Question

What causes low blood sugar? What should be done if you have symptoms of this condition? Thank you very much!

Answer

The causes of low blood sugar mainly include:

  1. Fasting low blood sugar:
    • Excessive glucose utilization:
      • High insulin levels: such as insulinoma; infants of mothers with high insulin levels; excessive use of insulin, sulfonylurea diabetes drugs, salicylates, propranolol, dichloroacetic acid, monoamine oxidase inhibitors, etc.
    • Insufficient glucose production:
      • Endocrine diseases: such as hypopituitarism, adrenal insufficiency, hypothyroidism;
      • Glucose storage disease;
      • Severe liver disease and hepatic congestion;
      • Advanced kidney disease;
      • Galactosemia (due to deficiency of galactose-1-phosphate uridyltransferase, which prevents galactose from being converted to glucose).
      • Others: chronic alcoholism (inhibits gluconeogenesis); sepsis; starvation; cachexia; intense exercise, etc.
  2. Postprandial (reactive) low blood sugar:
    • Functional hypoglycemia (emotional instability and neuroticism, more common in middle-aged women).
    • Nutritional insulin hypersecretion: such as dumping syndrome after gastric bypass surgery; after pyloroplasty and gastrojejunostomy.
    • Spontaneous hypoglycemia in children.
    • Mild early diabetes (delayed insulin peak).