With increasing urban lifestyles, diabetes is increasing in epidemic form around the globe. With the cumulative prevalence of diabetes, more and more people are becoming aware of diabetes and the implications of high blood sugar.

But they need to be aware of low blood sugar as well because it is also harmful. Any level of blood sugar, below 60 mg/100 ml in a fasting condition is low and known as hypoglycaemia.

Hypoglycaemia is a complication of diabetes both type 1 (insulin-dependent) and type 2 (non-insulin-dependent) but is more common with type 1 diabetes. Missing a meal for a diabetic person poses a risk of hypoglycaemia. The risk is enhanced by taking the anti-diabetic medication without meals. Taking an excess dose of anti-diabetic medications or insulin also lowers blood sugar levels. Physical and mental stress, use of alcohol, severe infections, dehydration, etc., can also cause hypoglycaemia in persons, more so in diabetic people.

Low blood sugar is not restricted to diabetic individuals. If a non-diabetic person misses a meal, they start to feel tired and listless. This happens because the blood glucose levels start reducing in the brain. Excess work to which one is not accustomed can cause hypoglycaemia in a person. Alcohol reduces blood glucose levels producing hypoglycaemia.

Whatever the cause, hypoglycaemia is a potentially fatal condition. The brain cells are highly dependent on glucose for their functioning. Therefore, the early stages of hypoglycaemia are characterised by difficulty in concentration and confusion. If it is not corrected at this stage it can lead to delirium, convulsions, unconsciousness, coma and even death.

Early treatment can reverse this condition, but if delayed it can be fatal. It can also lead to a permanent neurological deficit in some form, like paralysis of limbs or some parts of the body.

Other cells of the body also depend on glucose to obtain the necessary energy needed for their functioning. Therefore, as the blood glucose level goes down, one starts to feel exhausted. It becomes difficult to concentrate on the work at hand.

To combat the low blood glucose levels, the body starts compensating by producing counter-regulatory hormones like glucagon and adrenaline. Adrenaline causes palpitations, sweating and also a rise in blood pressure, rhythm disturbances of the heart and cardiac arrest in severe cases.

A person with diabetes has to be very careful about his or her diet. Small frequent meals are the best way to avoid hypoglycaemia. It is advisable to take hot tea, soup, a light snack, etc., before sleeping to avoid early morning hypoglycaemia.

One has to be very particular about the timings of meals also. Diabetic patients are instructed to carry some food with them always, if away from home. On experiencing, the earliest symptom of hypoglycaemia they should take a bite. One should never miss a meal, especially breakfast to prevent low blood glucose levels.

Alcohol should be avoided in all persons irrespective of their diabetic status as it is harmful to health in many ways.

Physical exercise if started recently should not be very strenuous to begin with. Any exercise done should be increased in quantity gradually. This prevents hypoglycaemia and also muscle damage.

Hypoglycaemia is a condition of the body which can be easily diagnosed by the affected person himself. Only thing is that one should be aware of the condition, its symptoms and its consequences.

On experiencing any one or more symptoms of hypoglycaemia, all that is needed is to have a small bite or a hot sweet drink. This is very useful in mild cases. Failure to do that, as the condition progresses, may lead to hospitalisation for injections of glucose.

Dr Rachna Pande is a specialist in internal medicine.