Hypoglycemia

Description:

The hypoglycemia is the state which is characterized by the low level of sugar in blood.
The human body and especially brain for normal functioning need the constant level of glucose in blood.  Therefore the hypoglycemia represents the state demanding urgent measures. At development of a hypoglycemia plentiful sweating, constant feeling of hunger, feeling of a pricking of lips and fingers, pallor, heartbeat, a small shiver, and also muscular weakness and fatigue are observed. At interest the central nervous system, misting and doubling of sight, a headache, spastic reductions of muscles or frequent yawning are possible. Sometimes there are also mental symptoms in the form of a depression and irritability, a drowsy state in the afternoon and sleeplessnesses at night. In this regard make to many patients wrong diagnoses of neurosis or depression.

Hypoglycemia reasons:

Decrease in content of sugar can develop in blood as at the healthy person, and the patient, with disturbance of carbohydrate metabolism.
The reasons leading to development of a hypoglycemia are various.
- dehydration;
- irrational food with abuse of the refined carbohydrates, with sharply expressed deficit of cellulose, vitamins, mineral salts;
- treatment of a diabetes mellitus insulin, peroral glucose-lowering drugs at overdose;
- alcohol abuse;
- unusual exercise stress;
- somatic diseases;
- periods at women;
- insufficient or late meal;
- critical insufficiency of body: renal, liver or heart failure, sepsis, exhaustion;
- hormonal insufficiency: cortisol, growth hormone or both of them, glucagon + adrenaline;
- not a r-cellular tumor;
- a tumor (insulinoma) or inborn anomalies — 5-cellular hypersecretion, an autoimmune hypoglycemia, 7-ectopic secretion of insulin;
- a hypoglycemia at newborns and children;
- intravenous administration of physical solution dropper.

Hypoglycemia symptoms:

Various symptoms are characteristic of a clinical picture of a hypoglycemia.
Vegetative:
- Adrenergic: excitement, the increased aggression, concern, alarm, fear
- Pallor of integuments
- Arrhythmias (tachycardia)
- Tremor (muscular shiver), muscle hyper tone
- Mydriasis (mydriasis)
- The increased perspiration
- Hypertensia (increase in arterial pressure)

Parasympathetic:

- Feeling of hunger
- Nausea, vomiting
- General weakness

Neyroglikopenicheskiye:

- Decline in the ability to concentration of attention
- Disorientation
- Headache, dizziness
- Paresthesias
- Lack of coordination of movements
- Visual disturbances: a diplopia ("doubling" in eyes)
- Focal neurologic symptomatology (hemiplegia, aphasia)
- Primitive avtomatizm (grimaces, disinhibition of a grasp reflex)
- Inadequate behavior
- Amnesia
- Focal neurologic frustration
- Epileptiform attacks
- The drowsiness passing in defiance of consciousness in the form of a faint, and then a coma
- Disorder of breath and blood circulation (central genesis)

Severity of a hypoglycemia:

1. An easy hypoglycemia — 2,7-3,3 mmol/l the content of glucose in blood;
2. Moderately severe — 1.3 mmol/l;
3. Heavy — it is lower than 1.1 mmol/l;
4. A coma - 0.0 mmol/l

At decrease in level of sugar lower than 2 mmol/l can develop such acute state as hypoglycemic shock.

Treatment of the Hypoglycemia:

Medical tactics at correction of content of glucose in blood depends on hypoglycemia level. In case of an easy hypoglycemia (content of glucose in blood of 50-60 mg/dl (2,7-3,3 mmol/l)), 12-15 g of simple carbohydrate, ideal option a monosaccharide - dextrose (d-glucose) which does not demand time for digestion and is soaked up in blood in an oral cavity at once, or 120 g of unsweetened fruit juice or not dietary soft drink there are quite enough.
At more expressed symptoms of a hypoglycemia it is necessary to accept quickly 12-15-20 g of simple carbohydrate and after 15-20 g difficult, such as thin biscuit or bread. Patients who are unconscious never should give liquids and other food stuffs since it can lead to undesirable effects, such as asphyxia. In this case  ннобходимо to enter intramusculary 1 mg of a glucagon. The glucagon thanks to its impact on a liver indirectly causes increase in content of glucose in blood. In the conditions of hospital intravenous administration of 40% of glucose is more available, than a glucagon, and as a result leads to bystry return of consciousness.
The application instruction of the tablets and gels containing a dextrose (d-glucose) and a glucagon has to be an essential part of training of the persons living with the patients with diabetes receiving insulin. It is necessary to instruct patients and family members that they did not allow overdose of glucose at treatment of a hypoglycemia especially easy. The overdose conducts to the subsequent hyperglycemia therefore use of tablets with a dextrose is more rational since it is possible to accept minimum necessary amount of fast-assimilable carbohydrates. Patients also should be instructed how to carry out tests for the content of glucose to blood when it is possible if the symptoms inherent to a hypoglycemia take place. If such testing is impossible, then it is the best of all to start treatment anew. The patients who are on treatment should be instructed that they checked the content of glucose in blood before driving the car.