Hypoglycemia is a medical condition in which the blood sugar level drops below the normal value, which is usually defined as a value lower than 70 milligrams per deciliter. Glucose is the primary energy source for the body and especially for the brain, so when such a plunge occurs, the various systems begin to send acute distress signals.
Although the phenomenon is mainly identified with diabetics, it is important to know that it can also appear in people who do not suffer from the disease under certain circumstances. In type 1 and type 2 diabetes patients, the condition is usually caused by an imbalance between the amount of insulin or medications taken and the amount of carbohydrates consumed in a meal. Sometimes hypoglycemia develops following a skipped meal, a delay in eating time, or performing unusually strenuous physical activity without adjusting medication dosages.
At the same time, healthy people can also experience a drop in sugar in situations of prolonged fasting, excessive alcohol consumption on an empty stomach, or following the intake of certain medications that affect sugar production in the liver. There are also rarer conditions where tumors in the pancreas cause excess secretion of insulin, but in the absolute majority of cases where we encounter a person suffering from hypoglycemia on the street or at home, it will be a diabetes patient.
The early identification of the condition is critical, since the deterioration can be very rapid. The first signs usually include hand tremors, cold sweating, accelerated heart palpitations, and a feeling of extreme hunger. As the sugar level continues to drop, the brain begins to suffer from a lack of glucose and then neurological signs appear such as: Confusion, blurred vision, difficulty speaking, acute dizziness, and even strange or aggressive behavior that may look outwardly like drunkenness.
When identifying a person exhibiting these signs, the first question to ask them is whether they are a diabetes patient. If they are able to communicate and swallow, one should act according to the updated "rule of 15." This rule states that one must immediately consume 15 grams of simple carbohydrates that are rapidly absorbed in the digestive system. Examples of such a portion are: Half a cup of fruit juice, half a cup of a non–diet carbonated drink, a generous tablespoon of honey or sugar, or three to four dedicated glucose tablets that many diabetes patients carry with them.
After consuming the sugar, one must wait exactly 15 minutes and check the sugar level again with the home glucose meter. If the level is still lower than 70, the action should be repeated once more. It is important to emphasize that chocolate or cakes should not be used for initial treatment of hypoglycemia, because despite being sweet, the fat in them delays the absorption of sugar into the blood and therefore they are not efficient enough during an emergency.
Even though the initial treatment seems simple, there are situations in which one must not hesitate and medical help must be summoned immediately. If the person is unresponsive, is in a state of clouded consciousness, or is unable to swallow safely, no attempt should be made to put food or drink into their mouth under any circumstances due to the risk of choking. In such cases, one must immediately dial Magen David Adom at number 101.
One must leave the dispatcher on speakerphone, provide the exact location details, and listen to the professional instructions until the ambulance arrives. If the patient is unconscious, they should be laid on their side to maintain an open airway and prevent aspiration of secretions. At the same time, if the patient experiences seizures due to the drop in sugar, sharp objects that could injure them should be moved away, but no attempt should be made to forcefully restrain their movements.
In recent years, technology has changed the way patients manage the disease and identify emergencies. Many diabetes patients currently use sensors, which are continuous glucose monitors attached to the arm or abdomen. These devices measure the sugar level every few minutes and transmit the data to an application on a smartphone or watch. When the sugar begins to drop rapidly, the device sounds an alarm even before the patient feels the physical signs. If you are near a person who begins to behave strangely and they carry such a technological sticker on their body, it is possible that their device is beeping and warning of danger. Familiarity with this technology allows those around them to provide help even before the situation worsens to the point of loss of consciousness.
Even after the patient has recovered and the sugar level has risen above 70, they must eat a full meal that includes complex carbohydrates such as: Whole bread or proteins in order to maintain the stability of the sugar level over time and prevent another crash. Nonetheless, any event of significant hypoglycemia requires a medical inquiry with the treating physician to understand what caused the crash and to make adjustments to the medication treatment.