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Low blood sugar: The silent killer

By Ogechukwu Agwu

The body requires sugar to be healthy or to survive. However, when the sugar level in the body is too high, it is a problem. Also, when the sugar level is too low, it is an issue. Incidentally, low sugar level, called Hypoglycaemia, is more dangerous and fatal, as without enough glucose, the body can’t perform its normal functions.

According to the World Health Organisation (WHO), the body experiences low sugar level when there is blood glucose or blood sugar concentration of less than three millimoles per litre (mmol/l) or less than 54 milligrams per decilitre (mg/dl).

People suffering diabetes are prone to low blood sugar, as they take medicines that increase insulin levels in the body. Indeed, taking too much medication, skipping meals, eating less than normal, or exercising more than usual can lead to low blood sugar.

In malnourished children, this condition leads to brain damage – since glucose is the main fuel for the brain – and ultimately death. Treating or, ideally, preventing hypoglycaemia is vital during the initial stabilisation phase of the treatment of severe malnutrition.

The underlying causes for the development of hypoglycaemia in children with severe malnutrition are many.  According WHO, first, the quantity of stored glucose in the body is reduced in a malnourished child because of muscle wasting. Second, mechanisms for re-establishing glucose equilibrium by converting protein and fat reserves into glucose are impaired. Third, the immune response to infections, which are common in malnourished children, uses up glucose. Fourth, glucose absorption is impaired. And fifth, a long journey to a hospital and the process of admission to the hospital may result in the child not being fed for several hours.

A medical expert said “hypoglycemia occurs when blood sugar (glucose) level falls too low,” adding: “There are several reasons this may happen and they include; the body’s sugar being used up too quickly, glucose being released into the body too slowly, too much insulin released into the blood stream and the most common being a side effect of drugs used for the treatment of diabetes.”

People without diabetes may also have low blood sugar. This may be caused by alcohol intake, insulinoma, a rare tumor in the pancreas that produces too much insulin, lack of a hormone, such as cortisol or thyroid hormones, severe heart, kidney or liver failure, infection that affects the whole body and some type of weight loss.

Mildly low blood sugar levels are somewhat common for people with diabetes. However, severely low blood sugar levels can be life-threatening. They may lead to seizures and nervous system damage if left untreated long enough.

The dangerous thing about low sugar is that those who suffer it do usually know that their blood sugar is dropping.  The signs may even go unnoticed. However, Uche Chiemelie, a lab scientist listed some of the symptoms to look out for. They include, blurry vision, rapid heartbeat, sudden mood changes, sudden nervousness, unexplained fatigue, pale skin, headache, hunger, shaking, dizziness,  sweating, difficulty in sleeping, skin tingling, trouble thinking clearly or concentrating, loss of consciousness, seizure and coma.

Immediate treatment for low blood sugar levels is important to prevent more serious symptoms from developing, such as fainting, experiencing a seizure or falling into a coma.

Causes

When we eat food that contains carbohydrates, the body breaks it down into various sugar molecules. One of these molecules is called glucose, which happens to be the main source of energy for the body.  Without the help of insulin, a hormone secreted by the pancreas, glucose cannot be absorbed into the blood stream.

If you have diabetes, the effects of insulin on your body are drastically diminished, either because your pancreas doesn’t produce enough of it (type 1 diabetes) or because your cells are less responsive to it (type 2 diabetes). As a result, glucose tends to build up in the bloodstream and may reach dangerously high levels.

People with diabetes use a variety of treatments such as oral medications that increases insulin production and insulin injections to help their bodies use the glucose in their blood. These treatments come with side effect and low blood sugar is one of them.

People also sometimes experience low blood sugar when planning to eat a big meal, but then they do not eat enough. Skipping meals, eating less than normal or eating later than normal but taking your medication at your normal time can also lead to low blood sugar levels.

Other causes include, unplanned excess physical activity without eating enough. Drinking alcohol when you’re on these medications can also lead to low blood sugar, especially if it replaces food. When the body is trying to get rid of alcohol, it becomes worse at managing blood sugar levels. Certain medications, such as quinine, some medical conditions, such as hepatitis or kidney disorders, a tumor that produces excess insulin, endocrine disorders, such as adrenal gland deficiency could cause low sugar. Drinking alcohol when you’re on these medications can also lead to low blood sugar, especially if it replaces food.

Diagnosis

It is important for people with diabetes to check themselves regularly, especially those on insulin medication. Even if you don’t have diabetes but you suspect your blood sugar, talk to your doctor about the symptoms you are experiencing.

According to healthline.com, there are three criteria to diagnose low blood sugar. These include:

Signs and symptoms of low blood sugar: Your  doctor may require you to fast or abstain from drinking and eating for an extended period of time so that they can observe your blood sugar signs and symptoms.

Documentation of low blood sugar: When your sign and symptoms occur, your doctor will perform a blood test to analyse your blood sugar levels in a laboratory.

Disappearance of the signs and symptoms of low blood sugar: Your doctor will want to know whether the signs and symptoms go away when your blood sugar are raised.

Prevention

Check your blood sugar as often as you can. This will help put you in target range, especially if you have had low blood sugar episodes in the past. You may also consider having a few snacks handy. It is advisable to keep a carbohydrate-based snack on hand with you at all times, in case your blood sugar dips while you are out and about. Snacks like cookies, granola bars, and even fruit juice are good.

Treatment

The key to combating this condition is taking anything that is made of carbohydrate. Having any carbohydrate-based food can come in handy. The American Diabetes Association recommends that your snack have least 15 grammes of carbohydrate.

Glucose tablets can also help to boost your blood sugar when low. Your doctor may give you a shot of glucagon, which helps to raises blood sugar.

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