The signs and symptoms of hypoglycemia may not always be evident at specific blood glucose levels. Individual variations may explain why some patients show symptoms at blood glucose levels that would be considered low but normal. However, in order for hypoglycemia to be conclusively be diagnosed, it should meet with the three criteria as outlined in Whippleâ€™s triad.
These three criteria help to identify borderline hypoglycemia :
Signs and symptoms of hypoglycemia (listed below).
Low plasma glucose â€“ blood glucose level below 54mg/dL (3mmol/L) in non-diabetics and 63mg/dL (3.5mmol/L) in diabetics.
Resolution of symptoms once the blood glucose levels rise.
Signs and Symptoms of HypoglycemiaThe signs and symptoms of hypoglycemia can be divided into two categories :
There are are also general and non-specific signs and symptoms which should not be used in isolation to diagnose hypoglycemia. These general symptoms include nausea, fatigue, and headaches. Often the term â€˜low blood sugarâ€™ is used frivolously to explain the cause of these symptoms although other causes could account for it.
When the blood glucose levels drop significantly, the body releases epinephrine. This triggers certain processes like releasing the glucose stored in the liver (glycogen) in an attempt to stabilize the blood glucose levels. Epinephrine also affects the nervous system and results in these characteristic signs and symptoms :
These symptoms are the early warning signs but may be absent in certain cases. In patients who experience frequent episodes of hypoglycemia, the body may stop releasing epinephrine. This is known as hypoglycemic-associated autonomic failure (HAAF) or is also referred to as hypoglycemia unawareness. The blood glucose levels continue to drop until the neuroglycopenic symptoms may be evident. It may only be at this point that the appropriate measures are implemented.
As the blood glucose levels continue to drop without any intervention, the glucose supply to the brain is severely impaired and may result in the symptoms listed below.
Eventually seizures and even a coma may ensue. Changes in behavior at this stage may resemble inebriation (alcohol intoxication, drunkeness) and is sometimes mistaken for alcohol dementia in alcoholics.