Diabetic or not, how deadly can low blood sugar levels be if left untreated? Malaysian expert explains

Hypoglycaemia occurs when blood sugar levels dip below the normal range. — Pxhere.com pic
Hypoglycaemia occurs when blood sugar levels dip below the normal range. — Pxhere.com pic

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KUALA LUMPUR, Nov 13 — Many have heard about the risks of high blood sugar levels, but very few may know the deadly consequences of the lack of glucose in one’s body.   

The condition, clinically known as hypoglycaemia, occurs when the blood sugar levels drop below the normal range. 

According to family and occupational health doctor, Dr Ramli Tahir, glucose is the main source of energy for the body.

Therefore, he added, if the blood sugar levels fall below the normal range, it may result in a variety of symptoms, including clumsiness, trouble talking, confusion, loss of consciousness and seizures. 

Hypo stages

Highlighting the dangers of hypoglycaemia, Dr Ramli broke down the condition into three stages of mild, moderate and severe.

“In mild cases, the blood glucose levels are between 3.0 mmol/L (millimole) and 3.9 mmol/L.

“During mild hypoglycaemic episodes, the patient will show symptoms of sweating, shaking, nausea, extreme hunger, nervousness and dizziness,” said Dr Ramli, who is also Malaysian Muslim Doctors Organisation secretary-general.

For moderate cases, Dr Ramli said the blood glucose is usually below 3.0 mmol/L with more severe symptoms such as difficulty concentrating or speaking, confusion, weakness, vision changes and mood swings. 

“In severe hypoglycaemia cases, the person would be unable to function because of mental or physical changes,” he said. 

Dr Ramli added that most of the time during a hypoglycaemic episode, people may only experience one or two of the symptoms. 

However, he noted that, sometimes, people may not feel anything out of ordinary at all, which is a condition called hypoglycaemia unawareness. 

“For these reasons, it’s important to test your blood sugar levels often.”

If not handled appropriately, Dr Ramli warned that the condition may have a rapid onset with dangerous consequences.

He said the condition is often related to diabetes, but some drugs and a variety of conditions such as overproduction of insulin and hormone deficiency may also cause low blood sugar in people who don’t have diabetes.

“Hypoglycaemia in people without diabetes is much less common but it could be caused by excessive alcohol consumption, liver or kidney disorder, long-term starvation, insulin overproduction and hormone deficiencies.”

To quickly shoot back the sugar levels up, Dr Ramli said it would be helpful to have a small apple, banana or an orange.

Alternatively, you may have 15 grapes, a few prunes or dates, two tablespoons of raisins, half a cup of juice or one tablespoon of honey. 

The fuel to keep you going  

Dr Ramli said when one eats, the body then breaks down carbohydrates from the food into various sugar molecules, including glucose, which is the main energy source.

“Glucose will then enter the cells of most of your tissues with the help of insulin to provide the cells with the fuel they need.

“Extra glucose is stored in your liver and muscles in the form of glycogen (a readily mobilised storage form of glucose),” he said.

However, Dr Ramli added that if you haven’t eaten for several hours and your blood sugar levels drop, another hormone called glucagon would signal the liver to break down the stored glycogen and release glucose into the bloodstream.

“This keeps your blood sugar within a normal range until you eat again.

“If you have diabetes, you might not make enough insulin (as in Type 1 diabetes) or you might be less responsive to it (as in Type 2 diabetes).”

As a result, he said glucose tends to build up in the bloodstream and can reach dangerously high levels.

“To correct this problem, you might take insulin or other drugs to lower blood sugar levels.”

He also noted that too much insulin or other diabetes medications may cause blood sugar levels to drop too low and cause hypoglycaemia. 

The risks 

According to Dr Ramli, an older patient, those with Type 2 diabetes and patients taking multiple medications have a higher risk of recurring hypoglycaemia.  

Over time, he added that repeated episodes of hypoglycaemia may lead to hypoglycaemia unawareness.

“The body and brain will no longer produce signs and symptoms that warn of low blood sugar levels, such as shakiness or irregular heartbeats.

“When this happens, the risk of severe, life-threatening hypoglycaemia increases.”

However, Dr Ramli said the worst-case scenario would be a diabetic coma.

Prolonged unconsciousness due to altered blood sugar levels is called a diabetic coma.

“In a diabetic coma, you are unconscious and unable to respond to your environment and need urgent medical attention,” he said.

To treat the patient, Dr Ramli said they would give glucagon injection to quickly bring up blood sugar levels.

“Intravenous dextrose also may be given to raise blood glucose levels.”

The condition can be fatal without urgent medical care. 

Preventive measures 

To minimise the risk of having hypoglycaemic episodes, Dr Ramli said diabetic patients should consult their doctor and follow diabetes management plan.

He also advised the patients to talk to always discuss with their doctor before changing diet plans or medication schedules as well as exercise plans to avoid any risk of having low blood sugar levels.

“On top of that, always have a fast-acting carbohydrate with you, such as juice, Milo or glucose so that you can treat hypoglycaemia before it dips dangerously low.”

For non-diabetic patients who experience recurring episodes of hypoglycaemia, Dr Ramli said eating frequent small meals throughout the day may be a stopgap measure to help prevent blood sugar levels from getting too low.  

However, he noted that this approach isn’t advised as a long-term strategy.

“You should work with your doctor to identify and treat the cause of hypoglycaemia.”

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