HYPOGLYCAEMIA

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🧠 WHY BLOOD SUGAR MATTERS

Glucose is the main fuel source for the brain and body. When levels drop too low, it affects brain function, coordination, and organ systems — and can become life-threatening if not corrected.

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📉 BLOOD GLUCOSE LEVEL CATEGORIES

Category	Blood Sugar Level
Normal (fasting)	70–99 mg/dL (3.9–5.5 mmol/L)
Mild Hypoglycaemia	55–69 mg/dL (3.0–3.8 mmol/L)
Moderate	40–54 mg/dL (2.2–2.9 mmol/L)
Severe	<40 mg/dL (<2.2 mmol/L)

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⚠️ SYMPTOMS OF HYPOGLYCAEMIA

Early Symptoms (warning signs)	Severe Symptoms
Sweating	Confusion
Trembling or shakiness	Seizures
Hunger	Loss of consciousness
Rapid heartbeat	Coma
Headache	Death (if untreated)
Irritability
Dizziness or blurred vision

Symptoms can vary between individuals and become less noticeable with frequent episodes (hypoglycaemia unawareness).

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🔍 CAUSES OF HYPOGLYCAEMIA

Category	Examples
Diabetes-related	Too much insulin or diabetes meds (e.g., sulfonylureas), missed meals, delayed eating, excessive exercise
Non-diabetic	Insulinoma (rare pancreatic tumor), adrenal insufficiency, severe liver/kidney disease
Reactive hypoglycaemia	Drop in blood sugar after eating (typically 1–3 hours later)
Alcohol-induced	Especially without eating
Fasting or starvation	Especially in children or underweight adults
Critical illness	Sepsis, liver failure, cancer, endocrine disorders

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🧪 DIAGNOSIS

• Blood glucose test during symptoms

• Whipple’s triad (for diagnosis in non-diabetics):

  1. Low blood sugar

  2. Symptoms of hypoglycaemia

  3. Relief of symptoms after glucose intake

Additional tests may include:

• Fasting test

• Insulin and C-peptide levels

• Imaging (for tumors)

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💊 TREATMENT OF HYPOGLYCAEMIA

🔹 1. Immediate Management (Conscious Patient)

Use the 15-15 rule:

• Eat 15 grams of fast-acting carbohydrates (e.g., glucose tablets, juice, soda, candy)

• Wait 15 minutes and recheck blood glucose

• Repeat if still low

Examples of 15g of carbs:

• 4 glucose tablets

• ½ cup fruit juice

• 1 tablespoon sugar or honey

• ½ can of soda (not diet)

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🔹 2. Emergency Management (Unconscious Patient)

Situation	Treatment
Unable to swallow	Glucagon injection (e.g., GlucaGen or Baqsimi nasal spray)
Hospital setting	IV dextrose (D50 or D10)

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🔹 3. Preventing Hypoglycaemia

Strategy	Details
Regular meals/snacks	Avoid prolonged fasting
Blood sugar monitoring	Especially for diabetics
Adjust meds	Avoid overtreatment with insulin/sulfonylureas
Exercise planning	Eat before/after activity as needed
Alcohol caution	Eat before and avoid binge drinking

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📦 TREATMENTS FOR UNDERLYING CAUSES

Cause	Treatment
Insulinoma	Surgical removal
Adrenal insufficiency	Corticosteroid replacement
Medication-induced	Adjust or switch medications
Liver/kidney failure	Manage organ function; supportive therapy

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🧭 COMPLICATIONS OF UNTREATED HYPOGLYCAEMIA

• Seizures

• Permanent brain damage

• Falls or accidents

• Coma or death

Repeated hypoglycaemic episodes can lead to hypoglycaemia unawareness, where warning signs are absent — increasing risk of severe complications.