Hypoglycemia-known as low sugar-is a condition in which the blood sugar level falls below70mg%.When blood sugar level s fall, there is an increase in counter- regulatory harmone levels to maintain the optimum blood sugar levels.
In Diabetics hypoglycemia is very common among the
* Debilitated patients
* Patients with infections
* Patients with impaired kidney function
* Patients on insulin therapy
* After alcohol abuse (or) vigorous exercise
* Psychological illness
* Diabetics who fast for religious reasons or those with continuous vomiting are prone to hypoglycemia.
It is more common in insulin-dependent diabetes than maturity onset diabetes(type ll diabetes).Hypoglycemia is more common and pronounced if one aims for intense blood sugar control. Hypoglycemia can result in ECG changes with or without any symptom(silent ischemia). It also can trigger angina,heart attacks,acute heart failure and/or cardiac rhythm disturbances. Some of the recent studies have shown that hypoglycemic episodes increase cardiovascular events and mortality. Studies have also shown that adverse cardiovascular events are three times more common among those with intense glucose control compared with optimal control.Swings in blood sugar levels are equally hazardous.
The challenge of physicians is to adjust blood sugar levels to near normal range and reduce complications of diabetes, while at the same time minimize or prevent hypoglycemic events. One must particularly be more cautious in diabetics with underlying heart disease. Blood HbA1c level is a biochemical parameter to assess long-term glucose control. Hypoglycemic episodes are more common if HbA1c level is <7%. “Lower the better is no longer the rule.”