Hypoglycemia and how to manage.

      The body absorbs sugar through foods that are high in carbohydrates such as rice, potato bread, cereals, milk, fruit, and sweets. Sugar is stored in the liver and tissues as glucose, which is then broken down into glucose for energy.

Symptoms of hypoglycaemia usually occur when fasting or away from meals, corresponding to the time of maximum effect of the drug (insulin or sulphonamide to lower blood sugar) in diabetic patients. The above symptoms improve rapidly when glucose is given immediately.

Hypoglycemia is common when diabetic patients are being actively treated with insulin or oral sulfonylureas, can occur due to the following reasons: eating too little, eating late or skipping meals, insulin overdose, oral hypoglycemic drugs: such as sulfonylureas (diamicron, amaryl, …) and meglitinides, increased activity or excessive exercise, excessive alcohol consumption, kidney failure, …

Other causes: alcoholism, hypoglycemia in liver and kidney disease; insulinoma, malnutrition, infection,…

* Warning signs of low blood sugar .

* At mild level:

Systemic signs: The patient has a feeling of physical and mental fatigue, drowsiness, dizziness, sweating (very important signs in this stage). In the digestive system, the feeling of hunger and epigastric spasm, vomiting or diarrhea may occur. On the cardiovascular system is also affected with palpitations, tachycardia or extrasystoles; hypertension; precordial pain with arrhythmia or angina pattern.

In the respiratory system, asthma-like dyspnea occurs. Nervous system will appear cramps, paresthesia of the extremities and around the lips, frequent or paroxysmal headache; accommodation disorder, double vision, chills (easy to mistake for infection). In addition, patients also have neuropsychiatric symptoms such as personality and temperament disorders with manifestations: arousal, cheerful, quick, or sometimes sad or short-tempered. If this stage is detected in time and treated with sugar-containing drinks, the clinical signs will improve quickly and the above symptoms will pass quickly.

 Severe:

May occur suddenly or occur against the background of the clinical manifestations of mild hypoglycemia mentioned above. In this stage, clinical manifestations are mainly neuropsychiatric such as: stupor, lethargy, depressive episodes with suicidal tendencies, agitation, paranoia, hallucinations, transient loss of consciousness; jaw stiffness (significant sign easily confused with tetanus); Generalized or focal Bravais-Jackson epilepsy, hemiplegia, focal, cerebellar – vestibular disorders such as dizziness, movement disorders (easy to mistake cerebrovascular accident). In this phase, using intravenous hypertonic glucose directly rather than giving it orally, the patient will recover quickly.

* For the case of coma due to hypoglycemia:

Clinical and laboratory symptoms often do not correspond to each other. The onset is usually not abrupt, with muscle spasms, convulsions, increased tendon reflexes, mydriasis, jaw stiffness, profuse sweating, flushing of the face, and recovery from glucose infusion early before passing the period. irreversible (with deep coma, irreversible brain damage and death if hypoglycemia is severe and prolonged). Therefore, when a patient has these signs, immediate emergency care is needed to avoid serious complications, even leading to death.

* Prevention of hypoglycemia.

Do not starve, or let the body starve for too long, should not fast but do excessive physical activity. It is imperative not to skip breakfast, especially the elderly, children, people with chronic diseases, and weak bodies. Strictly follow the doctor’s treatment instructions on the drug regimen and diabetes treatment diet. Eliminate risk factors such as excessive abstinence, skipping meals due to fatigue or other diseases… Regularly check your blood sugar at medical facilities or you can do it yourself at home by checking your blood sugar at home. Monitor capillary blood sugar as directed by medical staff. It is necessary to have a regular and appropriate exercise regime for each person according to the advice of the treating doctor to ensure health. Always have sugar or sugary products available such as candy, cake, chocolate, sugary soft drinks… in your bag, in your briefcase so that when low blood sugar occurs, you can use it right away.