low blood sugar symptoms without actual hypoglycemia?

Emergency RN · Mar 23, 2010

Maybe you should check his blood pressure or temperature instead. Sometimes patient's assign the wrong reasons to what they're feeling. Since the patient isn't a known diabetic, never had a hypoglycemic episode, isn't on insulin or oral hypoglycemics; but nonetheless feels something, then you need to investigate what that something (now known to be NOT hypoglycemia) is.

Further, classic symptoms of hypoglycemia would include:

hunger
shakiness
nervousness
sweating
dizziness or light-headedness
sleepiness
confusion
difficulty speaking
anxiety
weakness

I would question the patient as to exactly what he was feeling, and instruct him to describe it without trying to assign a clinical cause (low blood sugar) to it.

Kooky Korky, BSN, RN · Mar 23, 2010

Maybe it was hypoglycemia but transient.

Some people who frequently run high sugars start feeling hypoglycemic at numbers that are normal or even above normal.

Perhaps your friend or patient should have a GTT and make sure about not being diabetic.

A patient we once had had episodes of hypoglycemic feelings but her GTT was normal, as were here sugars all the many times we checked them. Saw a neurologist, cardiologist, and endocrinologist, as well as internist NP. These episodes are believed to be due to a degree of mitral valve failure. Wow. So something is going with your patient. The body is wonderful and mysterious. Sometimes we have to sleuth.

Yeah, yeah, I know all about horses and zebras. Well, I think rare diseases are supposedly rare because no one believes those hoofbeats could be pointing to a zebra.

Don't forget occult infection, drug interaction or reaction, must be dozens of things to rule out.

itsmejuli · Mar 23, 2010

I told my doctor about the symptoms I'd get if I hadn't eaten for a few hours. Told him I'd feel weak, sometimes dizzy, get a headache, shakiness, get angry easily.

I asked him if this could be hypoglycemia and if I should be tested. He said no need to test you, just make sure you eat every 2 - 3 hours. So that's what I do, I never skip meals and have snacks in between.

Bottom line, if you're patient is non-diabetic and gets hypoglycemic symptoms...did you ask him how often he eats?

JulieCVICURN, BSN, RN · Mar 23, 2010

I am a diabetic. I can tell you that yes, it is possible to have symptoms of hypoglycemia without being hypoglycemic. If you don't have good control over your glucose levels and your body has gotten physically used to a blood sugar of, let's say, 180-190 for example, you might very well start feeling shaky at 110. It's not a true hypoglycemia, it's just the way the body has adapted. I wouldn't "treat" for it, but just be aware that it can happen and as long as the sugar is in range it's probably benign.

Also, from personal experience, drinking diet soda can give me that exact same feeling. Perhaps this patient is sensitive to aspartame?

I'm not sure if this applies to non-diabetic patients.

cherrybreeze, ADN, RN · Mar 23, 2010

I get occassional (sp, sorry) low blood sugars...have not found a reason, I am not diabetic. I have a cheap meter that I'll use to check it when I'm symptomatic (I am curious to know how low it goes), and when I feel s/s it can be anywhere from in the 30's to normal (70's and 80's). I think that if it drops quickly, for whatever reason, I'll feel symptoms even if it doesn't drop below normal....does that make sense? A few times I've been SURE it's low and was surprised it was not, so either it had already started to correct itself, or was just a quick drop.

kcochrane · Mar 23, 2010

My husband who is diabetic will feel shaky/weak at anything less than 80. When I'm at 80 (not diabetic) I feel fine. I do think there are some people diabetic or non who just don't feel well at certian levels.

Davidnelsonigoma · Mar 23, 2010

Hypoglycemic : it could be manifestations of other disease conditions. Ensured patient carryout other investigations to rule out cardiac conditions and urinary complications. But the mean time, re do BS analysis and inform the diabetic doctor, dm nurses and provide emotional support.

classicdame, MSN, EdD · Mar 23, 2010

hypoglycemia symptoms are autonomic nervous system responses so various issues should be assessed.

Also, if a diabetic is used to having higher BS, then gets controlled due to your interventions, they may actually feel "low". Normal is low to them.

Kooky Korky, BSN, RN · Mar 23, 2010

I am a diabetic. I can tell you that yes, it is possible to have symptoms of hypoglycemia without being hypoglycemic. If you don't have good control over your glucose levels and your body has gotten physically used to a blood sugar of, let's say, 180-190 for example, you might very well start feeling shaky at 110. It's not a true hypoglycemia, it's just the way the body has adapted. I wouldn't "treat" for it, but just be aware that it can happen and as long as the sugar is in range it's probably benign.
Also, from personal experience, drinking diet soda can give me that exact same feeling. Perhaps this patient is sensitive to aspartame?
I'm not sure if this applies to non-diabetic patients.

Some patients I've cared for get feeling hypoglycemic around 150! I guess we need to look at the patient, not the numbers. I would treat it, though, even if the numbers are WNL. Why leave the person feeling sick when little sugar can help so quickly.

And if it doesn't help and the numbers are WNL, then they need to start doing a fuller work-up.