What All Nurses and Patients Should Know

This is an educational paper for nurses and patients. It is written in simple language so that an ordinary person can understand the signs and symptoms of low blood sugar. This is a common condition for patients who suffer from diabetes mellitus. It is a condition which Nurses, Doctors and Patients manage daily and is still poorly understood.

Hypoglycaemia is defined as low blood sugar. Many authors consider 3.3 mmols to be low (Farrell, 2005), others accept 4.0mmols/L to be on the lower side. There is consensus that the normal range of blood sugar, on the metric scale, is between 4.0 and 8.0mmols per/L.

High blood sugar is called hyperglycemia. It is the opposite of hypoglycemia. Hyperglycemia is said to occur when the blood sugar is more than 10 mmols per liter.

A sign is any objective evidence of disease. For example, gross blood in stool is a sign of disease. It can be recognized by the patient, doctor, nurse, or others. It forms part of objective data gathered from a patient during history taking and other examinations.

A symptom is a subjective statement made by a patiet. For example, I have abdominal pain is a pain is a symptom. It is something only the patient can know or feel and report.

When hypoglycaemia occurs, the bood sugar falls to below 3.3mmols/L. This condition can occur at any time of the day or night. The signs and symptoms of hypoglycaemia are due to stimilation of the sympathetic nervous system which results in the production of adrenaline and noradrenaline. Surges in the level of adrenaline and noradrenaline will produce the following signs and symptoms. It will be helpful to note that Adrenaline and Noradrenaline are the naturally occuring hormones which bring about the “flight and fright” response in mammals.

Tachycardia: One of the early signs of hypoglycaemia is tachycardia. Tachycardia is a heart rate of more than 100 beats per minute. The pulse is generally thready.

Sweating: Patients in hypoglycaemic states are usually diaphoretic (sweat excessively). Quite often all their clothes become wet with sweat and my require to change them.

Tremours: The hypoglycaemic patient often displays fine tremour of the hands. This is due to the high levels of adrenaline and noradrenaline.

Palpitations: Complaints of palpitations in the chest are usual. The patients heart tries to get as much energy to the brain as is possible. It does this by working harder than usual. Hence the palpitaions.

Hunger: The low blood sugar stimulates the patients hunger centre. If the patient consumes something containing sugar then the hypoglycaemic condition will be corrected and the sumptoms will disappear.