Summary about Disease
Fasting hypoglycemia refers to abnormally low blood glucose (sugar) levels occurring after a period of fasting (typically 8 hours or more). It's not a disease in itself but rather a symptom of an underlying medical condition. Prolonged low blood sugar can lead to various symptoms, and if severe, can cause serious complications.
Symptoms
Symptoms can vary, but commonly include:
Shakiness or trembling
Sweating
Anxiety or nervousness
Irritability or confusion
Dizziness or lightheadedness
Hunger
Rapid heartbeat
Blurred vision
Headache
Weakness or fatigue
In severe cases: seizures, loss of consciousness, coma
Causes
Fasting hypoglycemia can arise from various causes, including:
Medications: Certain drugs, especially those used to treat diabetes (like insulin or sulfonylureas), are a common cause.
Alcohol: Excessive alcohol consumption, especially without food.
Critical Illness: Severe liver, kidney, or heart failure.
Hormone deficiencies: Deficiencies in hormones like cortisol or growth hormone.
Tumors: Insulinomas (tumors that produce insulin).
Non-islet cell tumors: rare tumors that produce insulin-like growth factor 2 (IGF-2).
Inherited metabolic disorders: Certain rare genetic conditions.
Severe malnutrition or starvation.
Medicine Used
The primary "medicine" used to treat an episode of fasting hypoglycemia is glucose. This can be administered in several ways:
Oral glucose: Glucose tablets, juice, or sugary drinks.
Intravenous glucose: Given in a hospital setting for severe cases or when oral intake isn't possible.
Glucagon: An injectable hormone that stimulates the liver to release stored glucose. This is often used in emergencies. Long-term management depends on the underlying cause. For example, if medications are the cause, adjusting the dosage or switching medications may be necessary. Insulinomas require surgical removal. Hormone deficiencies are treated with hormone replacement therapy.
Is Communicable
Fasting hypoglycemia is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
Precautions depend on the cause, but generally include:
Identifying and treating the underlying cause: This is the most important step.
Regular monitoring of blood glucose levels: Especially for individuals at risk.
Avoiding prolonged fasting.
Eating regular, balanced meals.
Limiting alcohol consumption, especially on an empty stomach.
Wearing a medical alert bracelet: For individuals prone to severe episodes.
Educating family and friends: On how to recognize and treat hypoglycemia.
Carrying a source of fast-acting glucose: Such as glucose tablets or juice.
How long does an outbreak last?
Hypoglycemia is not an "outbreak" as is often used when discussing infectious diseases. An episode of hypoglycemia itself lasts until blood sugar levels are brought back to normal. The underlying condition causing the fasting hypoglycemia may be chronic (long-lasting).
How is it diagnosed?
Diagnosis involves:
Medical history and physical exam.
Blood glucose testing: Measuring blood sugar levels after a period of fasting. A level below 70 mg/dL (3.9 mmol/L) is generally considered hypoglycemia.
Additional blood tests: To evaluate hormone levels, liver and kidney function, and screen for other underlying conditions.
Fasting study: Under medical supervision, blood glucose levels are monitored during a prolonged fast to identify the cause of hypoglycemia. This would be done in cases where initial testing does not reveal the cause.
Timeline of Symptoms
Symptoms can develop rapidly as blood glucose levels fall. The timeline varies depending on how quickly blood sugar drops:
Initial symptoms: Often include shakiness, sweating, anxiety, and hunger. These can appear within minutes of blood sugar dropping.
Progressive symptoms: If blood sugar continues to fall, symptoms like confusion, dizziness, blurred vision, and headache can develop within 15-30 minutes.
Severe symptoms: If left untreated, seizures, loss of consciousness, and coma can occur within an hour or longer. The specific timeline varies greatly from person to person.
Important Considerations
Fasting hypoglycemia is a symptom, not a disease itself. Finding the underlying cause is critical.
People with diabetes are more likely to experience medication-induced hypoglycemia, even when not fasting.
Prompt treatment is essential to prevent serious complications.
If you experience frequent or unexplained episodes of fasting hypoglycemia, consult a healthcare professional.
The definition of hypoglycemia may vary slightly between medical professionals.
Some individuals may experience symptoms at slightly higher blood glucose levels than the standard cutoff.