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Expert Q&A

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Are my daily low blood-sugar spells dangerous?

Asked by Beth, Worcester, Massachusetts

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I tend to get low blood sugar at times throughout the day. I work out on a regular basis and have difficulty knowing when to eat, what to eat, how much to eat before a workout. So, information on that would be helpful.

Also I am curious what kind of internal damage, if any, am I doing each time I experience low blood sugar?

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Conditions Expert Dr. Otis Brawley Chief Medical Officer,
American Cancer Society

Expert answer

Dear Beth:

Thanks for your question. Many people worry about low blood sugar, but in reality this is rarely a problem for other than diabetics under tight blood sugar control. Those few nondiabetics can usually avoid it with small frequent snacks containing carbohydrates.

In order to be considered hypoglycemic the person has to have:

1) Symptoms of hypoglycemia,

2) A documented low blood sugar (less than 60 mg/dl) using a laboratory measurement -- not a personal glucometer -- and

3) relief of the symptoms after consumption of sugar.

The symptoms of low blood sugar are sweating, trembling, a sensation of warmth, anxiety, nausea, palpitations, a fast heart rate and hunger. Most true hypoglycemic people have three or four of these symptoms and not all of them.

Very low blood sugar can cause fatigue, dizziness, headache, visual disturbances, drowsiness and ultimately loss of consciousness and seizures. Again, all people with very low blood sugar will most likely not have all symptoms.

Occasionally, people get hypoglycemia because they're taking certain drugs such as aspirin-like drugs, quinine-like drugs and antipsychotics such as haloperidol, or consuming alcohol. Extreme exercise also can lead to this condition.

By far the most common cause of hypoglycemia is treatment of diabetes that is too strict. Some diabetics can actually get hypoglycemic by missing a meal or having a meal with fewer starches and carbohydrates than expected. Very rarely, hypoglycemia can be the result of a malignancy secreting insulin (this is called an insulinoma). This is so rare most experienced physicians have never seen such a patient.

Long-term, numerous bouts of low blood sugar can lead to difficulty speaking, inability to concentrate, abnormal behavior, loss of memory and confusion. This again is rarely seen in other than diabetics.

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