Presentation
Recognizing these psychiatric presentations is crucial in order to stabilize patients and prevent unnecessary testing. [ncbi.nlm.nih.gov]
Review the disposition of a patient presenting to the emergency department with hypoglycemia. Hypoglycemia is an important and easily reversible cause of altered mental status in patients presenting to the emergency department. [saem.org]
Entire Body System
- Weakness
A 50-year-old woman with a large right breast mass was emergently hospitalized for generalized weakness and fatigue. A histological examination of tumor biopsy specimens revealed a phyllodes tumor (PT). [ncbi.nlm.nih.gov]
shaky, or lightheaded If you suddenly feel weak, shaky, or lightheaded—or you even faint–you could be experiencing these common signs of hypoglycemia. [healthcentral.com]
Weakness or shaking. Moist skin, sweating. Fast heartbeat. Dizziness. Sudden hunger. Confusion. Pale skin. Numbness in mouth or tongue. Irritability, nervousness. Unsteadiness. Nightmares, bad dreams, restless sleep. [my.clevelandclinic.org]
Signs include hunger shakiness dizziness confusion difficulty speaking feeling anxious or weak in people with diabetes, hypoglycemia is often a side effect of diabetes medicines. Eating or drinking something with carbohydrates can help. [icd9data.com]
It’s normal to feel fatigue, weakness, or have a headache periodically, especially if someone has had a stressful day or too little sleep. [rchsd.org]
- Falling
Diabetics are more prone to hypoglycemia and are advised to carry such food items at all times in case of a falling blood sugar that needs urgent correction. [news-medical.net]
In certain situations, plasma glucose may fall to a dangerous level. When plasma glucose falls, hormonal and sympathoadrenal mechanisms get activated to restore glucose levels to normal. [medlink.com]
Blood sugar levels in someone with diabetes are considered low when they fall below the target range. [kidshealth.org]
Hypoglycemia occurs when they level of glucose or sugar present in the blood falls below a set point - 4 mmol/L (millimoles per litre). Some people get confused regarding the spelling of hypoglycemia. [web.archive.org]
The body first responds to a fall in the level of glucose in the blood by releasing epinephrine from the adrenal glands. [msdmanuals.com]
- Unconsciousness
A 53-year-old woman fell unconscious during postprandial exercises. [ncbi.nlm.nih.gov]
Consult with Your Doctor It’s imperative to monitor and treat low blood sugars immediately in order to prevent severe hypoglycemia and unconsciousness. [beyondtype2.org]
Severe low blood sugars are those less than 40 mg., those requiring help from another person, or those which cause you to have a convulsion or become unconscious. [uihc.org]
- Fatigue
Sugar and Adrenal Fatigue For this reason, it is common for those with Stage 3 and beyond Adrenal Fatigue to require sugar replenishment every 2-3 hours. A small snack usually suffices. In fact, as Adrenal Fatigue recovers, this period lengthens. [drlam.com]
With each plunge their adrenal fatigue can increase and their hypoglycemia may worsen. To the body, hypoglycemia is a strong stressor, an emergency call to action that can further drain already fatigued adrenals. [adrenalfatigue.org]
— Sy Mukherjee, Fortune, "A $43 Billion Biotech Now Has a Female CEO: Brainstorm Health," 25 July 2019 Firshein begins by looking for underlying causes of fatigue or the ability to focus, such as hormone imbalance or conditions such as hypothyroidism [merriam-webster.com]
A system‑wide disturbance is created that results in one of the endocrine fatigue syndromes we call hypoglycemia. The standard for diagnosis has been the five-hour glucose tolerance test (GTT). [fibromyalgiatreatment.com]
It comes from being inside an office building without natural ventilation and natural light, resulting in a general feeling of malaise or fatigue. Dr. [thebalance.com]
- Malnutrition
Physicians should be aware of the possibility of carnitine deficiency and/or severe hypoglycemia, especially in hemodialysis patients with malnutrition. [Indexed for MEDLINE] Free full text [ncbi.nlm.nih.gov]
Alcohol together with liver disease (cirrhosis) and malnutrition Medical drugs + predisposition see list ( Drugs ) factitious hypoglycaemia Insulin or anti-diabetic drugs (beta-cytotropic agents, i.e. sulfonylureas) extreme physical activity extreme athletics [web.archive.org]
If glucose is abnormally low, and no cause can be identified from history (eg, drugs, adrenal insufficiency, severe malnutrition, organ failure or sepsis), serum insulin, insulin antibodies and sulfonylurea level should be checked. [msdmanuals.com]
Disorders of glucose underproduction Inadequate glucose stores are associated with prematurity, infants who are small for gestational age, malnutrition, and ketotic hypoglycemia. [emedicine.com]
Gastrointestinal
- Nausea
Few hours later, she developed a strong food craving, nausea, abdominal pain, and a headache. The lowest recorded serum glucose was 44 mg/dl (2.4 mmol/l) 14 h post-ingestion. [ncbi.nlm.nih.gov]
We present a 45-fold overdose of liraglutide (confirmed by P-liraglutide measurements) leading to nausea and vomiting, but no hypoglycaemia and no sign of pancreatitis. [pure.au.dk]
Hypoglycemia may be associated with symptoms such as anxiety, sweating, tremor, palpitations, nausea, and pallor. Hypoglycemia also starves the brain of glucose energy, which is essential for proper brain function. [rxlist.com]
Symptoms can include trembling, nausea, drowsiness, dizziness, headaches, confusion, or even a loss of consciousness. Learn more about low blood glucose and tips to help keep your blood glucose levels steady. [healthlinkbc.ca]
- Vomiting
We present a 45-fold overdose of liraglutide (confirmed by P-liraglutide measurements) leading to nausea and vomiting, but no hypoglycaemia and no sign of pancreatitis. [pure.au.dk]
A 66-year-old woman presented to an urgent care clinic for 2 to 3 weeks of general malaise, nausea/vomiting, night sweats, and dyspnea. [ncbi.nlm.nih.gov]
Children may vomit. Causes/Pathophysiology : Currently idiopathic. [pedclerk.bsd.uchicago.edu]
[…] responsive subtypes; classic form presents in the first week of life with ketoacidosis, hypoglycemia, emesis, neonatal seizures, and hypertonia; the intermediate and intermittent forms present in childhood or later with acute episodes of ataxia and vomiting [icd9data.com]
A 41 years old male was hospitalized with 4 days history of fever, headache vomiting and icterus. On examination he was found to be in good mental status, had a normal blood pressure, and a body temperature of 40°C. [neliti.com]
- Failure to Thrive
At 3 months of age, she had ichthyosis, growth retardation, and failure to thrive. She had not cytopenia. Ultrasonography (US) showed pancreatic diffuse high echogenicity. [ncbi.nlm.nih.gov]
Hepatomegaly, jaundice, cataracts, failure to thrive, sepsis ( E. coli ), diarrhea, vomiting, pseudotumor cerebri, mental retardation and renal Fanconi syndrome. Usually presents in first few days of life, or after milk exposure. [pedclerk.bsd.uchicago.edu]
Cardiovascular
- Palpitations
Hypoglycemia, which is characterized mainly by palpitations, dizziness, and sweating, is common and easy to identify. [ncbi.nlm.nih.gov]
Hypoglycemia may be associated with symptoms such as anxiety, sweating, tremor, palpitations, nausea, and pallor. Hypoglycemia also starves the brain of glucose energy, which is essential for proper brain function. [rxlist.com]
Autonomic Neuroglycopenic General malaise Sweating Palpitations Shaking Hunger Confusion Drowsiness Odd behavior Speech difficulty Incoordination Headache Nausea Table 4. Edinburgh hypoglycemia scale. 8. [intechopen.com]
Common Symptoms of Hypoglycemia: Fine tremors Excessive sweating Dizziness Palpitations Fatigue Pale skin Confusion Loss of consciousness Coma Risk factors for Hypoglycemia: Low blood sugar can happen to anyone. [rxdx.in]
They may also have palpitations (rapid, pounding, and/or irregular heartbeat) or tremors. Sweating is common during periods of hypoglycemia. Seizures and loss of consciousness are rare. [jamanetwork.com]
- Hypertension
On hospital day 8 the patient developed hypertensive emergency and was taken to the operating room for exploratory laparotomy. Twenty-two poorly wrapped packages were removed from the bowel. [ncbi.nlm.nih.gov]
Dr.Mehra has vast experience in diagnosing and medically treating all kinds of ailments and medical conditions like Diabetes, Hypertension, Thyroid Disorders, Asthma, Emphysema and other chronic medical conditions in patients of all ages. [rxdx.in]
Hyperinsulinemia can also result from in utero or perinatal stress (eg, maternal hypertension, prematurity, small for gestational age, hypoxia, Caesarian delivery). [5] These infants have no genetic mutations. [emedicine.com]
Hsu et al[ 31 ] performed a nationwide cohort study, and suggested that comorbidities such as hypertension and renal disease are associated with hypoglycemic episodes. [doi.org]
- Heart Failure
A CASE REPORT: The authors describe a case of a 39-year-old female with so far untreated advanced AN, admitted to hospital due to profound hypoglycemia (17 mg/dl), cachexia (BMI 11) and with heart failure. [ncbi.nlm.nih.gov]
They include kidney, liver, or heart failure, infection, low levels of certain hormones (such as cortisol or growth hormone), certain tumors, some types of stomach surgery, and starvation. [jamanetwork.com]
Nondiabetic patients [2][3] Causes of hypoglycemia in nondiabetic patients Critical illness Hepatic disease Renal failure Heart failure Malnutrition Sepsis Trauma Burns Drugs that cause hypoglycemia [3] Nonselective beta blockers Antimalarial drugs: quinine [amboss.com]
- Tachycardia
Signs and symptoms include tachypnea, respiratory distress, tachycardia or bradycardia, lethargy, and seizures 775.6 Excludes infant of mother with diabetes mellitus ( 775.0 ) ICD-9-CM Coding Information 775.6 is only applicable to newborns of age 0 years [icd9data.com]
The typical patient presenting with acute hypoglycemia will have an altered mental status and exhibit tachycardia and diaphoresis. [saem.org]
Hypoglycemia manifests with autonomic symptoms (i.e., hunger, sweating, tachycardia) and neuroglycopenic symptoms (i.e., confusion, behavioral changes, somnolence). [amboss.com]
The primary hormone that produces tachycardia and pale, cool and clammy skin in the shock patient is epinephrine, which is also released in the hypoglycemic patient producing similar signs. [ems1.com]
Tachycardia, the medical name for an especially fast heartbeat, has also been reported. Cold sweats are another reported symptom. [lifeseasons.com]
- Hypotension
WARNINGS AND PRECAUTIONS Hypotension: Empagliflozin causes intravascular volume contraction and symptomatic hypotension may occur. [jardiancehcp.com]
In AN various cardiac complications may occur: hypotension, bradycardia, life-threatening ventricular arrhythmias, pericardial effusion, reduction of left ventricular mass and impairment of its function. [ncbi.nlm.nih.gov]
Symptoms of a serious allergic reaction to GlucaGen ® may include rash, difficulty breathing, or low blood pressure (hypotension) The most common side effects of GlucaGen ® include: nausea vomiting temporary fast heartbeat or pounding in your chest (tachycardia [glucagenhypokit.com]
Skin
- Sweating
Severe hypoglycemia eventually lead to glucose deprivation of the central nervous system resulting in hunger; sweating; paresthesia; impaired mental function; seizures; coma; and even death Abnormally low blood sugar Abnormally low level of glucose in [icd9data.com]
Hypoglycemia causes hunger, sweating, shakiness, and weakness, and makes it hard to think clearly If you have diabetes, you're more likely to get hypoglycemia—it can happen if you take too much medicine, don’t eat enough, or exercise too much To treat [msdmanuals.com]
Hypoglycemia causes hunger, sweating, shakiness, weakness, and makes it hard to think clearly If you have diabetes, you're more likely to get hypoglycemia—it can happen if you take too much medicine, don’t eat enough, or exercise too much To treat hypoglycemia [merckmanuals.com]
During the treatment of intestinal obstruction, the patient presented paroxysmal loss of consciousness and sweating. [ncbi.nlm.nih.gov]
Extreme fatigue, especially when the symptoms of shakiness, dizziness, or sweating are present, could be a warning sign of reactive hypoglycemia. [thebalance.com]
Musculoskeletal
- Muscle Cramp
Certain drugs other than those for diabetes, most notably pentamidine, used to treat a form of pneumonia that occurs most often as part of AIDS, and quinine, used to treat muscle cramps, occasionally cause hypoglycemia. [msdmanuals.com]
- Muscle Twitch
Symptoms of muscle twitching, irritability, and/or increased urination. Poor appetite that does not improve. If you notice excessive sleepiness, confusion. [chemocare.com]
Eyes
- Blurred Vision
This can cause dizziness, headache, blurred vision, difficulty concentrating and other neurological symptoms. Hypoglycemia also triggers the release of body hormones, such as epinephrine and norepinephrine. [health.harvard.edu]
You have blurred vision or vision changes. You feel very tired and weak. You are sweating more than usual for you. You have a fast heartbeat. You feel dizzy, lightheaded, and shaky. You have questions about your condition or care. [drugs.com]
[…] anxious feeling behavior change similar to being drunk blurred vision cold sweats confusion cool pale skin difficulty in concentrating drowsiness excessive hunger fast heartbeat headache nausea nervousness nightmares restless sleep shakiness slurred speech [beyondtype1.org]
More severe hypoglycemia reduces the glucose supply to the brain, causing dizziness, fatigue, weakness, headaches, inability to concentrate, confusion, inappropriate behavior that can be mistaken for drunkenness, slurred speech, blurred vision, seizures [msdmanuals.com]
- Diplopia
It may also present with transient hemiplegia, hypothermia or hyperthermia, convulsions, diplopia and strabismus [ 9 ]. If untreated, it can progress to stupor, coma and, exceptionally, death. [patient.info]
[…] contents) autonomic symptoms (sympathetic activation) Diaphoresis Tremulousness, anxiety Tachycardia, palpitations, increased blood pressure Hunger brain dysfunction is usually the most obvious clinical finding Confusion Visual changes (blurred vision, diplopia [emcrit.org]
It can also include transient focal neurological deficits such as diplopia, hemiparesis. Neurogenic and neuroglycopenic symptoms are manifested by the activation of the sympatho-adrenal system and brain’s glucose deprivation. [intechopen.com]
Neurologic
- Confusion
What you will feel is probably: shaky, a bit confused, a little uncoordinated, sweaty, some peoples eyes go funny. [web.archive.org]
In some cases, people with normal blood glucose levels experience symptoms that can be confused with hypoglycemia. [msdmanuals.com]
You may become very confused and unable to manage your condition. In severe cases, you may even lose consciousness, have a seizure, or go into a coma. [hormone.org]
When to see a doctor Hypoglycemia can leave you confused or even unconscious, which requires emergency care. Make sure your family, friends and co-workers know what to do. [mayoclinic.org]
- Seizure
He demonstrated progressive encephalopathy, seizure activity, second-degree atrioventricular block type I, respiratory failure, hypotension, hypothermia, and hypoglycemia. [ncbi.nlm.nih.gov]
Severe hypoglycemia eventually lead to glucose deprivation of the central nervous system resulting in hunger; sweating; paresthesia; impaired mental function; seizures; coma; and even death Abnormally low blood sugar Abnormally low level of glucose in [icd9data.com]
However, not all are aware that these symptoms can rapidly progress to seizures, coma and even death if hypoglycemia is severe. [hopkinsmedicine.org]
Hypoglycemic encephalopathy, comprising of delirium, coma, seizures, and a "stroke-like illness" was described in the 1960s. In most hospitals, a lower limit of normal plasma glucose is 70 mg/dL. [medlink.com]
In severe cases, you may even lose consciousness, have a seizure, or go into a coma. [hormone.org]
- Dizziness
This can cause dizziness, headache, blurred vision, difficulty concentrating and other neurological symptoms. Hypoglycemia also triggers the release of body hormones, such as epinephrine and norepinephrine. [health.harvard.edu]
Hypoglycemia, which is characterized mainly by palpitations, dizziness, and sweating, is common and easy to identify. [ncbi.nlm.nih.gov]
The challenge is to recognize the mild symptoms, which can vary in different people, but might include dizziness, sweating, drowsiness and a pounding heartbeat. Severe symptoms can include impaired vision, confusion, seizures, and unconsciousness. [web.archive.org]
Dizziness. Sudden hunger. Confusion. Pale skin. Numbness in mouth or tongue. Irritability, nervousness. Unsteadiness. Nightmares, bad dreams, restless sleep. You might pass out if your hypoglycemia is not treated. [my.clevelandclinic.org]
Signs include hunger shakiness dizziness confusion difficulty speaking feeling anxious or weak in people with diabetes, hypoglycemia is often a side effect of diabetes medicines. Eating or drinking something with carbohydrates can help. [icd9data.com]
- Headache
If you have a cluster headache, sinus headache, migraine headache or any other type of headache you may want to consult a doctor. Long Lasting Relief Always have Vanquish ® on hand to provide effective, yet gentle headache relief. view product info ❯ [vanquishheadacherelief.com]
We have found that some patients who are viewed as receiving sufficient doses of glucocorticoids occasionally exhibit morning headache or morning discomfort, which may be caused by unrecognized nocturnal hypoglycemia. [ncbi.nlm.nih.gov]
It’s normal to feel fatigue, weakness, or have a headache periodically, especially if someone has had a stressful day or too little sleep. [rchsd.org]
This can cause dizziness, headache, blurred vision, difficulty concentrating and other neurological symptoms. Hypoglycemia also triggers the release of body hormones, such as epinephrine and norepinephrine. [health.harvard.edu]
- Irritability
An infant presented with short history of jaundice and irritability, examination showed soft hepatomegaly. [ncbi.nlm.nih.gov]
Irritability, nervousness. Unsteadiness. Nightmares, bad dreams, restless sleep. You might pass out if your hypoglycemia is not treated. Get useful, helpful and relevant health + wellness information enews More health news + info [my.clevelandclinic.org]
Symptoms Early warning signs and symptoms Early signs and symptoms of diabetic hypoglycemia include: Shakiness Dizziness Sweating Hunger Irritability or moodiness Anxiety or nervousness Headache Nighttime symptoms Diabetic hypoglycemia can also occur [mayoclinic.org]
[…] abnormal behavior lightheadedness unsteady movement inability to concentrate personality changes headache restlessness depressed mood tingling in the hands, feet, lips, or tongue irritability abnormal behavior lightheadedness unsteady movement inability [glucagenhypokit.com]
Symptoms If you’re not carrying around a blood testing kit, here are some other symptoms that may indicate a hypoglycemic state: Sweating Shakiness, dizziness, weakness Anxiety Rapid pulse Irritability (if you’re “hangry” – ‘hungry’ and ‘angry’ – chances [woundcareinc.com]
Workup
This case highlights the importance of an appropriate workup that can lead to avoidance of unnecessary testing in such patients. [ncbi.nlm.nih.gov]
Perform diagnostic workup based on the leading differential diagnosis and whether the patient has diabetes or not. If the Whipple triad is not confirmed, no further workup is indicated. [amboss.com]
Some patients may present with typical symptoms of neuroglycopenia like slurred speech, confusion, and, rarely, seizures and coma, in which case further workup is required. [emedicine.com]
Urine
- Ketonuria
[…] seizures, and hypertonia; the intermediate and intermittent forms present in childhood or later with acute episodes of ataxia and vomiting Applies To Disturbances of metabolism of leucine, isoleucine, and valine Hypervalinemia Intermittent branched-chain ketonuria [icd9data.com]
Serum
- Hypoglycemia
Convert to ICD-10-CM : 251.2 converts directly to: 2015/16 ICD-10-CM E16.2 Hypoglycemia, unspecified Approximate Synonyms Hypoglycemia Hypoglycemia (low blood sugar) Hypoglycemia (low blood sugar), reactive Hypoglycemia unawareness Hypoglycemia, reactive [icd9data.com]
Hypoglycemia unawareness. Sometimes people with diabetes don’t feel or recognize the symptoms of hypoglycemia, a problem called hypoglycemia unawareness. [niddk.nih.gov]
- Glucose Decreased
In a 24-week continuous glucose monitoring (CGM) substudy, postprandial glucose decreased ( P ≤ 0.009) and CGM demonstrated up to 3 h more time in the target range of 3.9-10.0 mmol/L with sotagliflozin. [ncbi.nlm.nih.gov]
Low blood sugar is a condition that occurs when the body's blood sugar (glucose) decreases and is too low. Blood sugar below 70 mg/dL (3.9 mmol/L) is considered low. Blood sugar at or below this level can be harmful. [nlm.nih.gov]
The fast is terminated at 72 hours if the patient has experienced no symptoms and glucose remains normal, sooner if glucose decreases to ≤ 45 mg/dL (≤ 2.5 mmol/L) in the presence of hypoglycemic symptoms. [msdmanuals.com]
- Glucagon Increased
Insulin levels were not different among sessions, whereas glucagon increased with MDG administration ( P < 0.001). [ncbi.nlm.nih.gov]
Glucagon increases the amount of glucose in the blood by breaking down stored glucose (starch, called glycogen) and releasing it from the liver into the bloodstream. [emedicinehealth.com]
Treatment
While dietary restriction alone did not result in sufficient glucose control in this patient with autoimmune hypoglycemia, treatment with hydrothermally modified slow release corn starch led to stable euglycemia. [ncbi.nlm.nih.gov]
You have diabetes and hypoglycemia isn't responding to treatment. Initial treatment of hypoglycemia is drinking juice or regular soft drinks, eating candy or taking glucose tablets. [mayoclinic.com]
Treatment of hypoglycemia consists of correcting the glucose deficiency and directing further treatment to the underlying cause. [3, 4, 5, 6, 7, 8] Consultation is guided generally by determination of the underlying cause of hypoglycemia. [emedicine.com]
Prognosis
Insulin-like growth factor 2 is overexpressed in various cancers, and is associated with a poor prognosis. Also, it is known that insulin-like growth factor 2 is an etiology of non-islet cell tumor hypoglycemia. [ncbi.nlm.nih.gov]
In ill, hospitalized patients, spontaneous hypoglycemia that is not caused by drugs portends a poor prognosis and can occur when poor nutrition is combined with advanced organ failure (especially liver, kidney, or heart failure) and/or sepsis. [msdmanuals.com]
Etiology
Clinical hypoglycemia has diverse etiologies. [icd9data.com]
Also, it is known that insulin-like growth factor 2 is an etiology of non-islet cell tumor hypoglycemia. In this report, we describe a case of unexpected hypoglycemia caused by a dedifferentiated liposarcoma producing insulin-like growth factor 2. [ncbi.nlm.nih.gov]
Epidemiology
Few studies have examined the epidemiology of hypoglycemia in a community-based population. RESEARCH DESIGN AND METHODS: We included 1,206 Atherosclerosis Risk in Communities (ARIC) Study participants with diagnosed diabetes (baseline: 1996-1998). [ncbi.nlm.nih.gov]
Epidemiology of severe hypoglycemia in the diabetes control and complications trial. Am J Med 1991;90:450–9. Davis EA, Keating B, Byrne GC, et al. [guidelines.diabetes.ca]
Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000 ; 283 : 2008 -12. ↵ Noto H, Goto A, Tsujimoto T, Noda M. [doi.org]
Epidemiology Hypoglycaemia is uncommon in people without diabetes [ 2 ]. Aetiology [ 2, 4 ] Alcohol is the most common non-iatrogenic (non-physician) cause of hypoglycaemia in adults. [patient.info]
Data from various epidemiological studies are shown in Tables 1 and 2. Epidemiological data from interventional trials The U.K. [care.diabetesjournals.org]
Pathophysiology
Causes/Pathophysiology : Currently idiopathic. [pedclerk.bsd.uchicago.edu]
Physiology and pathophysiology To understand the signs and symptoms of hypoglycemia, one must comprehend some basic normal physiology and pathophysiology. The primary energy fuel for cells is glucose. [ems1.com]
[…] information 1 Department of Internal Diseases, Diabetology, and Cardiometabolic Diseases, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland. [email protected]. 2 Department of Pathophysiology [ncbi.nlm.nih.gov]
In this article, the author has described the definition, physiology, pathophysiology, clinical features, imaging abnormalities, and management of hypoglycemia. [medlink.com]
Thursday October 06, 2016 Many patients with diabetes often do not completely grasp the consequences of hypoglycemia and hyperglycemia on vascular health, and health care providers should not assume that a patient has been well educated on the pathophysiology [contemporaryclinic.pharmacytimes.com]
Prevention
Current approaches to prevent exercise-induced hypoglycemia include reduction in insulin dose or ingestion of carbohydrates, but these strategies may still result in hypoglycemia or hyperglycemia. [ncbi.nlm.nih.gov]
Prevention In the short term, confusion or fainting can cause a fall or an accident. Over the long term, repeated hypoglycemia can have serious health consequences. [diabete.qc.ca]
The severe symptoms alter the person’s mental state, sometimes preventing them from consuming more sugar. Standardization of insulin doses was important for preventing accidental insulin overdoses, which lead to hypoglycemia. [web.archive.org]