Chapter 8 Hypoglycemia

8.1 Importance of blood glucose

Glucose is a major source of fuel for all cells. Brain and RBCs are completely dependent on glucose for producing energy.

8.2 Hypoglycemia

Hypoglycemia is decrease in blood glucose level. It can lead to impaired function of the brain since glucose is the only source of energy for the brain. If severe, hypoglycemia can cause coma and death and so it is a medical emergency.

8.3 Diagnosis of hypoglycemia

Hypoglycemia is clinically diagnosed when all three of the following are present:

  • Symptoms of hypoglycemia

  • Decrease in blood glucose level

  • Relief of symptoms after blood glucose level is increased by treatment

8.4 Causes of hypoglycemia

  • Treatment of diabetes mellitus (Insulin and oral hypoglycemic drugs)

  • Alcohol intake (Decreased NAD+ due to alcohol inhibits gluconeogenesis)

  • Critical illness (Sepsis, hepatic failure)

  • Endocrine disorders (Insulinoma, deficiency of glucagon/epinephrine/cortisol)

  • Metabolic defects affecting gluconeogenesis (E.g. Von Gierke’s disease)

  • Exercise, Starvation

8.5 Symptoms of hypoglycemia

Symptoms of hypoglycemia are due to - Symptoms of autonomic nervous system such as hunger,sweating,palpitations, anxiety, and tremor - Symptoms due to glucose deprivation in the brain such as headache, fatigue, weakness, blurry vision, dizziness, and irritability. More severe symptoms include seizures, coma and ultimately death if untreated.