Talk:Hypoglycemia

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[edit] Functional hypoglycemia

Some members of the medical community believe that functional hypoglycemia does not actually exist, as a disease, at all. They only recognise hypoglycemia as a side-effect of diabetes - if a diabetic takes in too much insulin for the amount of sugar in their blood, the effect is a severe and potentially life-threatening hypoglycemic attack or a 'hypo'.

Agree...hypoglycemia is in reality a very rare disorder, rarer than what the lay perception would lead you to believe. Andrew73 00:12, 14 October 2005 (UTC)

[edit] Pregnancy and hypoglycemia

It seems like many pregnant women deal with hypoglycemia. Does anyone know how often and if it should be addressed on this page. Does pregnancy contribute to the likelihood of a hypoglycemic attack?

Most of the net metabolic changes of pregnancy would make hypoglycemia less likely rather than more likely (which is why diabetes so often develops during pregnancy). There is not a recognized "hypoglycemia of pregnancy". It should not be added this page unless you have citations from the medical literature demonstrating its recognized nature and frequency. alteripse 02:49, 12 July 2006 (UTC)

[edit] diabetic coma

How low can your blood sugar go before a person goes into a coma. - (unsigned)


  • 60 mg/dL is the definition of hypoglycemia, and glucose levels of 50 mg/dL (3 mmol/L) or so puts you at risk of coma (though there's no magic number: some people can be conscious with startlingly lower levels). -- Binky 00:33, 15 Jan 2004 (UTC)

The symptoms of hypoglycemia can vary much more than the list presented might indicate. I have suffered all of those listed, with "fear of dying" extending to a more general paranoia, hysteria, and I have also vomited on several occasions, with no other physical reason for such a thing present other than my very low blood sugar reading. Other type 1 diabetics I have come in contact with have also described a wide variety of symptoms, though many can clearly be linked to the wild release of other kinds of hormones (such as adrenaline) and their effect on the system.

fear of dying isn't an actual symptom, it only happens because you believe hypoglycemia will end your life. --Ditre 16:41, 17 February 2007 (UTC)

I removed the following section because it was doubious. Could not find evidence to support it as being credible. As well I found inaccuracies in its use of the term functional hypoglycemia. This is saved here for posterity or in case some portion of it is worth reviving.

Hypoglycemia is also a term of contemporary American folk medicine which refers to a recurrent state of symptoms of altered mood and cognitive efficiency, sometimes accompanied by adrenalin symptoms, but not by measurably low blood glucose. The symptoms are primarily those of altered mood, behavior, and mental efficiency. This condition is usually treated by dietary changes which range from simple to elaborate. Because the blood glucose levels are not actually low, this type of hypoglycemia does not carry the same risks of coma or brain damage as measurable hypoglycemia. In the medical literature, this condition is sometimes referrd to as functional hypoglycemia, and resembles reactive hypoglycemia but is distinguished by the inability to demonstrate low blood glucose.

Catskul 15:50, 2004 Nov 22 (UTC)

Catskul, if you noticed, I am the one who wrote most of this article, including the paragraph you removed. I appreciate that you noted and explained here. Rather than simply revert you, could you tell me why you think the paragraph is inaccurate? I can cite ample papers to support this description of this type of hypoglycemia but before I go to the trouble I want to know that we both are playing by the same epistemological and taxonomical rules. What aspect of the paragraph do you object to? Do you think there are not people with the condition described? Do you not think a brief description of this condition belongs in this article? Do you think no version of the term hypoglycemia should be used if low sugars are not documented? Do you think that mainstream American culture somehow is different from other cultures in not having any aspects that can be considered "folk medicine"-- which basically means a concept of a disease that is not recognized by other cultures, does not have objectively verifiable tissue or lab abnormalities or biological abnormalities, or is diagnosed and treated outside of professional procedures? Thanks in advance. alteripse 22:37, 22 Nov 2004 (UTC)

I modified the paragraph and reinserted. Catskul, please respond to above questions if you still think it needs to be improved. thanks alteripse 13:19, 23 Nov 2004 (UTC)

[edit] different ethnic normals and different ethnic tendency to reactive hypoglycemia

I removed the following text for reasons explained below.

Additionally, there is some evidence that people from certain ethnic groups with traditional diets very low in simple carbohydrates and high in complex carbohydrates (e.g., Scots, Scandinavians, Japanese) will often develop a propensity for normal body function within a range of blood sugar levels that is lower than for most people (e.g., a normal range of 60 mg/dL or 3.3 mmol/L to 100 mg/dL or 5.6 mmol/L, instead of 80 mg/dL or 4.5 mmol/L to 120 mg/dL or 6.7 mmol/L. These people may be described as "naturally hypoglycemic," but they are actually "hypoglycemic" only by comparison to what is normal for the general populace. That said, their apparently hypoglycemic propensity can present a medical problem if it is accompanied by a sensitivity to simple carbohydrates (sugars). That is, when consumption of foods very high in sugar (e.g., hard candies, fudge, chocolate, pre-sweetened cereals, etc.) can or does cause a rise in blood sugar so sharp that it produces a mild degree of intoxication (in the vernacular, a "buzz"), followed by an equally sharp drop or "crash" that typically produces sensations similar to alcoholic "hangover."

This is a potentially serious form of reactive hypoglycemia. In some individuals, a very serious "crash" of this type can produce unconsciousness and/or cause convulsions, but this is thought to be rare (except in naturally hypoglycemic children, particularly during periods of growth spurt, who routinely eat a diet that is too low in complex carbohydrates to at least 'balance' their intake of simple carbohydrates). When people who function normally with lower than normal blood sugar levels suffer a serious hypoglycemic "crash," they must only take complex carbohydrates (starchy foods) until they fully recover, which usually takes a few minutes to an hour. Consuming more simple carbohydrates will only repeat the cycle of intoxication, and lead to another "crash."

Reasons for removal:

  1. This text seems to be suggesting that different ethnic groups have different normal glucose ranges, which is a bizarre idea that needs supportive citations of real evidence to belong here.
  2. Even if completely true, this rare subform of reactive hypoglycemia does not deserve half of the text of the introduction to the whole article. We have a reactive hypoglycemia and an idiopathic postprandial syndrome stub which need expansion. If the author can verify this info, one of these would be the appropriate place to put it. Do not put it back at the beginning of this introduction.
  3. The primary clue that this is total crap is the ignorance of hypoglycemia implied by the phrases "crash" and "potentially serious". No one familiar with the coma, seizures, and brain damage risks of the truly "serious" forms of hypoglycemia described in this article would think of describing reactive hypoglycemia or idiopathic postprandial syndrome this way. This is "folk medicine" at best. alteripse 11:22, 23 Jun 2005 (UTC)

I'm part Native American and there is clinical evidence that people of Native American heritage are more sensitive to the high-carbohydrate modern American diet than are many people of pure European background.

Diabetes among Southwestern Indian populations is now being treated successfully by a return to lower carb traditional Southwestern Native American diet that also features indigenous low glycemic index vegetables and low glycemic legumes as well.

Phil

67.42.243.184 17:55, 8 January 2007 (UTC)

[edit] Infobox

The article has grown an infobox with a lot of ICD-9 codes. As hypoglycemia is not a disease but a symptom, is there any way to present this information? JFW | T@lk 6 July 2005 22:33 (UTC)

user:arcadian put the info box there labeled leukemia. I changed it to hypoglycemia and added the icd9 codes covered by the article. I am not sure that it is a particularly informative box as it stands, but a long table of icd9 codes certainly doesn't belong at the top of the page either. Any suggestions? alteripse 6 July 2005 23:46 (UTC)

[edit] Carbohydrates

It the recommendation of eating carbohydrates to prevent further episodes correct?

NO not at all-- eating very complex carbs can help (unless you have severe hypo)-- but eating simple carbs will make it much worse over time. Eating more protein in small amopunts all day can also help as can omega 3 oils and Vitimin supplementation.

67.42.243.184 18:02, 8 January 2007 (UTC)

Yes, for most types of hypoglycemia described in this article. You may be thinking about idiopathic postprandial syndrome. alteripse 21:00, 20 August 2005 (UTC)

[edit] Hypoglycemia

My mother often had hypoglycemia, and, unfortunately, she passed it on to me. I have it a LOT. If I eat anything with sugar in it in the morning, I get sick during the day. So, to be safe, I eat Cheerios every day of my life. :( I had 7 years Perfect Attendance until last year, when I got extremely sick and had to go home early. Ugh.

Even cheerios are medium-glycemic carbs. You might try a high protein/low carb diet with low carb veggies and vitamin supplementation-- that may make you feel even better (but keep the meals small and eat 5 or 6 times a day because even protein if eaten in large quanitities can be converted to glucose by the body).

Phil

67.42.243.184 17:59, 8 January 2007 (UTC)


The above statement seems to imply that hypoglycemia is an inherited genetic trait. I also suffer from hypoglycemia, and my mother and grandmother have it too. However, I don't recall seeing anything in this article about whether or not the condition is congenital. Is that my oversight, the oversight of the writers, or is the congenital nature of hypoglycemia a myth? 69.168.108.191 18:13, 29 June 2006 (UTC)

As the article states, there are hundreds of causes and types of hypoglycemia, some inherited and congenital, some inherited but not congenital, some congenital but not inherited, and many that are neither. How can we make it clearer? alteripse 19:44, 29 June 2006 (UTC)

[edit] Rarely is not never

I believe in the first paragraph below the title where it says that hypoglycemia (rarely) causes death is inaccurate. Any Diabetic (or anyone for that matter) that experiences a severe enough episode will indeed die as their brain will not recieve oxygen.--Commodore64 18:33, 26 June 2006 (UTC)

Hypoglycemia rarely causes death. The statement is true. Many people with well-controlled diabetes by current methods suffer 1-2 symptomatic episodes of hypoglycemia each week and even more asymptomatic episodes for perhaps a common frequency of at least 300 per year. Average lifespan of someone with type 1 diabetes now is well over 30 years from diagnosis and those with closer to normal glucose levels live longer, not shorter. So if only 1 in 10,000 episodes of hypoglycemia is fatal the statement is true. Rarely is not never. alteripse 12:34, 27 June 2006 (UTC)

[edit] Permanent brain damage?

The article notes of course that low glucose levels can impair brain functions. It would be good if the article also noted whether permanent damage can result from certain circumstances. These circumstances should span the various degrees of: hypoglycemic severity, isolation vs recurrence, and duration of the fit. 74.132.209.231 21:56, 29 June 2006 (UTC)

Good suggestion but no simple answer, certainly not a "below x level for y minutes" type of answer. See my recent additions to the article. alteripse 22:10, 29 June 2006 (UTC)

[edit] Temperature Extremes

I would like this article to open up debate on whether temperature extremes (either extreme cold conditions or extreme hot conditions) can make risk of hypoglycaemia in diabetics more likely. Any information on this subject will be gratefully received. ACEO 08:12, 24 July 2006 (UTC)

A better place is the talk:Diabetic hypoglycemia page, before putting anything in an article. If you move the question there I will tell you what I know about the topic. alteripse 11:31, 24 July 2006 (UTC)

Thank you Alteripse. I have now raised this question on the Wikipedia site talk: Diabetes, so I do hope that you will be able to respond. By the way, are you a qualified medical doctor? I have seen a number of comments from you on medical articles in Wikipedia, and also believe that your name is in the category Category:Wikipedian physicians. I am not a medical doctor myself (my doctorate is a Ph.D. in Psychology, not an M.D.) but do find medical articles in Wikipedia very interesting and, from what I know about medicine, pretty good compared with some other health information on the web! ACEO 12:44, 26 July 2006 (UTC)

[edit] Section titles

The section titles of much of this article aren't very "Wikipedia-ish." It looks like it was copied-and-pasted from another source. While the content seemed okay when I scanned through it, I didn't that that close a look; it seems however, that the only thing really requiring cleanup is the section titles. They all ought to be less than four words, IMO. 205.157.110.11 23:25, 25 August 2006 (UTC)

You are complaining about a style issue. The captions contain too much information for the reader? Why don't you get an account and write some articles and you can make your own decisions about section heading styles. Thanks for your input. alteripse 00:13, 28 August 2006 (UTC)

[edit] Sub-clinical Adrenal Insufficiency as one route to Hypoglycemia

I wish I had more time to post, but there is evidence, both in Western medicine and also Traditional Chinese Medicien that elevated insulin levels in hypoglycemia may also be due to sub-clinical adrenal insuficency (adrenals not weak enough to be called 'addisons disease' but weak enough nevertheless for adrenals to underperform in their usual role as insulin antagonists).

The adrenals are widely known for temporarily boosting blood sugar during fight or flight reactions-- but one of the many less well known functions of the adrenal glands is to also counteract insulin under non-emergency conditions-- normally pushing insulin levels lower while the pancreatic system pushes insulin higher-- the two opposing systems therefore creating a balance in healthy individuals. In the case of sub-clinical adrenal insufficiencey (also called 'adrenal exhaustion') the weakness of underfunctioning adrenals in relation to healthy pancreas may cause an overabundance of insulin which therefore sets the stage for hypoglycemia. There is also a theory that years of of this imbalance may overwork the pancreas causing it to eventually begin to fail, so chronic adrenal-insufficiency based hypoglycemia may also eventually lead to diabetes. This has at times been called a part of 'Syndrome X', although there are other problems that influence syndrome X as well-- this syndrome may weaken the adrenals initially, or weak adrenals may trigger this syndrome initially.

In any case-- attending to increased support of adrenal function through vitamins, omega oils and Chinese herbs (under the supervision of a clinically trained Chinese herbalist) can help hypoglycemia along with the more well-known dietary changes.

(NOTE: Although Chinese herbs can help greatly-- there are no one-size-fits all Chinese herbs for hypoglycemia-- or any illness-- because Traditional Chinese Medicine works on correcting unique individual imbalances-- therefore a careful individual evaluation must be carried out by a trained professional before Chinese herbs can be safely administered).

Phil

Sean7phil 15:22, 8 January 2007 (UTC)

Sean7phil 15:24, 8 January 2007 (UTC)

The problem with folk medicine is that the unwary will think "adrenal" in the passage above means adrenal, that "insulin" means insulin, and "hypoglycemia" means hypoglycemia, when in fact none of that entire passage is grounded in measurable phenomena whatsoever and has nothing to do with actual adrenal or pancreatic function or blood glucose levels. There is no better way to knock an animal's insulin levels to undetectable than by removing the adrenal glands. States of adrenal glucocorticoid excess (Cushing's syndrome) reduce insulin sensitivity and produce higher insulin levels. Thanks for not trying to mix this stuff into the article. Why can't the alt med folks spin their stories using different words that do not already have precise meanings? If you stick to words like yin, yang, and chakras, there will be no grounds for reader confusion and I will not argue with you. alteripse 23:09, 8 January 2007 (UTC)

[edit] Hypoglycemia unawarness

There used to be an article on this, but it seems to have been deleted. I wondered whether information on this topic should have been moved here? ACEO 20:38, 7 November 2006 (UTC)

There was an article with the title hypoglycemia unawareness but it was deleted because it was a copyright violation. The topic should probably be included in diabetic hypoglycemia (with a redirect from the empty hypoglycemia unawareness), but the article doesnt cover it. Please go ahead if you know something about it. Or I will when I get a round tuit. alteripse 23:47, 7 November 2006 (UTC)
The total text deleted from that article was the following, which in my opinion isnt worth much and doesnt cover the topic. alteripse 23:53, 7 November 2006 (UTC)
Hypoglycemia (or hypoglycemic) unawareness is the inability to recognize early symptoms of low blood sugar until they become severe. Once symptoms reach this stage, urgent treatment is necessary to prevent further progression and life-threatening health problems, such as a seizure or stroke.
Severe symptoms of low blood sugar include confusion, slurred speech, unsteadiness when standing or walking, muscle twitching, and personality changes. People with diabetes who tightly control their blood sugar levels are more likely to have episodes of low blood sugar. Frequent and severe low blood sugar episodes are likely to evolve into hypoglycemia unawareness. Once a person has had one hypoglycemia unawareness episode, more are likely to occur.

[edit] Endocrinologist

Suggest modification of definition of endocrinologist in 1st paragraph--specialty includes, but is more than just disorders of blood glucose metabolism. Hallbrianh 22:42, 19 February 2007 (UTC)

  • Sure, but that is the aspect of endocrinology relevant to this article. alteripse 01:14, 20 February 2007 (UTC)

[edit] fear of dying

until there is an actual reliable source that says fear of dying is a symptom i am going to remove it as it as nonsense and original research, the following 5 websites talk about symptoms of hypoglycemia and not a single one of them say anything about a fear of dying
http://www.nlm.nih.gov/medlineplus/print/ency/article/000386.htm
http://www.medicinenet.com/hypoglycemia/article.htm
http://www.drpodell.org/hypoglycemia_symptoms.shtml
http://www.fred.net/slowup/habul44.html
http://health.learninginfo.org/hypoglycemia.htm
PS: the part "The most effective means of preventing further episodes of hypoglycemia depends on the cause" that is true about all problems so it isn't necessary to keep...

--Ditre 22:55, 9 March 2007 (UTC)

Do not remove the topic sentence. It replaced a series of erroneous assertions that hypoglycemia is treated with oral glucose. There are many ways of treating hypoglycemia depending on cause (oral glucose, IV glucose, oral food, glucagon IM, glucagon infusion, octreotide injections, octreotide infusions, diazoxide, etc, depending on circumstances and cause. It is not a trivial statement. Leave it alone. alteripse 06:20, 11 March 2007 (UTC)

That doesn't prove its not a trivial statement, it doesn't give any information that is useful. all that needs to be there are the methods. --Ditre 04:53, 12 March 2007 (UTC)

If the stylistic reasons for retaining the overview sentence before subdivision do not convince you, the strongest practical argument is simply that in the real world, doctors do not always remember all 3 aspects of management or sometimes confuse one with the other. I'm glad that you have such a comprehensive understanding of this topic that the statement seems trivial to you, but I assure you that others need reminding. Feel free to have the last word here, but thanks in advance for desisting from further removal. And as for including "fear of dying" in the symptom list, I did not insert it and will not contest it, but would remind you that none of your cited symptom lists claims comprehensiveness and it would be easy to find signs or symptoms absent from each of them. alteripse 12:11, 12 March 2007 (UTC)
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