hypoglycemia - a condition of the body, which is characterized by the fall of glucose levels in the blood to such indicators, in which, first of all, cells in the brain and the whole body feel energetic starvation due to insufficient amount of glucose. This disrupts their function, which manifests itself in different clinical symptoms.
Hypoglycemia is true and false (no less dangerous).When false hypoglycemia, glycemic control may be either normal or elevated.This is usually due to the rapid decrease of blood sugar level with sufficiently high values to low levels, e.g., from 20-25 to 10-15 mmol / l.
True hypoglycemia is characterized by indicators of blood glucose below 3.3 mmol / L, it can be argued that hypoglycemia - a kind of reaction to the rapid fall in blood glucose levels below the usual values.When the blood sugar decreases, inhibits the formation of glucose from glycogen and insulin action.Then there is the inclusion of some of the mechanisms that contribute to the
Hypoglycemia develops a number of reasons, which include an increased production of insulin in the pancreas;rather high level of insulin, and other drugs in patients with diabetes mellitus;a change in the pituitary and adrenal glands;violation of carbohydrate metabolism in the liver.
also hypoglycemia can be divided into disease dependent on drugs or not.Typically, hypoglycemia, which depends on the medication occurs in patients diagnosed with diabetes.The second version of the pathological condition observed fasting as hypoglycemia occurring after the famine, and as reactive hypoglycemia that occurs after ingestion of carbohydrate foods.
Very often, hypoglycemia can cause insulin or sulfonylurea drugs, which are assigned to patients with diabetes to reduce blood sugar levels.Too high a dose of the drug with respect to the eaten food, drug capable of reducing sugar to too low values.The patients with a severe form of diabetes, in the ground and are at risk of hypoglycemia.As a rule, this is due to insufficient production of islet glucagon and the adrenal gland - epinephrine.But these hormones take a direct role in the mechanisms of the first protection of the hypoglycemia.This disease can also be caused by other drugs.
Often hypoglycemia diagnosed with mentally disturbed people who secretly take sugar-lowering drugs or self-administered insulin.This is due to free access to the drug.
severe hypoglycemia is enough, and sometimes stupor may occur in patients in alcoholic intoxication, as well as alcohol abuse and neglect proper nutrition.As a result, the liver reserve carbohydrates ends.
stupor when hypoglycemia can occur even with a small amount of alcohol in the blood, but below the level that allowed for road driving.Therefore it is not always the inspector of traffic police or health worker will be able to determine that the person in a stupor by disease rather than a symptom of a state of intoxication.
Sometimes hypoglycemia can occur in a healthy person, and who has been intense exercise.Prolonged starvation symptoms of hypoglycemia can be observed simultaneously with adrenal or pituitary disorders, as well as the abuse of alcohol.In this case there is a severe depletion of carbohydrates that can not maintain normal blood glucose levels.But in some cases, hypoglycemia appears immediately after fasting.In children with the disorder of a liver enzyme system, the symptoms of hypoglycemia occur in between breakfast, lunch and dinner.
Alimentary hypoglycemia occurs in people who have undergone resection of the stomach.In this case there is too rapid absorption of sugar, which stimulates the production of insulin, which in a large amount causes a decrease in their blood sugar.If hypoglycemia alimentary type develops for no apparent reason, it is idiopathic alimentary hypoglycemia.
For reasons that cause the disease can be attributed to some products with fructose or galactose, preventing the release of glucose from the liver.A leucine is involved in stimulating an excessive amount of insulin in the pancreas.Thus, these products reduce blood sugar after a period of time after eating.
addition, insulinoma can trigger the occurrence of hypoglycemia due to excessive insulin production.Very rarely the disease can cause tumors that are not localized in the pancreas.
rare cause hypoglycemic state is a disease associated with an autoimmune abnormality.In this case, the body tries to develop insulin antibodies that it leads to a drastic fluctuation, since the pancreas produces insulin excess amount for neutralizing antibodies.Such a state can be found both in patients with diabetes and those who are not sick with this disease.
The development of hypoglycemia may affect heart or kidney failure, severe infections, malignant diseases as cancer, poor and unhealthy diet, shock, viral hepatitis and cirrhosis.All of these diseases can cause the appearance of a hypoglycemic condition.
The clinical picture consists of hypoglycemia symptoms that can be divided into certain categories.They are characterized by common disturbances, autonomic, neurological and metabolic.They are not always easy to differentiate and to hold the ratio of blood glucose.But there is a certain regularity: hypoglycemia reduces the glucose concentration to nearly 3 mmol / L.It was then and there are common symptoms and autonomic, with a small number of neurological manifestations.But when sugar concentration from 2.3 to 2.7 mmol / L developed hypoglycemic coma.
Common symptoms of hypoglycemia is characterized by anxiety, pain in the head, a feeling of irritation, nervousness, constant hunger and a burning sensation in the epigastric region.However, these symptoms can not argue about hypoglycemia, but their complex combination of hypoglycemic condition can be diagnosed.
Violations vegetative nature due to the appearance of tachycardia and tremor in the muscles.Then there is a ripple in the head and on the periphery of the body, due to the rapid movement of blood.
Among vegetative disorders secrete adrenergic and parasympathetic symptoms.In the first case of hypoglycemia clinic consists of the appearance of tachycardia, arrhythmias with a predisposition to it, pallor, shaking hands (tremor), hypertension and increased frequency of respiratory rate.But the symptoms of the parasympathetic clinic consists of hunger, rumbling in the stomach, as a result of strengthening the peristalsis in the stomach and intestines, as well as the appearance of a burning sensation in the epigastric region.All of this clinical picture is characteristic of the beginning of hypoglycemia, so it is important to always carry out the differentiation of these symptoms with various pathologies of metabolism.
neurological symptoms of hypoglycemia When there is a feeling of relative energy shortage in the brain, which is characterized by dizziness, pain in the head and throbbing in the blood vessels.Then the disease becomes severe form, so partially disconnected areas of the cerebral cortex.Marked focal symptoms of disorders of sensitivity of some areas of the body, and sometimes partially lost motor activity.
One of the most severe violations of hypoglycemia is a hypoglycemic coma that develops as a result of a sharp decline in glucose.This causes a loss of consciousness and the lack of sensitivity to various forms of stimuli, even painful.After leaving the coma patients' pain in the head, weakness throughout the body, dizziness, anxiety and disorientation, muscle tremors, inadequate behavior, there are pathological reflexes.Sometimes a deep lesion of the cerebral cortex, patients do not remember everything that was before the onset of hypoglycemic coma.
All this symptoms occurs before loss of consciousness.But the patient does not have time to notice it, because consciousness is turned off quite rapidly.It is this clinical picture allows us to differentiate hypoglycemic someone with hyperglycemic, hyperosmolar ketoatsidoticheskaya and comas.They are characterized by a gradual shutdown of consciousness with a number of neurological, metabolic, and common traits.
Signs of hypoglycemia
distinguish hypoglycemia hypoglycemic state and hypoglycemic coma.The symptoms do not always appear gradually.Sometimes, even a sudden come soporous manifestation of hypoglycemia, seizures or acute form of psychotic symptoms.
Signs of hypoglycemia are the initial stage of a severe famine, hand tremors and autonomic disturbances in the form of sweating, pain in the head, general weakness, palpitation, causeless irritability, aggression and fear.At untimely elimination of these symptoms by using foods that are easily absorbed carbohydrates, enhanced or there are some other characteristic signs of this condition.Among them are such as tremors, sweating profuse properties, double vision, fixed stare, and hemiplegia.
Hypoglycemia characteristic signs of mental reactions, namely aggression, an excited state, the inability to navigate around, and sometimes hallucinations.Very often, these symptoms are mistaken for drunkenness, as a result of alcohol or hysteria.If hypoglycemic state is not eliminated at this stage, that there twitching of certain muscle groups, especially in the face, as well as enhanced excited state, there is vomiting with single or bilateral symptom Babinski, clonic and tonic spasms that trigger epilepsy, also occursblackout and then coma.
characteristic sign of hypoglycemia is to change the part of the cardiovascular system, which is reflected in the reduction of blood pressure, enhanced the appearance of the heart rate, arrhythmia as early contractions of the heart, sometimes the low heart rate, sinus arrhythmia.A marked depression in the ECG segment S-T, and T-wave amplitude decreases.In patients with coronary artery disease with a sharp decrease in blood glucose levels observed angina.In the blood revealed a slight leukocytosis and lymphocytosis, and sometimes leucopenia.
in compensated form of diabetes hypoglycemia has a negative value of sugar in the urine, and the reaction of acetone.But hypoglycaemia decompensated diabetes is characterized by an increase in hormones such as glucocorticoids, growth hormone, ACTH and catecholamines, which help develop ketoacidosis and form in the urine acetone.
Another sign of hypoglycemia is considered hypoglycemic coma, which is characterized by sweating, damp skin, pallor, increased muscle tone, tremors, strengthening the tendon reflexes, and seizures.It also reduces, in particular, diastolic blood pressure, pupils dilate, your eyeballs in a normal tone or slightly reduced, with marked mental symptoms delusional hallucinations.The values of blood sugar levels are low and acetone in urine is present.Sometimes studies initially disease can be detected by a low content of sugar in urine of approximately 1%.A repeat laboratory tests after 30 minutes gave a negative answer to the urinary sediment unchanged.
Hypoglycemia in Children
This condition in children is not a rare disease.Very often the causes of children's hypoglycemia may be different diseases of the nervous and endocrine systems, as well as stress, exercise and an unbalanced diet.
Symptoms of a hypoglycemic condition in children is manifested as lethargy, drowsiness, irritability, pallor, sweating, hunger and heart rhythm disturbances.The values of blood sugar levels are at least 2.2 digits mg / dL.
Hypoglycemia is very dangerous for the life of the child, as it violates the body's metabolism and the coordination of movements, provokes pain in the head, promotes the appearance of cramps and fainting.Often there is hypoglycemic attacks negatively affect the mental and physical development of children.
Typically, hypoglycemia can occur in children type other diseases.Thus, the child must be fully examined, since the smaller the age, the more likely there may be a danger of the nervous system, mental retardation, or epilepsy due to its sensitivity to the variability of the nerve cells in blood sugar.
children at an older age are experiencing symptoms of hypoglycemia such as adults.They have seen it in the form of anxiety, pallor, chills throughout the body, blurred vision and loss of coordination.In addition, there are convulsions, tachycardia becomes more frequent, they have a strong sense of hunger and lose consciousness.
There are two fundamental reasons for the development of children's hypoglycemia, such as an increase in the content of ketone bodies in the blood and intolerance leucine.
When hypoglycemia in children's blood appears acetone as ketone bodies, which is characterized by a peculiar acetone breath.Since acetone refers to toxic substances, the relevant features of its action on the nervous system is the poisoning with nausea, vomiting, dizziness and fainting.In this situation, the child stomach is washed with a solution of soda or mineral water, causing vomiting.And to compensate for glucose, give a little honey or sugar and can be tableted and glutamic acid.After suffering a seizure, a child must be monitored by the specialist, it is necessary to continuously measure blood sugar and urine tests to make available to ketone bodies.
For the treatment of patients with hypoglycemia children a balanced diet with the exception of animal fats and simple carbohydrates.Preference is given to seafood and dairy, juices, fruits and vegetables.Food is important to take seven times a day in small quantities.
In rare cases, due to the nature of congenital metabolic disorders in children celebrated the incompatibility of the body with the amino acid leucine, which is part of the protein.This phenomenon is so named as leucine hypoglycemia, which occurs mainly in children's young age.A small amount of something sweet may slightly improve the situation of the patient.But a balanced diet in this form of hypoglycemia is very difficult to observe, as a growing body constantly needs protein.It is usually necessary to exclude eggs and milk, as well as pasta, nuts and fish.Therefore, for the preparation of diets for sick children with leucine hypoglycemia need help dietitian.
important to remember that early detection of the symptoms of hypoglycemia in a child as early as possible will allow to find the cause, and it will lead to a successful outcome.Also, in order to avoid complications in children's hypoglycemia, you should monitor the amount of blood sugar and stable content.