DefinitionThe condition called hypoglycemia is literally translated as low blood sugar. Hypoglycemia occurs when blood sugar (or blood glucose) concentrations fall below a level necessary to properly support the body's need for energy and stability throughout its cells.DescriptionCarbohydrates are the main dietary source of the glucose that is manufactured in the liver and absorbed into the bloodstream to fuel the body's cells and organs. Glucose concentration is controlled by hormones, primarily insulin and glucagon. Glucose concentration also is controlled by epinephrine (adrenalin) and norepinephrine, as well as growth hormone. If these regulators are not working properly, levels of blood sugar can become either excessive (as in hyperglycemia) or inadequate (as in hypoglycemia). If a person has a blood sugar level of 50 mg/dl or less, he or she is considered hypoglycemic, although glucose levels vary widely from one person to another.Hypoglycemia can occur in several ways.Drug-induced hypoglycemiaDrug-induced hypoglycemia, a complication of diabetes, is the most commonly seen and most dangerous form of hypoglycemia.Hypoglycemia occurs most often in diabetics who must inject insulin periodically to lower their blood sugar. While other diabetics also are vulnerable to low blood sugar episodes, they have a lower risk of a serious outcome than insulin-dependant diabetics. Unless recognized and treated immediately, severe hypoglycemia in the insulin-dependent diabetic can lead to generalized convulsions followed by amnesia and unconsciousness. Death, though rare, is a possible outcome.In insulin-dependent diabetics, hypoglycemia known as an insulin reaction or insulin shock can be caused by several factors. These include overmedicating with manufactured insulin, missing or delaying a meal, eating too little food for the amount of insulin taken, exercising too strenuously, drinking too much alcohol, or any combination of these factors.Ideopathic or reactive hypoglycemiaIdeopathic or reactive hypoglycemia (also called postprandial hypoglycemia) occurs when some people eat. A number of reasons for this reaction have been proposed, but no single cause has been identified.In some cases, this form of hypoglycemia appears to be associated with malfunctions or diseases of the liver, pituitary, adrenals, liver, or pancreas. These conditions are unrelated to diabetes. Children intolerant of a natural sugar (fructose) or who have inherited defects that affect digestion also may experience hypoglycemic attacks. Some children with a negative reaction to aspirin also experience reactive hypoglycemia. It sometimes occurs among people with an intolerance to the sugar found in milk (galactose), and it also often begins before diabetes strikes later on.Fasting hypoglycemiaFasting hypoglycemia sometimes occurs after long periods without food, but it also happens occasionally following strenuous exercise, such as running in a marathon.Other factors sometimes associated with hypoglycemia include:pregnancya weakened immune systema poor diet high in simple carbohydratesprolonged use of drugs, including antibioticschronic physical or mental stressheartbeat irregularities (arrhythmias)allergiesbreast cancerhigh blood pressure treated with beta-blocker medications (after strenuous exercise)upper gastrointestinal tract surgery
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