As high blood sugar levels are harmful for the body, so is low blood sugar. Hence one needs to be aware of it. Normal blood sugar levels are 60 to 100 mg / 100 ml. in a fasting condition and 100 to 160mg / 100 ml, 90 to 120 minutes after a full meal. Any level of blood sugar, below 60 mg / 100 ml in a fasting condition is low and is known as hypoglycaemia.

Hypoglycaemia is a complication of diabetes both Type 1 (Insulin dependant) and Type 2 (Non insulin dependant) but is more common with Type 1 diabetes. Missing a meal in a diabetic person poses risk of hypoglycaemia. The risk is enhanced on taking anti diabetic medication without meals. Low blood sugar can also occur due to taking excess dose of anti -diabetic medication. Physical and mental stress, use of alcohol, severe infections, dehydration, e.t.c., can also cause hypoglycaemia in persons, more so in diabetics.

Low blood sugar is not restricted to diabetic individuals. If a non diabetic person misses a meal and exerts, he starts feeling tired and listless. This happens because the blood glucose levels start reducing in the brain. Excess work to which one is not accustomed, can produce hypoglycaemia in a person. Alcohol reduces the blood glucose levels producing hypoglycaemia.

Whatever may be the cause, hypoglycaemia, is a potentially fatal condition. The brain cells are highly dependant on glucose for their functioning. Therefore, early stages of hypoglycaemia are characterized by difficulty in concentration and confusion. If it is not corrected at this stage it can lead to delirium, convulsions, unconsciousness, coma and even death. Early treatment can reverse this condition, but if delayed it can be fatal. It can also lead to permanent neurological deficit in some form, like paralysis of limbs or some part of the body.

Other cells of the body also depend on glucose for obtaining necessary energy needed for their functioning. Therefore as the blood glucose level goes down, one starts feeling exhausted. It becomes difficult to concentrate on the work at hand. To combat the low blood glucose levels, body starts compensating by producing counter regulatory hormones like glucagon and adrenaline. Adrenaline causes, palpitations, sweating and also rise in blood pressure, rhythm disturbances of the heart and cardiac arrest in severe cases.

A person with diabetes has to be very careful about his or her diet. Small frequent meals are the best way to avoid hypoglycaemia. It is desirable to take hot tea, soup, alight snack, e.t.c., some night-cap before sleeping to avoid early morning hypoglycaemia. One has to be very particular about timings of meals also. Diabetic patients are instructed to always carry some food stuff with them. On experiencing, the earliest symptom of hypoglycaemia they should take a bite. One should never miss a meal especially break-fast to prevent low blood glucose levels. Alcohol should be best avoided in all persons irrespective of their diabetic status as it is harmful for health in many ways.

Physical exercise if started recently, should not be very strenuous to begin with. Any exercise done, should be increased in quantity gradually. This prevents hypoglycaemia and also muscle damage.

Hypoglycaemia is a condition of the body which can be easily diagnosed by the affected person himself. Only thing is that he should be aware of the condition, its symptoms and consequences. On experiencing low blood glucose, all that is needed is to have a quick small bite, or a hot sweet drink. This is very useful in mild cases. Failing to do that, as the condition progresses, one may have to be hospitalised for injections of glucose.

Dr Rachna Pande, Specialist, internal medicine rachna212002@yahoo.co.uk