What are symptoms of hypoglycemia, and how low is too low?

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What are symptoms of hypoglycemia, and how low is too low?
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The body's biochemical response to hypoglycemia usually starts when sugars are in the high/mid 70's. At this point, the liver releases its stores and the hormones mentioned above start to activate. In many people, this process occurs without any clinical symptoms. The amount of insulin produced also declines in an attempt to prevent a further drop in glucose.

While there is some degree of variability among people, most will usually develop symptoms suggestive of hypoglycemia when blood glucose levels are lowered to the mid 60's. The first set of symptoms are called adrenergic (or sympathetic) because they relate to the nervous system's response to hypoglycemia. Patients may experience any of the following;

* nervousness,
* sweating,
* intense hunger,
* trembling,
* weakness,
* palpitations, and
* often have trouble speaking.

In most patients, these symptoms are easily recognizable. The vast majority of patients with diabetes only experience this degree of hypoglycemia if they are on medications or insulin. Patients (with diabetes or who have insulin resistance) with high circulating levels of insulin who fast or lower their carbohydrate intake drastically should also be cautioned. These individuals may also experience modest hypoglycemia.

Anyone who has experienced an episode of hypoglycemia describes a sense of urgency to eat and resolve the symptoms. And, that's exactly the point of these symptoms. They act as warning signs. At this level, the brain still can access circulating blood glucose for fuel. The symptoms provide a person the opportunity to raise blood glucose levels before the brain is affected.

If a person does not or cannot respond by eating something to raise blood glucose, the levels of glucose continue to drop. Somewhere in the 50 mg/dl range, most patients progress to neuro-glyco-penic ranges (the brain is not getting enough glucose). At this point, symptoms progress to confusion, drowsiness, changes in behavior, coma, and seizure.

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