: determine whether the patient’s airway is open, if necessary, do the corresponding treatment; with seizures must prevent tongue injury.
2.Emergency treatment: If the patient still has swallowing action, feed some sugar water, most of them can improve the symptoms quickly. For most patients, 20-60 ml of 50% glucose is sufficient to correct hypoglycemia. Symptomatic hypokalemia can occur when large amounts of sugar are injected rapidly. Most hypoglycemic patients can wake up within 5-10 min after sugar injection. If the hypoglycemia is severe and lasts for a long time, the neurological function cannot be fully recovered for a long time.
After the patient wakes up, consume juice and food as soon as possible. Sometimes it is necessary to eat carbohydrates and add high protein meals such as milk and 5% dextrose.
Personally, I think that hypoglycemia can also be related to our daily life in the recent period. For example, irregularity in our daily life or lack of nutrition in our diet may cause a temporary functional disorder in our body. So, we should not worry too much, but if it is prolonged, you should see a doctor.
What is hypoglycemia?
Glucose is a type of sugar that is the body’s primary source of energy. Hypoglycemia, or low blood sugar, occurs when blood glucose levels fall too low to provide the body with enough energy for normal physiological activities of cells. Carbohydrates such as sugar and starch are the main sources of glucose in our diet. During digestion, glucose is absorbed into the circulation and carried to the cells of the body to provide energy for normal physiological activities. Excess glucose is then stored in the liver as hepatic glycogen. These processes are closely controlled by the body’s hormones, so normal people have very stable blood glucose, and hypoglycemia rarely occurs. Hypoglycemia can occur in patients with diabetes and other diseases.
In diabetes, because of the treatment to lower blood sugar, hypoglycemia can occur at any time in anyone with diabetes, especially in patients who require strict control of blood sugar or whose blood sugar levels fluctuate greatly. That’s why it’s important for people with diabetes and their families and friends to learn how to cope with hypoglycemia. How does the body control blood sugar? Simply put, blood glucose is mainly controlled by the hormones insulin and glucagon, both of which, whether too much or too little, can cause blood glucose levels to fall too low (hypoglycemia) or rise too high (hyperglycemia). Other hormones that can affect blood glucose levels include adrenocorticosterone, growth hormone, and catecholamines (epinephrine and noradrenaline). The islets in the pancreas have alfa and beta cells, which produce glucagon and insulin, respectively. When blood glucose rises after a meal, the beta cells release insulin, which helps glucose enter the body’s cells and bring blood glucose levels down to a normal range. When the blood glucose level drops too low, glucagon is secreted by Alfa cells, which stimulates the liver to release stored liver sugar and convert it into glucose to raise the blood glucose level to a normal range.
Muscle can also store some liver glycogen, which can be converted into glucose. The normal blood glucose range is approximately 60-115 mg/dl; depending on when the individual last ate, blood glucose can occasionally drop below 60 mg/dl or even below 50 mg/dl during fasting without any serious abnormalities. This can be seen in healthy women, especially after a long fast. If the blood sugar is less than 45mg/dl, it usually represents an abnormal and serious problem. What are the symptoms of hypoglycemia? People with hypoglycemia may feel weak, drowsy, shaky, confused, hungry, and dizzy. Pale skin, headache, agitation, tremor, sweating, rapid heartbeat, chills, cramping sensation, sudden mood changes and behavioral changes such as crying over nothing, clumsy or spasmodic activities, inability to concentrate, and tingling sensation around the mouth are all symptoms of hypoglycemia. In severe cases, the patient may lose consciousness or even fall into a coma.
Long-term diabetic patients may not have any alert symptoms because some of the functions that respond to hypoglycemia are damaged, and they do not notice when hypoglycemia occurs. Hypoglycemia symptoms are sometimes mistaken for symptoms caused by circumstances unrelated to blood sugar. For example, unusual stress and anxiety, or shock caused by heart attack or other diseases can lead to the production of extra catecholamines, creating a condition similar to the symptoms of hypoglycemia, but not necessarily related to blood glucose levels. The most common complication of diabetic patients is hypoglycemia. The cause of diabetes is the inability to secrete enough insulin or to use insulin effectively, so that the body cannot use glucose as an energy source. As a result, glucose cannot enter the cells and accumulates in the blood, producing hyperglycemia. Depending on the severity of the disease, most diabetic patients will take glucose-lowering drugs or insulin.
Since they are treated with insulin or oral hypoglycemia, hypoglycemia can occur, especially in patients who are on insulin. Conditions that predispose to hypoglycemia include: receiving too high a dose of treatment, altered insulin absorption, not eating, delayed eating, eating too little, excessive exercise, drinking too much alcohol, or a combination of other causes. For example, a certain blood glucose range that is safe for a young adult without diabetes may be too low for a child or an older person with other medical problems. When you feel symptoms of suspected hypoglycemia and are unable to test your blood sugar, it is best to treat it first rather than wait. Remember this simple rule: “When in doubt, treat it.” Minor hypoglycemia that is not treated promptly may lead to further severe hypoglycemia, loss of consciousness, and inability to manage it on your own.
Because hypoglycemia often coincides with symptoms, diabetics can usually feel it when their blood sugar drops, and symptoms include shaking, palpitations, sweating and hunger. They can improve within 10-15 minutes by eating oysters, fruit juices, or non-low-calorie sodas, and using glucose lozenges or ointments (available over the counter) is a convenient and quick treatment. Do not use chocolate or ice cream to treat hypoglycemia because chocolate or ice cream contain a lot of fat, which slows down the absorption of sugar. Make sure you have at least one type of sugar with you and preferably an emergency glucagon kit. After you have measured your blood sugar and treated your hypoglycemia, wait 15-20 minutes before taking another test. Because insulin-dependent diabetic patients must receive insulin therapy, especially aggressive therapy, they are most at risk for severe hypoglycemia, which can lead to loss of consciousness.
A condition called “unrecognizable hypoglycemia” may occur in some patients with long-term insulin dependence, meaning that they do not develop alert symptoms when they are hypoglycemic and therefore do not know they are hypoglycemic. More severe hypoglycemia can affect the central nervous system and manifest as symptoms of central glucose deficiency, including headache, change of temper, agitation, inability to concentrate, drowsiness, seizures and unconsciousness. This situation may require the help of others to inject glucagon or send to the hospital for emergency care. Glucagon or glucagon injections can quickly relieve the symptoms of hypoglycemia and raise the glucose level in the blood. Diabetic patients can learn to identify the symptoms of hypoglycemia by taking blood glucose levels frequently and avoiding situations that trigger hypoglycemia to reduce the number of hypoglycemic episodes. In addition to carrying sugar tablets and ideally an emergency glucagon kit, wear a diabetes identification device whenever possible. Friends, relatives, and even anyone should know the symptoms of hypoglycemia and how to assist diabetics in an emergency.
It is important to treat hypoglycemia as soon as possible because it can get worse and you may pass out. If you pass out, your loved ones must give you emergency help such as glucagon injections or emergency hospital care. If you are in a coma with low blood glucose, the things your loved ones should do include:
1. Do not give insulin to the patient
2. Do not force food or liquid into the patient’s mouth
3.Do not put your hand in the patient’s mouth
4.Keep the airway open
5.Inject glucagon
6.Call the emergency number 120 for help Since aggressive insulin therapy can help prevent the occurrence of diabetic comorbidities, more and more patients with insulin-dependent diabetes are using this therapy, and the relative rate of hypoglycemic episodes is also increasing. To maintain blood glucose in the near-normal range and to avoid hypoglycemia, it is necessary to frequently test one’s blood glucose, to follow a regular diet and exercise program, to learn to recognize the symptoms of hypoglycemia, and to follow the guidance of a physician.