Hypoglycemia

Low blood sugar or hypoglycemia is not a disease but a health condition. For diabetics, it can result in serious complications. Almost all alcoholics have low blood sugar. Too low or too high blood sugar affects normal functioning of the body. The level varies from person to person under different circumstances. Generally, blood sugar level between 50 and 60 mg/dl is referred to as mild hypoglycemia, whereas that between 20 and 50 mg/dl is moderate hypoglycemia. A value that is lower than 20 mg/dl can prove to be fatal.

Symptoms of hypoglycemia

Those experiencing low blood sugar may have a combination of symptoms at any given time. These may include weakness, sweating, headache, nervousness, unclear thinking or feeling uneasy. After the initial warning, in the absence of remedial measures, the symptoms can progress to seizure, and even damage to the brain or death in extreme cases.

Causes of hypoglycemia

• Poor eating habits.
  
  
• Unhealthy diet.
  
  
• Intake of certain medicines particularly ones that may inhibit the liver and pancreas' respective functions.
  
  
• Drinking large amounts of beer, wine or hard liquor, particularly on an empty stomach.
  
  
• Certain types of tumor growth with particular reference to those that grown on organs that manage body's insulin such as liver or pancreas.
  
  
• Abnormal development of certain hormones wherein the body produces too much insulin (hyperinsulism), resulting in a rapid depletion of body's glucose. This in turn can lead to sudden lowering of blood sugar.
  
  
• Liver disease, kidney disease or other serious illness.
  
  
• People who have early diabetes mellitus or pre-diabetes.
  

Treating low blood sugar

Home monitoring devices or blood glucose monitoring devices are available. It is a quantitative test that helps find out the amount of glucose present in blood sample. The results can be obtained in few minutes.

The immediate action, for non-diabetics is to have a tablespoon of sugar, honey or syrup which relieves the symptoms in 10 to 15 minutes. Drinking fruit juice or a cup of milk also help in normalizing blood sugar levels. Candy or glucose tablets, if available also help to control blood sugar levels. Don't eat too much and wait for about 15 minutes before eating again.

If the symptoms have cleared and if the next meal is scheduled within 30 minutes or less, go ahead and eat on schedule. If it's due much later, have a snack to reduce the risk of recurrence. In extreme circumstances, be prepared to seek emergency help.

Diabetic coma

A kind of reversible coma that is noticed with patients suffering from diabetes, diabetic coma is a medical emergency. Diabetics who are taking insulin can sometimes lapse into a condition of hypoglycemia where they fall unconscious. It may be preceded by rapid heart beat, sweating and convulsions. This condition is treated immediately with intravenous glucose. Diabetic ketoacidosis occurs at a more advanced stage, when the patient is severely dehydrated and in a state of shock. After nearly a couple of days of hyperventilation and shock, diabetic coma might result. Nonketotic coma is a condition where extreme hyperglycemia causes dehydration due to inadequate fluid intake. The patient is given intravenous fluids, potassium, sodium and insulin.

Gestational diabetes

Gestational diabetes insipidus occurs during pregnancy. This is a type of diabetes and about 2-10 percent of expectant mothers develop this condition. When pregnant, hormonal changes make your cells less responsive to insulin. But during pregnancy, the pancreas cannot keep up with the increased insulin demand, and hence blood glucose levels rise resulting in gestational diabetes.

Significantly, most women with gestational diabetes do not remain diabetic after the baby is born. Once you've had gestational diabetes, though, you are at higher risk during a future pregnancy and for developing diabetes later in life.

Symptoms of gestational diabetes

There are no symptoms and that is perhaps why all pregnant women have to undergo a glucose screening test between 24 and 28 weeks. If you are at a high risk for diabetes and are showing signs of it, then the doctor would recommend this screening test at the first prenatal visit and then repeat at 24 weeks, the initial test being negative. Follow up tests are done to find out if the result on glucose screening is positive.

High risk factors for gestational diabetes

The American Diabetes Association prescribes the following condition for early screening, in case of high risk namely:

Obesity and BMI over 30
If you have had gestational diabetes in previous pregnancy
If the urine has sugar and
If you have a strong family history of diabetes.

Other risk factors

If earlier delivery was a big baby
If you have had a stillbirth
If you have high blood pressure and
If you are over 35.

An association between excessive weight gain during pregnancy, particularly in the first trimester and risk of gestational diabetes has been established.

Gestational diabetes: Pregnancy and baby

Poorly controlled diabetes may have short and long term consequences for you and your baby. If blood sugar levels are too high, the baby's blood may have too much glucose. The excess blood sugar and insulin can cause the baby to put on extra weight particularly in the upper body. This can lead to a condition called macrosomia. This baby may be too large to enter the birth canal or the baby's head may enter but shoulder may get stuck. This is a tricky condition called dystocia and the doctor has to use special procedures to deliver the baby.

Sometimes delivery of such babies may result in fractured bone or nerve damage which could become permanent in 99% of babies. It is better that babies of mothers with gestational diabetes, check their blood sugar regularly and breast feed the baby immediately after birth to prevent or correct hypoglycemia.

Such babies with hypoglycemia at birth are given IV glucose solution. Testing the baby's sugar and providing an IV if necessary can prevent serious problems such as coma, brain damage and seizures. The baby also exhibits high risk for breathing problems and newborn jaundice. In addition, the baby is also at risk for polycythemia or increase in the number of red cells in the blood and hypocalcaemia or low calcium in the blood. Women with gestational diabetes are at an increased risk of developing Preeclampsia, particularly those who are obese before pregnancy and blood sugar levels are uncontrolled.