text: NIZAK ŠEĆER U KRVI - Hitna Pomoc Kantona Sarajevo
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  Through various foods in the diet of pasta, bread, pastries, rice, fruits, vegetables, dairy products, the body's need for carbohydrates is met, which the body further breaks down by digestion to sugar molecules. One of these sugar molecules is glucose which is absorbed into the bloodstream after a meal. The hormone insulin is responsible for the entry of glucose into the cells of various tissues, while the level of sugar in the blood is maintained by the hormone glucagon. Most often between meals, in case of starvation, or skipping meals, ie. when blood sugar levels fall, glucagon stimulates the liver to release glucose back into the bloodstream, thus maintaining normal blood sugar levels.
  Glucose is the basic and immediate source of energy and the main "fuel" for the brain. Therefore, the unchanged concentration of glucose in the blood is one of the basic conditions for the normal functioning of the brain. Glucose is the basic and immediate source of energy and the main "fuel" for the brain. Therefore, unchanged blood glucose concentration is one of the basic conditions for normal brain functioning.
  Blood sugar levels are maintained within a fairly narrow range (3.9-6.7 mmol / l). Low blood sugar levels can lead to brain damage. It is perfectly normal for blood sugar levels to rise after a meal, but this value will be maintained for about two hours after eating or drinking.
  Hypoglycemia is defined as a low level of blood glucose.
  Hypoglycaemia occurs when the glucose in the blood is disturbed and can be divided into drug-induced (mostly in diabetics - insulin or oral antidiabetic drugs, medicines used to lower blood sugar) and non-drug-induced.
  The immediate causes of non-drug-induced hypoglycemia are: too little food taken, skipping meals and dieting, excessive physical activity, excessive insulin secretion, excessive alcohol intake. Hypoglycemia most often occurs in 50% of cases after starvation. Reactive hypoglycemia occurs after a meal, 1-3h after eating a larger amount of carbohydrate-rich foods. It results in the release of large amounts of insulin due to increased blood sugar levels, which is caused by copious reabsorption of glucose.
  Frequent registration of low blood sugar requires consultation with your family doctor and instructions for additional diagnostics. due to the fact that hypoglycemia can occur in many other diseases: liver disease, insulinoma, hormone deficiency, tumors, kidney or heart failure, cancer, poor diet, abnormal pituitary or adrenal function, shock and severe infection, taking certain medications.
  Acute alcohol poisoning (drunkenness) can cause hypoglycemia in otherwise healthy people if they starve for several days.
  People with long-term severe diabetes are particularly prone to severe hypoglycemia.
  Symptoms of hypoglycemia fall into two categories:
  Due to the increased secretion of adrenaline in sudden hypoglycemia occurs: sweating, general weakness, tremor, pallor, rapid heartbeat, restlessness, hunger…
  Due to disorders of the central nervous system, gradually occurring hypoglycemia occurs: dizziness, headache, blurred vision, decreased mental activity, decreased motor function, confusion, behavioral changes, convulsions, disturbances of consciousness, coma.
  Disorders of the state of consciousness are of different levels and intensity depending on the severity of hypoglycemia and the speed of its occurrence. Abnormal neurological outbursts may occur, such as unilateral body weakness, disorientation, convulsions, and coma.
  In the case of unconscious states, the data are very important: is the person diabetic, did he take insulin or oral antidiabetics, did he starve, did he have physical exertion…? Diabetics may be in a hyperglycemic coma, so the decision on therapy should not be made hastily before checking the blood sugar level. Glucometers, small portable blood glucose meters available to almost all diabetics, are available.
  If the person does not regain consciousness, it is necessary to turn the person to the side and call an ambulance.
  Symptoms of hypoglycemia subside within minutes after taking sugar: a sugar cube, a spoonful of honey, a bar of chocolate, fruit juice, Coca-Cola, candy or glucose tablets, a glass of milk… People who have recurrent hypoglycemia, especially diabetics, carry glucose tablets because the tablets they act immediately and provide a constant amount of sugar. It should be noted that people who are unconscious should not be given food or drink, due to the possibility of suffocation. It is possible to 'smear' the mucous membrane of the mouth with honey or try to give a spoonful of honey.
  If the blood sugar level does not rise, it is necessary to call an ambulance or transfer the person to the nearest clinic.
  When taking sugar by mouth is not possible, when a person has impaired consciousness, does not cooperate or there is a risk of suffocation, doctors give glucose intravenously.
  In all cases, glucose administration should be titrated according to effect.
  After 10 minutes, it is necessary to measure the blood sugar level, whether the minimum level of 5.0 mmol / l has been reached or whether the state of consciousness has improved.
  If glucose cannot be given intravenously, the doctor may prescribe glucagon (0.5-1mg IM or SC), which takes 5-10 minutes to act on.
  After prescribed therapy, it is necessary to continue taking complex carbohydrates such as dough and bread, especially diabetics, so it is good to have a meal rich in carbohydrates after hypoglycemia, in order to stabilize sugar. People who are prone to hypoglycemia can avoid episodes by eating small meals frequently, rather than the usual three meals a day.