Understanding Hypoglyceamia

How Big Is This Problem Globally?

  • 366 million people, which comes up to about 7% of the world population are diagnosed with diabetes. Most of them live in highly-populated Asian countries like China, India and Indonesia
  • The number of people with diabetes is expected to rise to 552 million by 2030
  • Every 8 seconds, a diabetes-related death occurs. Statistics from University Technology MARA (UiTM) show that there is an estimated 4 million deaths related to diabetes, each year
  • An estimated 1 million amputations is performed on diabetic patients each year

How Big Is This Problem Locally?

  • There are 2.6 million diabetics in Malaysia
  • In 2010, 23,800 deaths were diabetes-related
  • The 2011, the National Health and Morbidity Survey showed a diabetes prevalence of 20.8 percent among those above 30 years of age. This works out to about 1 in 5 people.
  • Fifteen percent of adults above 18 years are diabetic

Hypoglycaemia

Diabetes and its complications are major causes of morbidity and mortality in Malaysia. Although diabetes control programmes have been initiated in the country, there is a distinct lack of awareness when it comes to hypoglycaemia and weight gain, which are the 2 most common barriers for diabetic patients when achieving optimum glycaemic control.

According to MSD, Dr. Zanariah Hussein and Dr. Chan Siew Pheng —both Senior Consultant Endocrinologists — many individuals with diabetes remain unidentified, untreated and at risk for complications.

When it comes to diabetes, the spotlight tends to be on lowering high blood sugar levels (hyperglycaemia) but low blood sugar levels (hypoglycaemia) can also cause a list of serious complications.

Hypoglcaemia occurs when the level of glucose in the blood drops far below the body’s needs. In fact, this condition is a rather common adverse effect of some oral antihyperglycemic agents such as insulin secretagogues, sulfonylureas and insulin treatment.

So, what happens when your glucose levels drop too low?

Hypoglycaemia Complications

According to Dr. Chan, “When your glucose levels are too low, you may blackout or fall which may cause head injuries, dislocation of joints or bone fractures. You may also experience more severe complications such as cerebrovascular diseases and coronary heart diseases.”

There are several stages of hypoglycaemia complications that you can experience. These include the following:

Mild

If your glucose reading based on a finger-stick test is <3.9 mmol/L, you may be experiencing mild hypoglycaemia. You may feel shaky, hungry and light headed. In some cases, you may not experience any symptoms.

Symptomatic Severe Hypoglcaemia

If your glucose reading is <2.8 mmol/L you may experience symptomatic hypoglycaemia (HA). To increase your glucose levels and combat these symptoms, you should consume sweets, sugary products or foods high in carbohydrate, which will immediately boost your glucose levels and reduce symptoms.

You may also need assistance from others to help you grab some sweet snacks to get your sugar levels up or maybe drive you home if you’re feeling weak or dizzy.

On a more serious side, a diabetic patient who has a low reading of <2.8 mmol/L may also experience symptomatic severe hypoglycaemia which requires medical attention (HMA). This situation is severe and you will need immediate medical care.

At this stage you are totally at risk and vulnerable to other serious medical conditions such as loss of consciousness, convulsions and seizures, according to Dr.Chan. As your body requires glucose, your medical officer may feed you carbohydrates or if you are unable to consume solids, you may require IV glucose drips.

Diabetes Management

Diabetes management, which includes education and awareness, is essential.

According to Dr. Zanariah, there is still a huge percentage of people who are unaware that they are suffering from diabetes.

Diabetes is not just for the elderly, people who suffer from various medical conditions or those who struggle with obesity. You can lead an active lifestyle, be in your 30s, have a healthy Body Mass Index (BMI) and still be diagnosed with diabetes.

Just like any other disease, diabetes should not be taken lightly as it can lead to a series of serious health complications. Be sure to keep track of your blood sugar levels and if you’re a diabetic, it is important to discuss the best treatment options with your doctor so you can properly manage your blood glucose levels. “Some patients are concerned with the effects of the medication they are consuming and this may include weight gain and cardiovascular safety,” says Dr. Zanariah. However, she adds that it is vital to remember that at the end of the day, it is about achieving glyceamic control.

“With two thirds of the patients not adhering to advice on diet and exercise and the majority of patients having less than 10 years of formal education, more awareness, initiatives and efforts are needed on glucose profiling and lifestyle modification for effective management of diabetes,” she stresses.

Dr. Zanariah also says that you can reduce your risk of developing diabetes, specifically Type 2 Diabetes Mellitus, by making healthy lifestyle choices which includes a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco.

Editor’s note: This symbol < indicates “less than”

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