Hypoglykémie

Hypoglykémie, also spelled hypoglycémie in some languages, refers to abnormally low blood glucose levels. It is typically defined in clinical practice as plasma glucose below 3.9 mmol/L (70 mg/dL) and is most commonly encountered in people with diabetes who are treated with insulin or insulin secretagogues. It can also occur in non-diabetic individuals due to critical illness, hormonal deficiencies, liver disease, or excessive alcohol intake combined with fasting.

Symptoms develop as the body responds to low glucose and can be autonomic (sweating, tremor, palpitations, anxiety) or neuroglycopenic (confusion, dizziness, weakness, difficulty speaking, visual disturbances). Severe hypoglycemia can cause seizures, loss of consciousness, coma, and brain injury if not promptly treated.

Diagnosis relies on documenting low plasma glucose during symptoms, known as Whipple’s triad: symptoms compatible with hypoglycemia, a measured plasma glucose below threshold, and relief after glucose administration. In practice, capillary glucose (finger-stick) is used in the community and plasma glucose in labs.

Immediate management for conscious individuals is to consume 15–20 g of fast-acting carbohydrate (glucose tablets, juice, regular soda). Recheck after 15 minutes and repeat if still low. If symptoms do not resolve or the person is unable to swallow or is unconscious, administer glucagon if available or seek emergency medical care. After recovery, include a longer-acting carbohydrate and a meal or snack to prevent recurrence.

Prevention includes regular monitoring, adjusting medications (especially insulin or sulfonylureas), eating regular meals, limiting alcohol, and education to recognize early symptoms. Recurrent hypoglycemia or hypoglycemia unawareness requires medical review to identify underlying causes and modify therapy.