Materiały źródłowe

• #1 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. Impairments in counterregulatory responses and hypoglycemia unawareness constitute the main risk factors for severe hypoglycemia. […] Risk factors for hypoglycemia can be from therapeutic hyperinsulinemia or failure of defense mechanisms from a drop in plasma glucose concentration. Conditions causing therapeutic hyperinsulinemia include: (1) Treatment with insulin, sulfonylureas, or glinides, if administered at high dose or with incorrect timing related to meal; (2) Lack of exogenous glucose, such as when eating a very low carbohydrate food portion, or during prolonged fasting; Lack of endogenic glucose production after drinking alcohol, (3) Increase in glucose consumption during or after physical exercise; (4) Increase in insulin sensitivity due to weight loss or physical exertion; and (5) Drop in insulin excretion under conditions such as renal failure, hepatic failure, and hypothyroidism.

• #2 Low Blood Glucose (Hypoglycemia) | ADA

  https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose

  Low blood glucose is when your levels fall below 70 mg/dL. […] Severe low blood glucose is an emergency and will require help from others to treat it. […] Low blood glucose, sometimes just called a low, is when your blood glucose levels have fallen low enough that you need to take action to bring them back to your target range. This is usually when your blood glucose is less than 70 mg/dL. […] It’s important to talk to your health care professional about your own blood glucose levels and if you’re at risk for going low. […] There are many things that can cause blood glucose levels to drop. It is especially common for people with type 1 diabetes or people with type 2 diabetes taking insulin or other similar medications. […] Understanding what causes your blood glucose to go down is important so you can steps to prevent lows from happening. […] When low blood glucose isn’t treated and you need someone to help you treat it, it’s considered severe hypoglycemia.

• #3 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia occurs when your blood sugar (glucose) level falls too low for bodily functions to continue. There are several reasons why this can happen. The most common reason for low blood sugar is a side effect of medications used to treat diabetes. […] If you have diabetes, you might not make insulin (type 1 diabetes) or you might be less responsive to it (type 2 diabetes). As a result, glucose builds up in the bloodstream and can reach dangerously high levels. To correct this problem, you might take insulin or other medications to lower blood sugar levels. […] But too much insulin or other diabetes medications may cause your blood sugar level to drop too much, causing hypoglycemia. Hypoglycemia can also occur if you eat less than usual after taking your regular dose of diabetes medication, or if you exercise more than you typically do.

• #4 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors.[1] […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia.[2] […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #5 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Hypoglycemia happens when your blood sugar drops below a healthy range. Several factors can contribute to this for people with diabetes. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance. […] Common situations that can lead to hypoglycemia for people with diabetes include: Taking too much insulin, the wrong insulin or injecting it into your muscle instead of in your fat tissue. […] Hypoglycemia happens when your blood sugar drops below a healthy range. Several factors can contribute to this for people with diabetes. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance. […] There are two main types of non-diabetes-related hypoglycemia: reactive hypoglycemia and fasting hypoglycemia. […] Reactive hypoglycemia happens when you experience low blood sugar after a meal. It typically occurs about two to four hours after a meal.

• #6 Causes and How to Prevent Hypoglycemia (Low Blood Glucose) | American Diabetes Association

  https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/causes-prevention

  Hypoglycemia (or low blood glucose) is common for people with type 1 diabetes. It also can occur in people with type 2 diabetes taking insulin or certain diabetes medications. […] The average person with type 1 diabetes has low blood glucose levels up to twice a week, and thats only counting episodes with symptoms. If you add in lows without symptoms and the ones that happen overnight, the number would likely be higher. […] Too much insulin or certain diabetes medications is a common cause of low blood glucose. Miscalculating for how many carbs you’ve eating can lead to giving too much insulin, resulting in a low. But there are a few other ways insulin can cause hypoglycemia. […] Not eating enough food. If you start eating smaller portions (or even when you start trying to make healthier food choices), eat less carbs then you planned to, or skip a meal or snack, it can lead to a low.

• #7 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Hypoglycemia happens when your blood sugar drops below a healthy range. Several factors can contribute to this for people with diabetes. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance. […] Common situations that can lead to hypoglycemia for people with diabetes include: Taking too much insulin, the wrong insulin or injecting it into your muscle instead of in your fat tissue. […] Hypoglycemia happens when your blood sugar drops below a healthy range. Several factors can contribute to this for people with diabetes. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance. […] There are two main types of non-diabetes-related hypoglycemia: reactive hypoglycemia and fasting hypoglycemia. […] Reactive hypoglycemia happens when you experience low blood sugar after a meal. It typically occurs about two to four hours after a meal.

• #8 Hypoglycemia in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=hypoglycemia-in-children-90-P01960

  Hypoglycemia can be a condition by itself. Or it can be a complication of diabetes or other disorder. Its most often a problem in someone with diabetes. It occurs when theres too much insulin. This is also called an insulin reaction. […] Causes in children with diabetes may include: Too much insulin or oral diabetes medicine […] The wrong kind of insulin […] Incorrect blood-glucose readings […] A missed meal […] A delayed meal […] Not enough food eaten for the amount of insulin taken […] More exercise than usual […] Diarrhea or vomiting […] Injury, illness, infection, or emotional stress […] Other health problems, such as celiac disease or an adrenal problem […] Taking diabetes medicine called sulfonylurea […] Problems present at birth (congenital) with how the body processes glucose and starches

• #9 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. Impairments in counterregulatory responses and hypoglycemia unawareness constitute the main risk factors for severe hypoglycemia. […] Risk factors for hypoglycemia can be from therapeutic hyperinsulinemia or failure of defense mechanisms from a drop in plasma glucose concentration. Conditions causing therapeutic hyperinsulinemia include: (1) Treatment with insulin, sulfonylureas, or glinides, if administered at high dose or with incorrect timing related to meal; (2) Lack of exogenous glucose, such as when eating a very low carbohydrate food portion, or during prolonged fasting; Lack of endogenic glucose production after drinking alcohol, (3) Increase in glucose consumption during or after physical exercise; (4) Increase in insulin sensitivity due to weight loss or physical exertion; and (5) Drop in insulin excretion under conditions such as renal failure, hepatic failure, and hypothyroidism.

• #10 Hypoglycemia (Low Blood Sugar): Symptoms, Causes, Treatment, Diet

  https://www.webmd.com/diabetes/hypoglycemia-overview

  When you have diabetes, your body has a hard time making or using insulin. Treatment usually includes insulin or other drugs to help manage your blood sugar. But if you take too much of these drugs or inject insulin into muscle instead of fatty tissue, then your blood sugar can drop. In addition to insulin, medications called meglitinides and sulfonylureas can cause low blood sugar. Repaglinide (Prandin) and nateglinide (Starlix) are two common meglitinides. Commonly used sulfonylureas include: Glimepiride (Amaryl) […] Glipizide (Glucotrol) […] Glyburide (Diabeta, Micronase) […] Micronized glyburide (Glynase). Older types of sulfonylureas tend to cause low blood sugar more often than newer ones. Examples of older drugs include: Chlorpropamide (Diabinese) […] Repaglinide (Prandin) […] Tolazamide (Tolinase) […] Tolbutamide (Orinase). You can also get low blood sugar if you drink alcohol or take allopurinol (Zyloprim), probenecid (Probalan), or warfarin (Coumadin) with diabetes medications. Your diet and activity levels are also important. If you don’t eat enough or exercise too much, but still take the same amount of medication, it creates an imbalance that lowers your blood sugar.

• #11 Low Blood Sugar (Hypoglycemia) | Diabetes | CDC

  https://www.cdc.gov/diabetes/about/low-blood-sugar-hypoglycemia.html

  Low blood sugar can be dangerous if left untreated. […] Low blood sugar is especially common in people with type 1 diabetes. […] Knowing how to spot low blood sugar is important because it can be dangerous if left untreated. […] There are many reasons why you may have low blood sugar, including: Taking too much insulin. […] Not eating enough carbohydrates for how much insulin you take. […] Timing of when you take your insulin. […] The amount and timing of physical activity. […] Drinking alcohol. […] Hot and humid weather. […] Unexpected changes in your schedule. […] Spending time at a high altitude. […] Going through puberty. […] Having your period (menstruation).

• #12 Patient education: Hypoglycemia (low blood glucose) in people with diabetes (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hypoglycemia-low-blood-glucose-in-people-with-diabetes-beyond-the-basics

  Hypoglycemia is the medical term for low blood glucose (blood sugar). People with type 1 diabetes who take insulin to manage their blood glucose levels are at risk for getting hypoglycemia. People with type 2 diabetes who take insulin and/or certain other medications (eg, sulfonylureas, meglitinides) can also develop hypoglycemia, although this is generally less common. The frequency of hypoglycemia among people with longstanding type 2 diabetes increases over time, as the body eventually stops making enough insulin. […] Low blood glucose can happen if you: […] Take too much insulin […] Take too much of oral diabetes medications that cause your body to release more insulin (eg, sulfonylureas, meglitinides) […] Do not eat enough food […] Exercise vigorously without eating a snack or decreasing your insulin dose beforehand […] Wait too long between meals […] Drink a lot of alcohol.

• #13 Low blood sugar (hypoglycaemia)

  https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/

  Low blood sugar usually affects people with diabetes who take insulin or some other diabetes medicines. […] Diabetes causes high blood sugar (hyperglycaemia). Diabetes medicines treat your condition by lowering your blood sugar, but they can sometimes make it go too low. […] You’re more likely to get low blood sugar if you: take too much insulin; have problems with the way you inject insulin, such as injecting in the same place too often; miss or delay meals, or do not eat enough carbohydrate; do a lot of exercise without eating more carbohydrate or reducing your insulin dose; drink a lot of alcohol, particularly without eating. […] It’s rare to get low blood sugar if you do not have diabetes. It can sometimes be caused by conditions including: malnutrition; Addison’s disease; a growth (tumour) in your pancreas.

• #14 Hypoglycemia in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=hypoglycemia-in-children-90-P01960

  Hypoglycemia can be a condition by itself. Or it can be a complication of diabetes or other disorder. Its most often a problem in someone with diabetes. It occurs when theres too much insulin. This is also called an insulin reaction. […] Causes in children with diabetes may include: Too much insulin or oral diabetes medicine […] The wrong kind of insulin […] Incorrect blood-glucose readings […] A missed meal […] A delayed meal […] Not enough food eaten for the amount of insulin taken […] More exercise than usual […] Diarrhea or vomiting […] Injury, illness, infection, or emotional stress […] Other health problems, such as celiac disease or an adrenal problem […] Taking diabetes medicine called sulfonylurea […] Problems present at birth (congenital) with how the body processes glucose and starches

• #15 Causes and How to Prevent Hypoglycemia (Low Blood Glucose) | American Diabetes Association

  https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/causes-prevention

  Hypoglycemia (or low blood glucose) is common for people with type 1 diabetes. It also can occur in people with type 2 diabetes taking insulin or certain diabetes medications. […] The average person with type 1 diabetes has low blood glucose levels up to twice a week, and thats only counting episodes with symptoms. If you add in lows without symptoms and the ones that happen overnight, the number would likely be higher. […] Too much insulin or certain diabetes medications is a common cause of low blood glucose. Miscalculating for how many carbs you’ve eating can lead to giving too much insulin, resulting in a low. But there are a few other ways insulin can cause hypoglycemia. […] Not eating enough food. If you start eating smaller portions (or even when you start trying to make healthier food choices), eat less carbs then you planned to, or skip a meal or snack, it can lead to a low.

• #16 Causes and How to Prevent Hypoglycemia (Low Blood Glucose) | American Diabetes Association

  https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/causes-prevention

  Alcohol, especially on an empty stomach. Alcohol use can cause dangerously low blood glucose, leading to a severe hypoglycemia incident. Low blood glucose can also happen many hours after alcohol use. […] Physical activity and exercise can lower your blood glucose. Also, more intense physical activity or exercise than usual can make your body more sensitive to insulin and lower your blood glucose levels after you’re done. […] Your best bet is to keep your blood glucose in your target range. Keep track of your personal symptoms you feel when go low. If you start to recognize those feelings, you can act faster to treat your low glucose before it drops lower. […] Studies consistently show that the more a person checks blood glucose, the lower their risk of low blood glucose.

• #17 Patient education: Hypoglycemia (low blood glucose) in people with diabetes (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hypoglycemia-low-blood-glucose-in-people-with-diabetes-beyond-the-basics

  Hypoglycemia is the medical term for low blood glucose (blood sugar). People with type 1 diabetes who take insulin to manage their blood glucose levels are at risk for getting hypoglycemia. People with type 2 diabetes who take insulin and/or certain other medications (eg, sulfonylureas, meglitinides) can also develop hypoglycemia, although this is generally less common. The frequency of hypoglycemia among people with longstanding type 2 diabetes increases over time, as the body eventually stops making enough insulin. […] Low blood glucose can happen if you: […] Take too much insulin […] Take too much of oral diabetes medications that cause your body to release more insulin (eg, sulfonylureas, meglitinides) […] Do not eat enough food […] Exercise vigorously without eating a snack or decreasing your insulin dose beforehand […] Wait too long between meals […] Drink a lot of alcohol.

• #18 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. Impairments in counterregulatory responses and hypoglycemia unawareness constitute the main risk factors for severe hypoglycemia. […] Risk factors for hypoglycemia can be from therapeutic hyperinsulinemia or failure of defense mechanisms from a drop in plasma glucose concentration. Conditions causing therapeutic hyperinsulinemia include: (1) Treatment with insulin, sulfonylureas, or glinides, if administered at high dose or with incorrect timing related to meal; (2) Lack of exogenous glucose, such as when eating a very low carbohydrate food portion, or during prolonged fasting; Lack of endogenic glucose production after drinking alcohol, (3) Increase in glucose consumption during or after physical exercise; (4) Increase in insulin sensitivity due to weight loss or physical exertion; and (5) Drop in insulin excretion under conditions such as renal failure, hepatic failure, and hypothyroidism.

• #19 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. Impairments in counterregulatory responses and hypoglycemia unawareness constitute the main risk factors for severe hypoglycemia. […] Risk factors for hypoglycemia can be from therapeutic hyperinsulinemia or failure of defense mechanisms from a drop in plasma glucose concentration. Conditions causing therapeutic hyperinsulinemia include: (1) Treatment with insulin, sulfonylureas, or glinides, if administered at high dose or with incorrect timing related to meal; (2) Lack of exogenous glucose, such as when eating a very low carbohydrate food portion, or during prolonged fasting; Lack of endogenic glucose production after drinking alcohol, (3) Increase in glucose consumption during or after physical exercise; (4) Increase in insulin sensitivity due to weight loss or physical exertion; and (5) Drop in insulin excretion under conditions such as renal failure, hepatic failure, and hypothyroidism.

• #20 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. […] Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #21 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors.[1] […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia.[2] […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #22 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors.[1] […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia.[2] […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #23 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. Impairments in counterregulatory responses and hypoglycemia unawareness constitute the main risk factors for severe hypoglycemia. […] Risk factors for hypoglycemia can be from therapeutic hyperinsulinemia or failure of defense mechanisms from a drop in plasma glucose concentration. Conditions causing therapeutic hyperinsulinemia include: (1) Treatment with insulin, sulfonylureas, or glinides, if administered at high dose or with incorrect timing related to meal; (2) Lack of exogenous glucose, such as when eating a very low carbohydrate food portion, or during prolonged fasting; Lack of endogenic glucose production after drinking alcohol, (3) Increase in glucose consumption during or after physical exercise; (4) Increase in insulin sensitivity due to weight loss or physical exertion; and (5) Drop in insulin excretion under conditions such as renal failure, hepatic failure, and hypothyroidism.

• #24 Causes and Risk Factors of Hypoglycemia

  https://www.verywellhealth.com/hypoglycemia-causes-risk-factors-1087616

  Hypoglycemia (low blood sugar) occurs when your blood sugar (glucose) levels are less than or equal to 70 mg/dL and certain symptoms are present. It can be caused by a number of factors, depending on whether or not you also have diabetes. […] If you have diabetes and take insulin or oral medications that stimulate insulin secretion, there are a number of factors that can cause hypoglycemia, including the following. […] Taking too much insulin or oral diabetes medication can cause hypoglycemia. Always take the dose specifically prescribed for you. […] If you’re taking insulin or an oral diabetes medication, drinking alcohol can cause hypoglycemia. […] Losing weight can make you more sensitive to insulin, resulting in needing less or no medication. […] One complication of diabetes is kidney disease, which can result in your kidneys taking longer to clear insulin from your system. This can potentially result in hypoglycemia.

• #25 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. […] Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #26 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors.[1] […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia.[2] […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #27 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. Impairments in counterregulatory responses and hypoglycemia unawareness constitute the main risk factors for severe hypoglycemia. […] Risk factors for hypoglycemia can be from therapeutic hyperinsulinemia or failure of defense mechanisms from a drop in plasma glucose concentration. Conditions causing therapeutic hyperinsulinemia include: (1) Treatment with insulin, sulfonylureas, or glinides, if administered at high dose or with incorrect timing related to meal; (2) Lack of exogenous glucose, such as when eating a very low carbohydrate food portion, or during prolonged fasting; Lack of endogenic glucose production after drinking alcohol, (3) Increase in glucose consumption during or after physical exercise; (4) Increase in insulin sensitivity due to weight loss or physical exertion; and (5) Drop in insulin excretion under conditions such as renal failure, hepatic failure, and hypothyroidism.

• #28 Hypoglycemia in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=hypoglycemia-in-children-90-P01960

  Hypoglycemia can be a condition by itself. Or it can be a complication of diabetes or other disorder. Its most often a problem in someone with diabetes. It occurs when theres too much insulin. This is also called an insulin reaction. […] Causes in children with diabetes may include: Too much insulin or oral diabetes medicine […] The wrong kind of insulin […] Incorrect blood-glucose readings […] A missed meal […] A delayed meal […] Not enough food eaten for the amount of insulin taken […] More exercise than usual […] Diarrhea or vomiting […] Injury, illness, infection, or emotional stress […] Other health problems, such as celiac disease or an adrenal problem […] Taking diabetes medicine called sulfonylurea […] Problems present at birth (congenital) with how the body processes glucose and starches

• #29 What is hypoglycaemia? | Signs and symptoms | Diabetes UK

  https://www.diabetes.org.uk/about-diabetes/complications/hypos

  Hypos can happen if the balance of food you eat, physical activity you do and diabetes medication you take, especially insulin, sometimes isn’t right. Not everyone with diabetes will have hypos. […] We dont always know why hypos happen, but some things make them more likely. These include: missing or delaying a meal or snack, not having enough carbohydrate at your last meal, doing a lot of exercise without having extra carbohydrate or without reducing your insulin dose (if you take insulin), taking more insulin (or certain diabetes medication) than you needed, drinking alcohol, being unwell, experiencing stress or anxiety, extreme changes in weather. […] Insulin and some other diabetes medications can make you more likely to have a hypo. Check with your diabetes healthcare team if youre not sure whether the treatment youre on is likely to cause hypos.

• #30 Low Blood Sugar (Hypoglycemia) | Diabetes | CDC

  https://www.cdc.gov/diabetes/about/low-blood-sugar-hypoglycemia.html

  Low blood sugar can be dangerous if left untreated. […] Low blood sugar is especially common in people with type 1 diabetes. […] Knowing how to spot low blood sugar is important because it can be dangerous if left untreated. […] There are many reasons why you may have low blood sugar, including: Taking too much insulin. […] Not eating enough carbohydrates for how much insulin you take. […] Timing of when you take your insulin. […] The amount and timing of physical activity. […] Drinking alcohol. […] Hot and humid weather. […] Unexpected changes in your schedule. […] Spending time at a high altitude. […] Going through puberty. […] Having your period (menstruation).

• #31 Low Blood Sugar (Hypoglycemia) | Diabetes | CDC

  https://www.cdc.gov/diabetes/about/low-blood-sugar-hypoglycemia.html

  Low blood sugar can be dangerous if left untreated. […] Low blood sugar is especially common in people with type 1 diabetes. […] Knowing how to spot low blood sugar is important because it can be dangerous if left untreated. […] There are many reasons why you may have low blood sugar, including: Taking too much insulin. […] Not eating enough carbohydrates for how much insulin you take. […] Timing of when you take your insulin. […] The amount and timing of physical activity. […] Drinking alcohol. […] Hot and humid weather. […] Unexpected changes in your schedule. […] Spending time at a high altitude. […] Going through puberty. […] Having your period (menstruation).

• #32 What is hypoglycaemia? | Signs and symptoms | Diabetes UK

  https://www.diabetes.org.uk/about-diabetes/complications/hypos

  Hypos can happen if the balance of food you eat, physical activity you do and diabetes medication you take, especially insulin, sometimes isn’t right. Not everyone with diabetes will have hypos. […] We dont always know why hypos happen, but some things make them more likely. These include: missing or delaying a meal or snack, not having enough carbohydrate at your last meal, doing a lot of exercise without having extra carbohydrate or without reducing your insulin dose (if you take insulin), taking more insulin (or certain diabetes medication) than you needed, drinking alcohol, being unwell, experiencing stress or anxiety, extreme changes in weather. […] Insulin and some other diabetes medications can make you more likely to have a hypo. Check with your diabetes healthcare team if youre not sure whether the treatment youre on is likely to cause hypos.

• #33 Low Blood Sugar (Hypoglycemia) | Diabetes | CDC

  https://www.cdc.gov/diabetes/about/low-blood-sugar-hypoglycemia.html

  Low blood sugar can be dangerous if left untreated. […] Low blood sugar is especially common in people with type 1 diabetes. […] Knowing how to spot low blood sugar is important because it can be dangerous if left untreated. […] There are many reasons why you may have low blood sugar, including: Taking too much insulin. […] Not eating enough carbohydrates for how much insulin you take. […] Timing of when you take your insulin. […] The amount and timing of physical activity. […] Drinking alcohol. […] Hot and humid weather. […] Unexpected changes in your schedule. […] Spending time at a high altitude. […] Going through puberty. […] Having your period (menstruation).

• #34 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  The above defense mechanisms are often impaired in patients with diabetes and significant beta-cell failure who lack an initial response to a drop in insulin. This leads to a delay in the secretion of glucose from the liver during hypoglycemia. The rate of hypoglycemic episodes increases with the duration of diabetes, perhaps due to the gradual lack of endogenous insulin, which occurs more rapidly in patients with type 1 diabetes and slower in those with type 2 diabetes. […] It is believed that the impaired sympathoadrenal response is secondary to repeated episodes of hypoglycemia that reduce the autonomic response to other hypoglycemic events. This exposes patients to a vicious cycle of frequent hypoglycemia events and shifts glycemic thresholds for symptoms to lower plasma glucose concentrations close to levels that cause cognitive failure.

• #35 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  The above defense mechanisms are often impaired in patients with diabetes and significant beta-cell failure who lack an initial response to a drop in insulin. This leads to a delay in the secretion of glucose from the liver during hypoglycemia. The rate of hypoglycemic episodes increases with the duration of diabetes, perhaps due to the gradual lack of endogenous insulin, which occurs more rapidly in patients with type 1 diabetes and slower in those with type 2 diabetes. […] It is believed that the impaired sympathoadrenal response is secondary to repeated episodes of hypoglycemia that reduce the autonomic response to other hypoglycemic events. This exposes patients to a vicious cycle of frequent hypoglycemia events and shifts glycemic thresholds for symptoms to lower plasma glucose concentrations close to levels that cause cognitive failure.

• #36 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  The above defense mechanisms are often impaired in patients with diabetes and significant beta-cell failure who lack an initial response to a drop in insulin. This leads to a delay in the secretion of glucose from the liver during hypoglycemia. The rate of hypoglycemic episodes increases with the duration of diabetes, perhaps due to the gradual lack of endogenous insulin, which occurs more rapidly in patients with type 1 diabetes and slower in those with type 2 diabetes. […] It is believed that the impaired sympathoadrenal response is secondary to repeated episodes of hypoglycemia that reduce the autonomic response to other hypoglycemic events. This exposes patients to a vicious cycle of frequent hypoglycemia events and shifts glycemic thresholds for symptoms to lower plasma glucose concentrations close to levels that cause cognitive failure.

• #37 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  The above defense mechanisms are often impaired in patients with diabetes and significant beta-cell failure who lack an initial response to a drop in insulin. This leads to a delay in the secretion of glucose from the liver during hypoglycemia. The rate of hypoglycemic episodes increases with the duration of diabetes, perhaps due to the gradual lack of endogenous insulin, which occurs more rapidly in patients with type 1 diabetes and slower in those with type 2 diabetes. […] It is believed that the impaired sympathoadrenal response is secondary to repeated episodes of hypoglycemia that reduce the autonomic response to other hypoglycemic events. This exposes patients to a vicious cycle of frequent hypoglycemia events and shifts glycemic thresholds for symptoms to lower plasma glucose concentrations close to levels that cause cognitive failure.

• #38 Hypoglycaemia (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/hypoglycaemia

  Hypoglycaemia is defined as blood glucose 3.5 mmol/L. However, blood glucose 2.5 mmol/L is considered pathological and requires investigation. […] There are many causes of hypoglycaemia but it is most commonly the result of an excess of either insulin or oral hypoglycaemic medications combined with reduced sugar intake or increased activity. […] Alcohol is the most common non-iatrogenic (non-physician) cause of hypoglycaemia in adults. […] People with diabetes treated with insulin or sulfonylureas: Recurrent hypoglycaemia often responds to changes in diet or treatment but referral for structured education may be required (eg, to a Diabetes Specialist Nurse or a local education programme). […] People with diabetes may develop impaired awareness of hypoglycaemia. […] People with diabetes with poor glycaemic control may experience hypoglycaemic symptoms with normal glucose concentrations (’false hypoglycaemia’).

• #39 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  The above defense mechanisms are often impaired in patients with diabetes and significant beta-cell failure who lack an initial response to a drop in insulin. This leads to a delay in the secretion of glucose from the liver during hypoglycemia. The rate of hypoglycemic episodes increases with the duration of diabetes, perhaps due to the gradual lack of endogenous insulin, which occurs more rapidly in patients with type 1 diabetes and slower in those with type 2 diabetes. […] It is believed that the impaired sympathoadrenal response is secondary to repeated episodes of hypoglycemia that reduce the autonomic response to other hypoglycemic events. This exposes patients to a vicious cycle of frequent hypoglycemia events and shifts glycemic thresholds for symptoms to lower plasma glucose concentrations close to levels that cause cognitive failure.

• #40 Severe Hypoglycemia | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/severe-hypoglycemia

  There are many causes of hypoglycemia, including the treatment of diabetes. […] Severe hypoglycemia can occur in people with diabetes who are taking insulin and certain diabetes medications, or changes in overall health. For example: […] Most cases of severe hypoglycemia occur in people with diabetes who take insulin or certain diabetes medications like sulfonylureas. […] The reason is often due to changes in the balance of the persons food intake, exercise level, or medicine while taking insulin or other medications for diabetes. […] Severe hypoglycemia is an emergency. […] If hypoglycemia is not corrected right away, it can quickly worsen.

• #41 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  The above defense mechanisms are often impaired in patients with diabetes and significant beta-cell failure who lack an initial response to a drop in insulin. This leads to a delay in the secretion of glucose from the liver during hypoglycemia. The rate of hypoglycemic episodes increases with the duration of diabetes, perhaps due to the gradual lack of endogenous insulin, which occurs more rapidly in patients with type 1 diabetes and slower in those with type 2 diabetes. […] It is believed that the impaired sympathoadrenal response is secondary to repeated episodes of hypoglycemia that reduce the autonomic response to other hypoglycemic events. This exposes patients to a vicious cycle of frequent hypoglycemia events and shifts glycemic thresholds for symptoms to lower plasma glucose concentrations close to levels that cause cognitive failure.

• #42 Causes and How to Prevent Hypoglycemia (Low Blood Glucose) | American Diabetes Association

  https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/causes-prevention

  Hypoglycemia (or low blood glucose) is common for people with type 1 diabetes. It also can occur in people with type 2 diabetes taking insulin or certain diabetes medications. […] The average person with type 1 diabetes has low blood glucose levels up to twice a week, and thats only counting episodes with symptoms. If you add in lows without symptoms and the ones that happen overnight, the number would likely be higher. […] Too much insulin or certain diabetes medications is a common cause of low blood glucose. Miscalculating for how many carbs you’ve eating can lead to giving too much insulin, resulting in a low. But there are a few other ways insulin can cause hypoglycemia. […] Not eating enough food. If you start eating smaller portions (or even when you start trying to make healthier food choices), eat less carbs then you planned to, or skip a meal or snack, it can lead to a low.

• #43 Diabetic hypoglycemia – Symptoms & causes

  https://www.sterlinghospitals.com/blogs/diabetic-hypoglycemia-symptoms-causes

  Hypoglycemia happens when the amount of sugar in your blood drops too low. This usually occurs when there’s an imbalance between the glucose in your blood and the insulin your body produces or receives through medication. […] Understanding the triggers of hypoglycemia is essential for prevention. Some common causes include: Insulin or medication overdose, Skipping meals or inadequate food intake (risk is more here if you are a diabetic), Alcohol consumption, Strenuous exercise, Stress and illness. […] People with type 1 diabetes, who depend on insulin injections, are especially susceptible to experiencing low blood sugar levels. Those with type 2 diabetes who use insulin also face an increased risk. Taking multiple diabetes medications can complicate blood sugar management and increase the risk of hypoglycemia. Previous episodes of severe hypoglycemia indicate a higher likelihood of recurrence. Hormonal fluctuations during pregnancy can affect blood sugar control. These health issues can interfere with how the body manages its blood sugar levels.

• #44 Hypoglycemia | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/hypoglycemia

  Diabetes is a disease in which blood glucose levels are too high. […] Hypoglycemia can also occur if you do not eat when you need to or as much as you need, or if you skip a meal, drink too much alcohol, or exercise more than usual. […] Elderly patients using insulin are at higher risk for hypoglycemia unawareness. […] These people may function and live normally with blood glucose values in the 70’s, and only experience symptoms of hypoglycemia when the glucose values drop into the 50’s or below. […] If hypoglycemia is not corrected right away, it can quickly worsen. […] Non-diabetic hypoglycemia, a rare condition, is low blood glucose in people who do not have diabetes. […] There are two kinds of non-diabetic hypoglycemia, reactive hypoglycemia and fasting hypoglycemia. […] Reactive hypoglycemia occurs after eating, usually after high carbohydrate meals or snacks. […] Fasting hypoglycemia occurs overnight when not eating or when there is too much time between meals. […] Serious illnesses, such as those affecting the liver, heart, or kidneys can cause low glucose. […] Treatment depends on the cause of hypoglycemia.

• #45 Diabetic hypoglycemia – Symptoms & causes

  https://www.sterlinghospitals.com/blogs/diabetic-hypoglycemia-symptoms-causes

  Hypoglycemia happens when the amount of sugar in your blood drops too low. This usually occurs when there’s an imbalance between the glucose in your blood and the insulin your body produces or receives through medication. […] Understanding the triggers of hypoglycemia is essential for prevention. Some common causes include: Insulin or medication overdose, Skipping meals or inadequate food intake (risk is more here if you are a diabetic), Alcohol consumption, Strenuous exercise, Stress and illness. […] People with type 1 diabetes, who depend on insulin injections, are especially susceptible to experiencing low blood sugar levels. Those with type 2 diabetes who use insulin also face an increased risk. Taking multiple diabetes medications can complicate blood sugar management and increase the risk of hypoglycemia. Previous episodes of severe hypoglycemia indicate a higher likelihood of recurrence. Hormonal fluctuations during pregnancy can affect blood sugar control. These health issues can interfere with how the body manages its blood sugar levels.

• #46 Causes of Hypoglycemia | IntechOpen

  https://www.intechopen.com/chapters/82036

  Diabetes particularly with the use of insulin or sulfonylurea, that is, insulin secretagogue treatment, is the classical cause of hypoglycemia. […] Drug-induced hypoglycemia is not limited to antidiabetic medication use; other medications can also induce hypoglycemia. […] Both absolute and relative insulin excess is a major cause of hypoglycemia. […] The hormonal deficiency was found to be associated with hypoglycemia. […] Hypoglycemia developing secondary to an underlying illness is associated with increased nutritional body demand due to increased metabolic response in critically ill patients. […] The fear of hypoglycemia is common in patients with diabetes. […] In diabetic patients with depression, hypoglycemia can occur frequently as a result of poor adherence to medications, diet, physical activity, smoking cessation, poor self-care, and blood glucose monitoring. […] Cognitive dysfunction and dementia may increase the risk of hypoglycemia, especially in elderly patients.

• #47 Causes of Hypoglycemia | IntechOpen

  https://www.intechopen.com/chapters/82036

  Diabetes particularly with the use of insulin or sulfonylurea, that is, insulin secretagogue treatment, is the classical cause of hypoglycemia. […] Drug-induced hypoglycemia is not limited to antidiabetic medication use; other medications can also induce hypoglycemia. […] Both absolute and relative insulin excess is a major cause of hypoglycemia. […] The hormonal deficiency was found to be associated with hypoglycemia. […] Hypoglycemia developing secondary to an underlying illness is associated with increased nutritional body demand due to increased metabolic response in critically ill patients. […] The fear of hypoglycemia is common in patients with diabetes. […] In diabetic patients with depression, hypoglycemia can occur frequently as a result of poor adherence to medications, diet, physical activity, smoking cessation, poor self-care, and blood glucose monitoring. […] Cognitive dysfunction and dementia may increase the risk of hypoglycemia, especially in elderly patients.

• #48 Hypoglycemia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122122-overview

  Several cases of nesidioblastosis were reported recently after gastric bypass surgery. […] Ethanol (including propranolol plus ethanol), haloperidol, pentamidine, quinine, salicylates, and sulfonamides („sulfa drugs”) have been associated with hypoglycemia. Other drugs that may be related to this condition include oral hypoglycemics, phenylbutazone, insulin, bishydroxycoumarin, p-aminobenzoic acid, propoxyphene, stanozolol, hypoglycin, carbamate insecticide, disopyramide, isoniazid, methanol, methotrexate, tricyclic antidepressants, cytotoxic agents, organophosphates, didanosine, chlorpromazine, fluoxetine, sertraline, fenfluramine, trimethoprim, 6-mercaptopurine, thiazide diuretics, thioglycolate, tremetol, ritodrine, disodium ethylenediaminetetraacetic acid (EDTA), clofibrate, angiotensin converting enzyme (ACE) inhibitors, and lithium.

• #49 Drug-induced low blood sugar: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000310.htm

  Drug-induced low blood sugar is low blood glucose that results from taking medicine. […] Low blood sugar (hypoglycemia) is common in people with diabetes who are taking insulin or other medicines to control their diabetes. […] Other than certain medicines, the following can also cause blood sugar (glucose) level to drop: Drinking alcohol, Getting more activity than usual, Intentionally or unintentionally overdosing on the medicines used to treat diabetes, Missing meals. […] Even when diabetes is managed very carefully, the medicines used to treat diabetes can result in drug-induced low blood sugar. […] The condition may also occur when someone without diabetes takes a medicine used to treat diabetes. […] In rare cases, non-diabetes-related medicines can cause low blood sugar. […] Medicines that can cause drug-induced low blood sugar include: Beta-blockers (such as atenolol, or propranolol overdose), Cibenzoline and quinidine (heart arrhythmia drugs), Glinides (such as nateglinide and repaglinide), Indomethacin (a pain reliever), Insulin, Metformin when used with sulfonylureas, SGLT2 inhibitors (such as canagliflozin, dapagliflozin, empagliflozin and ertugliflozin) with or without sulfonylureas, Sulfonylureas (such as glipizide, glimepiride, glyburide), Thiazolidinediones (such as pioglitazone and rosiglitazone) when used with sulfonylureas, Drugs that fight infections (such as gatifloxacin, levofloxacin, pentamidine, quinine, trimethoprim-sulfamethoxazole).

• #50 Drug-induced low blood sugar: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000310.htm

  Drug-induced low blood sugar is low blood glucose that results from taking medicine. […] Low blood sugar (hypoglycemia) is common in people with diabetes who are taking insulin or other medicines to control their diabetes. […] Other than certain medicines, the following can also cause blood sugar (glucose) level to drop: Drinking alcohol, Getting more activity than usual, Intentionally or unintentionally overdosing on the medicines used to treat diabetes, Missing meals. […] Even when diabetes is managed very carefully, the medicines used to treat diabetes can result in drug-induced low blood sugar. […] The condition may also occur when someone without diabetes takes a medicine used to treat diabetes. […] In rare cases, non-diabetes-related medicines can cause low blood sugar. […] Medicines that can cause drug-induced low blood sugar include: Beta-blockers (such as atenolol, or propranolol overdose), Cibenzoline and quinidine (heart arrhythmia drugs), Glinides (such as nateglinide and repaglinide), Indomethacin (a pain reliever), Insulin, Metformin when used with sulfonylureas, SGLT2 inhibitors (such as canagliflozin, dapagliflozin, empagliflozin and ertugliflozin) with or without sulfonylureas, Sulfonylureas (such as glipizide, glimepiride, glyburide), Thiazolidinediones (such as pioglitazone and rosiglitazone) when used with sulfonylureas, Drugs that fight infections (such as gatifloxacin, levofloxacin, pentamidine, quinine, trimethoprim-sulfamethoxazole).

• #51 Hypoglycemia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122122-overview

  Several cases of nesidioblastosis were reported recently after gastric bypass surgery. […] Ethanol (including propranolol plus ethanol), haloperidol, pentamidine, quinine, salicylates, and sulfonamides („sulfa drugs”) have been associated with hypoglycemia. Other drugs that may be related to this condition include oral hypoglycemics, phenylbutazone, insulin, bishydroxycoumarin, p-aminobenzoic acid, propoxyphene, stanozolol, hypoglycin, carbamate insecticide, disopyramide, isoniazid, methanol, methotrexate, tricyclic antidepressants, cytotoxic agents, organophosphates, didanosine, chlorpromazine, fluoxetine, sertraline, fenfluramine, trimethoprim, 6-mercaptopurine, thiazide diuretics, thioglycolate, tremetol, ritodrine, disodium ethylenediaminetetraacetic acid (EDTA), clofibrate, angiotensin converting enzyme (ACE) inhibitors, and lithium.

• #52 Drug-induced low blood sugar: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000310.htm

  Drug-induced low blood sugar is low blood glucose that results from taking medicine. […] Low blood sugar (hypoglycemia) is common in people with diabetes who are taking insulin or other medicines to control their diabetes. […] Other than certain medicines, the following can also cause blood sugar (glucose) level to drop: Drinking alcohol, Getting more activity than usual, Intentionally or unintentionally overdosing on the medicines used to treat diabetes, Missing meals. […] Even when diabetes is managed very carefully, the medicines used to treat diabetes can result in drug-induced low blood sugar. […] The condition may also occur when someone without diabetes takes a medicine used to treat diabetes. […] In rare cases, non-diabetes-related medicines can cause low blood sugar. […] Medicines that can cause drug-induced low blood sugar include: Beta-blockers (such as atenolol, or propranolol overdose), Cibenzoline and quinidine (heart arrhythmia drugs), Glinides (such as nateglinide and repaglinide), Indomethacin (a pain reliever), Insulin, Metformin when used with sulfonylureas, SGLT2 inhibitors (such as canagliflozin, dapagliflozin, empagliflozin and ertugliflozin) with or without sulfonylureas, Sulfonylureas (such as glipizide, glimepiride, glyburide), Thiazolidinediones (such as pioglitazone and rosiglitazone) when used with sulfonylureas, Drugs that fight infections (such as gatifloxacin, levofloxacin, pentamidine, quinine, trimethoprim-sulfamethoxazole).

• #53 Hypoglycemia – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/diabetes-mellitus-dm-and-disorders-of-blood-sugar-metabolism/hypoglycemia

  Hypoglycemia is most often caused by medications taken to control diabetes. Much less common causes of hypoglycemia include other medications, critical illness or organ failure, a reaction to carbohydrates (in susceptible people), an insulin-producing tumor in the pancreas, and some types of bariatric (weight loss) surgery. […] Most cases of hypoglycemia occur in people with diabetes and are caused by insulin or other medications (especially, sulfonylureas such as glyburide, glipizide, and glimepiride) that they take to lower the levels of glucose in their blood. […] Certain medications 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.

• #54 Hypoglycemia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122122-overview

  Several cases of nesidioblastosis were reported recently after gastric bypass surgery. […] Ethanol (including propranolol plus ethanol), haloperidol, pentamidine, quinine, salicylates, and sulfonamides („sulfa drugs”) have been associated with hypoglycemia. Other drugs that may be related to this condition include oral hypoglycemics, phenylbutazone, insulin, bishydroxycoumarin, p-aminobenzoic acid, propoxyphene, stanozolol, hypoglycin, carbamate insecticide, disopyramide, isoniazid, methanol, methotrexate, tricyclic antidepressants, cytotoxic agents, organophosphates, didanosine, chlorpromazine, fluoxetine, sertraline, fenfluramine, trimethoprim, 6-mercaptopurine, thiazide diuretics, thioglycolate, tremetol, ritodrine, disodium ethylenediaminetetraacetic acid (EDTA), clofibrate, angiotensin converting enzyme (ACE) inhibitors, and lithium.

• #55 Hypoglycemia (Low Blood Sugar Levels): Symptoms, Causes, Treatment

  https://www.webmd.com/diabetes/diabetes-hypoglycemia

  People with diabetes get hypoglycemia (low blood sugar) when their bodies don’t have enough sugar to use as fuel. […] It can happen for several reasons, including diet, some medications and conditions, and exercise. […] Insulin treatment can cause low blood sugar, and so can a type of diabetes medications called „sulfonylureas.” […] You can also get low blood sugar if you drink alcohol or take allopurinol (Zyloprim), aspirin, probenecid (Benemid, Probalan), or warfarin (Coumadin) with diabetes medications. […] You can get low blood sugar if you take too much insulin for the amount of carbohydrates you eat or drink. […] Don’t skip meals if you have diabetes, particularly if you’re taking diabetes medications. […] If you have diabetes and think you have hypoglycemia, check your blood sugar level.

• #56 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia causes physical and psychological morbidity in diabetic patients. Symptomatic hypoglycemia constitutes a concern and a distraction. It can impair judgment, performance of simple daily activities such as driving, and behavior. In more severe cases, hypoglycemia may result in convulsions and loss of consciousness. […] In a meta-analysis of more than 900000 patients, a 2-fold increase in the risk of cardiovascular morbidity was observed amongst patients with type 2 diabetes and severe hypoglycemia. […] Although severe, sustained hypoglycemia may cause brain death, with most cases of sudden death related to cardiac arrhythmias due to enhanced sympathoadrenal reaction causing QT prolongation.

• #57 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia causes physical and psychological morbidity in diabetic patients. Symptomatic hypoglycemia constitutes a concern and a distraction. It can impair judgment, performance of simple daily activities such as driving, and behavior. In more severe cases, hypoglycemia may result in convulsions and loss of consciousness. […] In a meta-analysis of more than 900000 patients, a 2-fold increase in the risk of cardiovascular morbidity was observed amongst patients with type 2 diabetes and severe hypoglycemia. […] Although severe, sustained hypoglycemia may cause brain death, with most cases of sudden death related to cardiac arrhythmias due to enhanced sympathoadrenal reaction causing QT prolongation.

• #58 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia causes physical and psychological morbidity in diabetic patients. Symptomatic hypoglycemia constitutes a concern and a distraction. It can impair judgment, performance of simple daily activities such as driving, and behavior. In more severe cases, hypoglycemia may result in convulsions and loss of consciousness. […] In a meta-analysis of more than 900000 patients, a 2-fold increase in the risk of cardiovascular morbidity was observed amongst patients with type 2 diabetes and severe hypoglycemia. […] Although severe, sustained hypoglycemia may cause brain death, with most cases of sudden death related to cardiac arrhythmias due to enhanced sympathoadrenal reaction causing QT prolongation.

• #59 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia causes physical and psychological morbidity in diabetic patients. Symptomatic hypoglycemia constitutes a concern and a distraction. It can impair judgment, performance of simple daily activities such as driving, and behavior. In more severe cases, hypoglycemia may result in convulsions and loss of consciousness. […] In a meta-analysis of more than 900000 patients, a 2-fold increase in the risk of cardiovascular morbidity was observed amongst patients with type 2 diabetes and severe hypoglycemia. […] Although severe, sustained hypoglycemia may cause brain death, with most cases of sudden death related to cardiac arrhythmias due to enhanced sympathoadrenal reaction causing QT prolongation.

• #60 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia causes physical and psychological morbidity in diabetic patients. Symptomatic hypoglycemia constitutes a concern and a distraction. It can impair judgment, performance of simple daily activities such as driving, and behavior. In more severe cases, hypoglycemia may result in convulsions and loss of consciousness. […] In a meta-analysis of more than 900000 patients, a 2-fold increase in the risk of cardiovascular morbidity was observed amongst patients with type 2 diabetes and severe hypoglycemia. […] Although severe, sustained hypoglycemia may cause brain death, with most cases of sudden death related to cardiac arrhythmias due to enhanced sympathoadrenal reaction causing QT prolongation.

• #61 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia causes physical and psychological morbidity in diabetic patients. Symptomatic hypoglycemia constitutes a concern and a distraction. It can impair judgment, performance of simple daily activities such as driving, and behavior. In more severe cases, hypoglycemia may result in convulsions and loss of consciousness. […] In a meta-analysis of more than 900000 patients, a 2-fold increase in the risk of cardiovascular morbidity was observed amongst patients with type 2 diabetes and severe hypoglycemia. […] Although severe, sustained hypoglycemia may cause brain death, with most cases of sudden death related to cardiac arrhythmias due to enhanced sympathoadrenal reaction causing QT prolongation.

• #62 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia causes physical and psychological morbidity in diabetic patients. Symptomatic hypoglycemia constitutes a concern and a distraction. It can impair judgment, performance of simple daily activities such as driving, and behavior. In more severe cases, hypoglycemia may result in convulsions and loss of consciousness. […] In a meta-analysis of more than 900000 patients, a 2-fold increase in the risk of cardiovascular morbidity was observed amongst patients with type 2 diabetes and severe hypoglycemia. […] Although severe, sustained hypoglycemia may cause brain death, with most cases of sudden death related to cardiac arrhythmias due to enhanced sympathoadrenal reaction causing QT prolongation.

• #63 Diabetic hypoglycemia – Symptoms & causes

  https://www.sterlinghospitals.com/blogs/diabetic-hypoglycemia-symptoms-causes

  Untreated hypoglycemia can lead to a cascade of complications, including: The brain is susceptible to low blood sugar levels, and prolonged hypoglycemia can cause permanent damage. Confusion and impaired coordination during a hypoglycemic episode can increase the risk of falls and other accidents. Fear of hypoglycemia can lead to anxiety and avoidance of activities, limiting your quality of life.

• #64 Diabetic hypoglycemia – Symptoms & causes

  https://www.sterlinghospitals.com/blogs/diabetic-hypoglycemia-symptoms-causes

  Untreated hypoglycemia can lead to a cascade of complications, including: The brain is susceptible to low blood sugar levels, and prolonged hypoglycemia can cause permanent damage. Confusion and impaired coordination during a hypoglycemic episode can increase the risk of falls and other accidents. Fear of hypoglycemia can lead to anxiety and avoidance of activities, limiting your quality of life.

• #65 Causes of Hypoglycemia | IntechOpen

  https://www.intechopen.com/chapters/82036

  Diabetes particularly with the use of insulin or sulfonylurea, that is, insulin secretagogue treatment, is the classical cause of hypoglycemia. […] Drug-induced hypoglycemia is not limited to antidiabetic medication use; other medications can also induce hypoglycemia. […] Both absolute and relative insulin excess is a major cause of hypoglycemia. […] The hormonal deficiency was found to be associated with hypoglycemia. […] Hypoglycemia developing secondary to an underlying illness is associated with increased nutritional body demand due to increased metabolic response in critically ill patients. […] The fear of hypoglycemia is common in patients with diabetes. […] In diabetic patients with depression, hypoglycemia can occur frequently as a result of poor adherence to medications, diet, physical activity, smoking cessation, poor self-care, and blood glucose monitoring. […] Cognitive dysfunction and dementia may increase the risk of hypoglycemia, especially in elderly patients.

• #66 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. […] Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #67 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors.[1] […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia.[2] […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #68 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. […] Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #69 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. […] Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #70 Hypoglycemia – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/diabetes-mellitus-dm-and-disorders-of-blood-sugar-metabolism/hypoglycemia

  Hypoglycemia is most often caused by medications taken to control diabetes. Much less common causes of hypoglycemia include other medications, critical illness or organ failure, a reaction to carbohydrates (in susceptible people), an insulin-producing tumor in the pancreas, and some types of bariatric (weight loss) surgery. […] Most cases of hypoglycemia occur in people with diabetes and are caused by insulin or other medications (especially, sulfonylureas such as glyburide, glipizide, and glimepiride) that they take to lower the levels of glucose in their blood. […] Certain medications 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.

• #71 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. […] Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #72 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. […] Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #73 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. […] Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #74 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Researchers dont yet know the exact cause. But they think it happens due to a sudden spike and then fall in blood sugar after eating certain foods, especially simple carbohydrate foods like white rice, potatoes, white bread, cake and pastries. […] For the majority of people without diabetes, not eating food for a long time (fasting) doesnt lead to hypoglycemia. This is because your body uses hormones and stored glucose to manage your blood sugar. […] However, certain conditions and situations can lead to fasting hypoglycemia in people without diabetes, including: Excessive alcohol consumption: Alcohol prevents your body from forming new glucose cells (gluconeogenesis). […] Adrenal insufficiency causes lower-than-normal cortisol levels. As cortisol (a hormone) helps regulate your blood sugar by increasing it, having low levels of cortisol can lead to hypoglycemia episodes.

• #75 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. […] Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #76 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Non-islet cell tumor hypoglycemia (NICTH): This is a rare but serious syndrome in which a tumor releases excess insulin-like growth factor 2 (IGF-2). […] An insulinoma is a rare tumor in your pancreas that produces excess insulin. It leads to hypoglycemia episodes most commonly in the early morning.

• #77 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  Counter-regulatory hormone deficiencies can occur in states of adrenal insufficiency. Hypoglycemia associated with such deficiencies is rare. Non-islet cell tumors may also cause hypoglycemia by increased insulin-like growth factor 2 (IGF-2) secretion.[3] IGF-2 increases glucose utilization, which can lead to hypoglycemia. […] Insulinomas are hyperfunctioning islet cell tumors associated with increased insulin secretion. They can be life-threatening and primarily manifest with fasting morning hypoglycemia. Although these tumors are rare, they should be a consideration in the workup of suspected cases.[4]

• #78 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Non-islet cell tumor hypoglycemia (NICTH): This is a rare but serious syndrome in which a tumor releases excess insulin-like growth factor 2 (IGF-2). […] An insulinoma is a rare tumor in your pancreas that produces excess insulin. It leads to hypoglycemia episodes most commonly in the early morning.

• #79 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors.[1] […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia.[2] […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #80 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Hypoglycemia happens when your blood sugar drops below a healthy range. Several factors can contribute to this for people with diabetes. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance. […] Common situations that can lead to hypoglycemia for people with diabetes include: Taking too much insulin, the wrong insulin or injecting it into your muscle instead of in your fat tissue. […] Hypoglycemia happens when your blood sugar drops below a healthy range. Several factors can contribute to this for people with diabetes. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance. […] There are two main types of non-diabetes-related hypoglycemia: reactive hypoglycemia and fasting hypoglycemia. […] Reactive hypoglycemia happens when you experience low blood sugar after a meal. It typically occurs about two to four hours after a meal.

• #81 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Researchers dont yet know the exact cause. But they think it happens due to a sudden spike and then fall in blood sugar after eating certain foods, especially simple carbohydrate foods like white rice, potatoes, white bread, cake and pastries. […] For the majority of people without diabetes, not eating food for a long time (fasting) doesnt lead to hypoglycemia. This is because your body uses hormones and stored glucose to manage your blood sugar. […] However, certain conditions and situations can lead to fasting hypoglycemia in people without diabetes, including: Excessive alcohol consumption: Alcohol prevents your body from forming new glucose cells (gluconeogenesis). […] Adrenal insufficiency causes lower-than-normal cortisol levels. As cortisol (a hormone) helps regulate your blood sugar by increasing it, having low levels of cortisol can lead to hypoglycemia episodes.

• #82 Hypoglycemia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122122-overview

  Causes of hypoglycemia are varied, but it is seen most often in diabetic patients. Hypoglycemia may result from medication changes or overdoses, infection, diet changes, metabolic changes over time, or activity changes; however, no acute cause may be found. Other causes include alimentary problems, idiopathic causes, fasting, insulinoma, endocrine problems, extrapancreatic causes, hepatic disease, and bariatric surgery, along with additional miscellaneous etiologies. […] A study by van Furth et al indicated that both dumping syndrome and postbariatric surgery hypoglycemia can be attributed to a common etiology, with glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) being key to the development of each. […] Fasting hypoglycemia usually diagnosed in infancy or childhood include inherited liver enzyme deficiencies that restrict hepatic glucose release (deficiencies of glucose-6-phosphatase, fructose-1,6-diphosphatase, phosphorylase, pyruvate carboxylase, phosphoenolpyruvate carboxykinase, or glycogen synthetase).

• #83 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. Impairments in counterregulatory responses and hypoglycemia unawareness constitute the main risk factors for severe hypoglycemia. […] Risk factors for hypoglycemia can be from therapeutic hyperinsulinemia or failure of defense mechanisms from a drop in plasma glucose concentration. Conditions causing therapeutic hyperinsulinemia include: (1) Treatment with insulin, sulfonylureas, or glinides, if administered at high dose or with incorrect timing related to meal; (2) Lack of exogenous glucose, such as when eating a very low carbohydrate food portion, or during prolonged fasting; Lack of endogenic glucose production after drinking alcohol, (3) Increase in glucose consumption during or after physical exercise; (4) Increase in insulin sensitivity due to weight loss or physical exertion; and (5) Drop in insulin excretion under conditions such as renal failure, hepatic failure, and hypothyroidism.

• #84 Low Blood Sugar (Hypoglycemia) | Diabetes | CDC

  https://www.cdc.gov/diabetes/about/low-blood-sugar-hypoglycemia.html

  Low blood sugar can be dangerous if left untreated. […] Low blood sugar is especially common in people with type 1 diabetes. […] Knowing how to spot low blood sugar is important because it can be dangerous if left untreated. […] There are many reasons why you may have low blood sugar, including: Taking too much insulin. […] Not eating enough carbohydrates for how much insulin you take. […] Timing of when you take your insulin. […] The amount and timing of physical activity. […] Drinking alcohol. […] Hot and humid weather. […] Unexpected changes in your schedule. […] Spending time at a high altitude. […] Going through puberty. […] Having your period (menstruation).

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