Tell Me About… Low Sugar

Tell Me About… Low Sugar - Just a couple of nights ago, I suddenly had a bout of dizziness and chills. I was very worried, because I thought that I was having a heart attack. I took a cab to a private hospital. They took my blood and told me I had hypoglycaemia. What is hypoglycaemia?

Hypoglycaemia means low sugar in the blood. There are many conditions which can cause hypoglycaemia. It isn’t really a disease in itself, but a condition that arises from other conditions and/or diseases.

But I did not feel hungry at all. I always thought that you would feel very hungry when you have hypoglycaemia, correct?

Not necessarily. Sometimes, you can experience hunger, but a lot of people who suffer from hypoglycaemia don’t.

Here are some of the symptoms you can look out for to know you are experiencing hypoglycaemia. A lot of these symptoms can be attributed to other diseases as well, so it can be difficult to diagnose.

However, hypoglycaemia is usually one of the things doctors look out for when you mention these symptoms, or combination of symptoms:

• Heart palpitations

• Tiredness

• Dizziness or giddiness

• Pale skin

• Trembling or tremors

• Anxiety

• Sweating

• Feeling faint

• Hunger

• Irritability

• Tingling sensation around the mouth

• Crying out during sleep

• Confusion, abnormal behaviour or both

• Blurred vision

• Seizures or fits

• Loss of consciousness

If I am feeling all these, I might be too anxious to recognise it, right?

It is also possible for people around you to recognise that you are not all right. This is especially important for people living with diabetic patients.

People who have very bad hypoglycaemia may appear as though they are drunk with alcohol. They may also slur their words and be very clumsy.

I don’t have diabetes. Why am I having hypoglycaemia?

You have to understand how your body regulates sugar to understand why hypoglycaemia is giving you all these symptoms.

When you eat carbohydrates like rice, pasta, bread, cakes or drink sugary drinks like sodas and fruit juices, your body breaks these down to glucose.

Glucose immediately enters the bloodstream. It is then aided by the hormone, insulin – produced by the pancreas – to enter blood cells from the bloodstream so that the body can use it for energy.

The very presence of glucose itself in the blood signals the pancreas to release insulin.

Insulin then helps the glucose from the bloodstream to enter our cells, thus lowering the glucose in the bloodstream. This in turn is a signal for the pancreas to decrease insulin production and release.

This entire feedback loop works pretty well in maintaining blood glucose level to a certain parameter. Excess glucose is stored in the liver and muscles as glycogen, to be used when glucose levels become too low – just in case you can’t find anything to eat!

If need be, the body can also manufacture glucose via a process called gluconeogenesis.

If you don’t have diabetes, anything that interferes with this entire feedback loop can give you hypoglycaemia.

Can you give examples?

The most common cause without diabetes is that if you did not eat enough, or if you skipped a meal. Or if you exercised too heavily, and you did not eat enough. Different people react differently to fasting and skipping meals.

Another common example is if you drink too much alcohol, and forgot to eat. Alcohol can fill your stomach up and intoxicate you, causing you to forgo regular meals.

Some diseases of the liver like hepatitis can also interfere with the liver’s ability to regulate the sugar process, thus leading to hypoglycaemia.

In rare cases, a pancreatic tumour called insulinoma may produce too much insulin, causing too much glucose to be depleted from the bloodstream.

Why do diabetics get hypoglycaemia? I thought the condition leads to excess glucose in the bloodstream.

If diabetic patients take too much diabetic medication or insulin, this can cause too much sugar to enter the body’s cells, thus causing hypoglycaemia. That is why it is so important for the doctor to help you find the right dosage of insulin or medication to regulate your blood glucose.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.