What's wrong with dizziness, panic, and weak legs?

Hypoglycemia refers to a fasting blood glucose concentration in an adult below 2.8mmol/L. Hypoglycemia can be diagnosed in diabetic patients when their blood glucose level is ≤3.9 mmol/L. Hypoglycemia is a syndrome caused by a variety of factors, characterized by low venous plasma glucose (blood sugar) concentration, and clinically by sympathetic nerve excitement and brain cell hypoxia. Symptoms of hypoglycemia usually include sweating, hunger, palpitations, tremors, pale complexion, etc. In severe cases, patients may also experience inattention, restlessness, irritability, and even coma.

Clinically, repeated occurrence of fasting hypoglycemia indicates an organic disease; reactive hypoglycemia caused by meals is more common in functional diseases.

1. Fasting hypoglycemia

(1) Excessive secretion of endogenous insulin: Common causes include insulinoma, autoimmune hypoglycemia, etc.

(2) Drug-related: such as injection of insulin, sulfonylurea hypoglycemic drugs, salicylic acid, drinking alcohol, etc.

(3) Serious diseases: such as liver failure, heart failure, kidney failure, malnutrition, etc.

(4) Insulin antagonist hormone deficiency: such as glucagon, growth hormone, cortisol, etc.

(5) Extrapancreatic tumors.

2. Postprandial (reactive) hypoglycemia

(1) Congenital deficiency of carbohydrate metabolic enzymes: such as hereditary fructose intolerance.

(2) Idiopathic reactive hypoglycemia.

(3) Trophic hypoglycemia (including dumping syndrome).

(4) Functional hypoglycemia.

(5) Postprandial hypoglycemia in the early stages of type 2 diabetes.

prevention

Diabetic patients, especially elderly patients with cardiovascular and cerebrovascular diseases, should pay attention to preventing the occurrence of hypoglycemia.

1. Establish appropriate individualized blood sugar control goals.

2. Conduct diabetes education: including educating the patient's family, identifying hypoglycemia, understanding the pharmacokinetics of the patient's medications, self-help methods, etc.

3. Fully understand the risk factors that cause hypoglycemia: ① Eat at regular times and in regular amounts. If the amount of food consumed is reduced, the dosage of medication should be reduced accordingly; ② Additional carbohydrate intake should be increased before exercise; ③ Alcohol can directly cause hypoglycemia. Avoid excessive drinking and drinking on an empty stomach.

4. Adjust the blood sugar lowering plan: use insulin or insulin secretagogues rationally.

5. Monitor blood sugar regularly, especially when blood sugar fluctuates greatly or when environmental, exercise and other factors change.