What can cause hypoglycemia in people without diabetes?
Hypoglycemia is uncommon to happen in people without diabetes.
Hypoglycemia (low blood sugar level) is a condition mostly seen in patients with diabetes, who are on insulin or medications. Hypoglycemia is uncommon to happen in people without diabetes.
Clinical hypoglycemia is a blood sugar level below 70 mg/dl.
Depending on when it happens, hypoglycemia without diabetes (nondiabetic hypoglycemia) can be categorized into two types:
Fasting hypoglycemia: It occurs when you do not eat for extended periods.
Reactive hypoglycemia: It occurs within a few hours of eating a meal.
Fasting hypoglycemia can be caused by any of the following factors:
- Medications (most common cause):
- Nonselective beta-blockers (such as Propranolol)
- ACE inhibitors (such as Captopril)
- Certain antibiotics (such as Ciprofloxacin, Levofloxacin)
- Liver disease (such as viral hepatitis)
- Hypothyroidism
- Pancreatic tumor
- Eating disorders (anorexia nervosa)
- Malnutrition
- Stomach surgery
- Hemodialysis (using an external filter placed outside the body that acts as an artificial kidney)
- Sepsis (widespread body infection that leads to organ damage)
- Insulinomas: These are a type of insulin-secreting tumors that can cause sudden episodes of hypoglycemia. They are sometimes a part of multiple cancer syndromes and genetic testing may be needed for diagnosis.
The cause of reactive hypoglycemia can be:
- Hyperinsulinism (excessive production of insulin)
- Refined carbohydrates (such as white bread)
- Prediabetes stage (a condition in which blood sugar is high but not enough to termed as diabetes)
- Surgeries of the digestive system
What are the signs and symptoms of nondiabetic hypoglycemia?
The signs and symptoms of hypoglycemia do not depend on whether you have diabetes or not. If hypoglycemia happens, it usually gives rise to one or more of the signs and symptoms that include:
- Sudden sweating (without exertion)
- Cold, clammy skin
- Tachycardia (fast pulse)
- Palpitations (pounding heart rate)
- Tremors in hands
- Weakness
- Dizziness
- Headache
- Shivering
- Nausea
- Hunger
- Blurred vision
- Anxiety
- Irritability
- Confusion
Untreated hypoglycemia can lead to seizures, coma, and can even be life-threatening.
How is nondiabetic hypoglycemia treated?
A person can use the 15-15 rule. In this rule, the person needs to have 15 grams of carbohydrate to raise the blood sugar level. After having this, they have to wait for 15 minutes and check the blood sugar level. If your blood sugar level is still below 70 mg/dL, have another 15 grams of carbohydrate.
The treatment of hypoglycemia aims to increase blood glucose levels as fast as possible:
- If you are conscious and able to eat, you will be asked to consume 15 to 20 grams of glucose powder every 15 minutes until the symptoms disappear and blood sugar level has returned to normal. You can also eat bread, rice, cereals, sugar candies, or fruits to increase the blood sugar level, however, sugar is the best substance to immediately raise the blood sugar levels.
- If you are unconscious or unable to eat, then the doctor will give you glucose through an IV. An IV is a small needle placed in your vein. They might also give you the hormone glucagon that raises your blood sugar levels.
- If the doctor suspects that certain medications to be the cause of your hypoglycemia, they will ask you to discontinue the medications and switch you to other medicines. The diseases that are responsible for your hypoglycemic spells will also be treated accordingly.
What should be the diet for a person with nondiabetic hypoglycemia?
If you suffer from episodes of hypoglycemia without even having diabetes, you will need to carry a pack of sugar candies or biscuits wherever you go. Ask your doctor or dietician about what your diet should be, which can help you prevent hypoglycemic episodes. The following may help you avoid episodes of hypoglycemia:
- Eat frequent, small meals each day instead of three large meals
- Do not skip meals
- Cut back on refined carbohydrates (white bread, pastries, soft drinks, syrups, and candy)
- Have a well-balanced diet that is rich in proteins, contains carbohydrates, fat (good fat), fruits, and vegetables
- Limit alcohol or drink it along with meals or after meals (not on an empty stomach)