Hypoglycemia means that your blood glucose is low—generally below 60 to 80 mg/dL. Symptoms occur quickly and need to be treated as soon as possible.
Not enough food | Eat all your meals and snacks on time. |
More physical activity than usual | Eat extra food to match your increased activity. |
Too much diabetes medicine | Take only the dose that has been prescribed. |
Symptoms
You may have one or more of the following symptoms:
- sweating
- shaking
- feeling weak or tired
- feeling anxious or nervous
- racing heart
- feeling hungry
- having a mild headache
- tingling sensation around lips and tongue
Treating hypoglycemia
If you are injecting insulin, always carry a simple sugar food with you. These include raisins, marshmallows, glucose tablets or a juice box.
- Test your blood glucose as soon as you feel symptoms.
- If your level is low, treat with 15 grams of carbohydrate. Examples include:
- 1/2 cup of fruit juice (you don't need to add sugar)
- 1/2 cup of regular pop
- 1 tablespoon of honey or sugar
- 2 tablespoons of raisins
- 3 large marshmallows
- 1 cup of skim milk
- 3 to 4 glucose tablets
- 15 grams of glucose gel
- After eating one of these foods, test your blood glucose every 10 to 15 minutes. If it is still low, eat another 15 grams of carbohydrate until your symptoms are gone or your blood glucose level is above 80.
Follow-up treatment after hypoglycemia
After you've experienced hypoglycemia, you may need more food.
- If your next meal or snack is less than one hour away, eat at your normal time.
- If your next meal or snack is one to two hours away, eat an extra snack that contains 15 grams of carbohydrate.
- If your next meal or snack is more than two hours away, eat a snack that contains 30 grams of carbohydrate.
Do not subtract what you eat to treat hypoglycemia from your next snack or meal. This food is needed to keep your blood glucose in a better range.
When to call your health care provider
Call your health care provider or diabetes educator if you have unexplained hypoglycemia two times in one day or two days in a week.
Reviewed By: Reviewed by Allina Health's Patient Education Department experts
First Published: 11/27/2006
Last Reviewed: 01/20/2014
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Original article
Pregnancy outcomes of women with hypoglycemia in the oral glucose tolerance test
Abstract
Objective
The aim of this study was to investigate the effects of hypoglycemia measured using 2-h 75-g oral glucose tolerance test (OGTT) on neonatal biometrics (birth weight, head circumference and body length of newborns) and perinatal outcomes.
Materials and Methods
According to the definition of hypoglycemia by the American Diabetes Association, women with blood glucose levels of ≤70 mg/dL after fasting or at 1 or 2 h after eating measured using on 2-h 75-g OGTT were grouped into a hypoglycemia group. In accordance with the criteria of World Health Organization and the International Association of Diabetes and Pregnancy Study Groups, as per the 2-h 75-g OGTT performed in the second trimester, women with gestational diabetes and were excluded from the study. Also, women meeting the following criteria were excluded from the study: missing records, aged <19 or ≥35 years, multiple pregnancies, delivery before the 24th gestational week, and ≤500-g newborn. Other exclusion criteria included pregnant women with known type 1 and type 2 diabetes mellitus, gestational or essential hypertension, cigarette and/or alcohol abuse, thyroid disease, BMI of <19 and >30, placental abnormalities with variation and/or dysfunction, intrauterine growth restriction, and abnormalities of the umbilical cord.
Results
A total of 625 pregnant women who met the inclusion criteria were included in the study. Hypoglycemia was found in 71 pregnant women according to 2-h 75-g OGTT. The remaining 554 women were grouped into the normoglycemia group. The birth weight, head circumference, and body length of newborns were significantly lower in the hypoglycemia group (p < 0.001, p = 0.004, and p = 0.006, respectively). There was no significant difference between both groups in terms of body mass index, parity, fetal sex, delivery type, and Apgar scores.
Conclusions
Glycemia with blood glucose levels of ≤70 mg/dL measured using 75-g OGTT during pregnancy is associated with lower birth weight, small head circumference, and short body length in newborns compared to the normoglycemic group. Hence, pregnant women who are diagnosed with blood glucose levels of ≤70 mg/dL using 2-h 75-g OGTT should be carefully managed.
Introduction
Gestational diabetes mellitus (GDM) is a condition wherein impaired glucose intolerance is first diagnosed during pregnancy [1]. Diabetes during pregnancy increases pregnancy risks, requiring close follow-up for both mother and fetus. Therefore, various protocols have been established worldwide for the screening and diagnosis of gestational diabetes.
Hypoglycemia is a syndrome characterized by various symptoms due to decreased blood glucose level, and the American Diabetes Association (ADA) states that a blood glucose level of ≤70 mg/dL indicates hypoglycemia [2]. Symptoms of hypoglycemia often vary depending on the amount of reduction in the blood glucose level, but it could also be asymptomatic [2].
Glucose is the basic nutrition for a fetus and is transported via placental trophoblasts by facilitated diffusion [3]. Trophoblasts mediate this transportation using molecules present on their membranes such as GLUT- 1, GLUT- 4, and GLUT- 9 [3]. Because glucose is transported to the fetus through diffusion, maternal blood glucose level is proportional to the amount of glucose reaching the fetus. Thus, placental dysfunction, maternal hypoglycemia due to malnutrition, or impaired maternal metabolism may lead to low-birth-weight newborns [[4], [5], [6], [7]]. Furthermore, hypoglycemia may be asymptomatic [2]; hence, maternal hypoglycemia and its effects on the fetus can easily be overlooked.
Therefore, the aim of this study was to investigate the effects of hypoglycemia measured using 2-h 75-g oral glucose tolerance test (OGTT) on neonatal biometrics (birth weight, head circumference and body length of newborns) and perinatal outcomes.
Section snippets
Study design
This retrospective study was conducted at Tepecik Training and Research Hospital. The study included women in their 24th–28th gestational weeks who were admitted to our hospital between 2016 and 2018 and who underwent 2-h 75-g OGTT.
Study participants
In accordance with the definition of hypoglycemia provided by ADA, women with blood glucose levels of ≤70 mg/dL after fasting or at 1 or 2 h after eating measured using 2-h 75-g OGTT were grouped into a hypoglycemia group [2]. Further, according to the WHO and IADPSG
Results
A total of 625 pregnant women who met the inclusion criteria were included in the study. Hypoglycemia was diagnosed in 71 women according to 2-h 75-g OGTT. The remaining 554 women had normoglycemia. Table 1 summarizes the demographic characteristics of the included women. There was no significant difference between the hypoglycemia and normoglycemia groups in terms of parity, and body mass index (BMI). Mean age was significantly lower in the hypoglycemia group than in the normoglycemia group (p
Discussion
Fetuses receive glucose (fundamental nutrition) from the mother via facilitated diffusion [3]. Therefore, the maternal blood glucose level is directly related to the amount of glucose that the fetus receives. Pathology of the fetoplacental unit, maternal undernutrition, and maternal diseases can affect fetal development by limiting glucose availability to the fetus [[4], [5], [6], [7]].
Several studies determined hypoglycemia levels to be 50–90 mg/dL on 50-g OGTT, 50–90 mg/dL on 100-g OGTT, and
Contributors’ statements
Dr. Bayraktar designed the study, drafted the initial manuscript, made statistical analysis and approved the final manuscript as submitted.
Dr. Balıkoğlu carried out the initial analyses, critically reviewed the manuscript and approved the final manuscript as submitted.
Dr. Kanmaz designed the data collection instruments, and coordinated data collection at hospital information system, critically reviewed the manuscript, and approved the final manuscript as submitted.
Declarations of Competing Interest
The authors have no conflicts of interest to declare.
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