When your blood-sugar level falls, your body responds by releasing a hormone called epinephrine (adrenaline) from your adrenal glands. This hormone stimulates your liver to release its stored glucose into your bloodstream. But this adrenaline rush also produces the unpleasant symptoms that are characteristic of hypoglycemia, which include sweating, nervousness, rapid heartbeat, anxiety, hunger, faintness and trembling.
If your blood-sugar level continues to fall, the reduced glucose supply will begin to affect your brain. When hypoglycemia interferes with brain activities, you may experience headache, dizziness, rapid heartbeat, sweating, confusion, blurred vision, difficulty concentrating, anxiety, agitation, weakness or fainting and abnormal behavior that could be mistaken for drunkenness. If your condition continues to worsen, convulsions, loss of consciousness and coma may result. Keep in mind that such life-threatening symptoms are usually caused by too much medication in people with diabetes.
Symptoms of hypoglycemia vary in severity among individuals and may progress from mild to severe in a short period of time.
Who’s at Risk?
Hypoglycemia is most common among people who have diabetes and take blood-sugar lowering medication. Other factors that can predispose you to hypoglycemia include fasting, following a low-calorie diet, being pregnant, having certain medical disorders and taking certain medications.
For some people, hypoglycemia develops when they drink alcohol after a long period without eating food. As their blood-glucose levels fall, they develop a hypoglycemia-induced stupor, which makes them appear drunk and confused. This type of stupor can develop even when blood-alcohol levels are well below the legal driving limit.
If you have symptoms of hypoglycemia and you do not have diabetes, your doctor may conduct some simple blood tests to measure your blood-sugar and insulin levels. Ideally, this test will be done while you are experiencing an episode of hypoglycemic symptoms. The diagnosis of hypoglycemia will be confirmed if the blood test indicates that your blood-sugar levels are below normal and your symptoms improve when you consume sugar.
Your doctor will also take your medical history and conduct a physical examination, and may test you for diabetes. Depending on the cause of your hypoglycemia, additional laboratory tests may be required.
For years doctors used the oral glucose tolerance test to diagnose hypoglycemia. However, its use has fallen out of favor because it can produce misleading results. It is now recognized that the signs and symptoms of hypoglycemia can occur in individuals who have blood-glucose levels within the normal range. And 10 percent of people who don’t have any symptoms of hypoglycemia show low blood-sugar levels when they take the oral glucose tolerance test. So relying on blood-sugar levels alone is often not enough to diagnose hypoglycemia.
One of the most useful ways to determine if you suffer from hypoglycemia is to assess your symptoms. In general, when symptoms appear three to four hours after eating and disappear after you’ve consumed food, hypoglycemia is a likely cause. The following questionnaire is a useful tool to help you determine if you are suffering from hypoglycemia.