Hypoglycemia...

What is hypoglycemia? ....gosh, I never heard of it...hypo? lack of something? what is that?? ...that was the first thing that came into my mind....the word 'hypoglycemia' ...that was what my baby Ridhwan had gone through on his 4th day in this world....now I know how my mother feels when I am sick or in pain...the feeling, the pain...the agony is unbearable...and that is what I felt...or probably worse...as on his 4th day in this world, my baby was rushed to the emergency room and then later to the ICU...

At first I thought...should I be telling this ....or maybe keep this to myself and never tell a soul..why tell the world what pain I had to go through or even worse, what pain and torture my baby had to go through...but then, things happened for a reason....maybe it is time for me to speak up and tell people what had happened and maybe, by telling I'll be telling my experience and in some way or another be educating others about what I had gone through...and take iktibar on what had happened...

And so, I shall tell you a story or journey that I, my husband and my baby boy had gone through on this very year 2005 in the month of June....

2nd June was a joyous day as darling Ridhwan was delivered into this world....then he came home with us two days later...however...my baby was diagnosed with hypoglycemia after experiencing fits/seizures when he was only 4 days old ....he was rushed to the emergency room on a fine sunday morning as we thought he was having breathing difficulties, only to found out at the ER that he had fits/seizures and he needs to be admitted into the ICU...that sunday was a very dark sunday for me...

HYPOGLYCEMIA

Alternative names

Insulin shock; Low blood sugar

Definition

Hypoglycemia occurs when your blood sugar, called glucose, is abnormally low. The term insulin shock is used to describe severe hypoglycemia that results in unconsciousness.

Causes, incidence, and risk factors

Hypoglycemia results when your body's glucose is used up too rapidly, when glucose is released into the bloodstream too slowly, or when too much insulin is released into the bloodstream. Insulin is a hormone that reduces blood glucose. It is produced by the pancreas in response to increased glucose levels in the blood.

Hypoglycemia is relatively common in diabetics. It occurs when too much insulin or oral antidiabetic medication is taken, not enough food is eaten, or from a sudden increase in the amount of exercise without an increase in food intake.

Relative hypoglycemia, where a newborn's blood glucose is low, is fairly common. Severe hypoglycemia may occur in an infant born to a woman with diabetes or gestational (caused by pregnancy) diabetes. In these cases, the child is referred to as an IDM (infant of diabetic mother).

If, during the pregnancy, the mother's blood sugar is persistently high, the fetus' pancreas assists in controlling the excess blood sugar by producing extra insulin. When the infant is born, it no longer gets the mother's glucose, but still produces large amounts of insulin, which drives the infant's blood sugar down to dangerous levels. This is a medical emergency that may result in seizures and damage to the baby's nervous system if not treated.

Sometimes the cause of hypoglycemia is unknown (idiopathic). In these cases, people who are not diabetic and who do not have another known cause of hypoglycemia experience these symptoms.

Hypoglycemia can occur because of an insulin-secreting tumor of the pancreas, liver disease, or as a response to the ingestion of alcohol. It can occur in adults, infants, and children, and affects approximately 1 out of every 1,000 people.

Symptoms

• Fatigue
• General discomfort, uneasiness, or ill feeling (malaise)
• Nervousness
• Irritability, or even aggression
• Trembling
• Headache
• Hunger
• Cold sweats
• Rapid heart rate
• Blurry or double vision
• Confusion
• Convulsions
• Coma

Additional symptoms that may be associated with this disease:

• Excessive sweating
• Sleeping difficulty
• Paleness
• Muscle pain
• Memory loss
• Palpitations, or feeling your heartbeat (heartbeat sensations)
• Hallucinations
• Fainting
• Different size pupils
• Dizziness
• Decreased consciousness

Signs and tests Return to top

• Serum glucose, or sugar level in the blood, is low.
• If the person is self-checking blood glucose levels, readings will be low (less than 50 mg/dl).

This disease may also alter the results of the following tests:

• Glucose tolerance test
• CSF collection
• Blood glucose monitoring

Treatment

A snack or drink containing sugar will raise the blood glucose level, and you should see an immediate improvement in symptoms.

Infants of diabetic mothers that develop low blood sugars are treated with glucose solutions given into the vein to maintain the blood sugar at normal levels. The glucose is slowly reduced over the next 24 - 48 hours while the infant begins to regulate its blood sugar at normal levels.

Unconsciousness or inability to swallow may occur if the person's blood sugar levels are very low. This is called insulin shock, and emergency medical treatment is needed. An injection of glucose solution or the hormone glucagon will be given immediately.

In the longer term, you may need to modify your diet so that you get glucose into your body more evenly throughout the day. This may prevent further hypoglycemic episodes. Small, frequent meals with complex carbohydrates, fiber, and fat and avoiding simple sugars, alcohol, and fruit juice may be recommended. You should also eat meals at regular intervals, and balance extra exercise with extra food.

If hypoglycemia is caused by an insulinoma (insulin-secreting tumor), surgery to remove the tumor is the best treatment.

Expectations (prognosis)

Severe hypoglycemia can often be avoided by recognizing the early warning signs of the condition and treating yourself rapidly and appropriately. Untreated hypoglycemia can progress to unconsciousness and if the brain is exposed to reduced glucose for a long period of time, there may be permanent damage.

Complications

• Loss of consciousness
• Coma

In the infant

• Seizure
• Permanent damage to the nervous system

Calling your health care provider

Go to the emergency room immediately or call a local emergency number, such as 911, if early signs of hypoglycemia do not improve after you've eaten a snack containing sugar. If a diabetic, or other person known to experience hypoglycemia, becomes unresponsive or you can't wake them, you should also call an emergency number.

Prevention

Diabetics should follow their doctors' advice regarding diet, medications, and exercise.

Pregnant diabetic women should maintain careful control of their blood sugar. Gestational diabetes, or diabetes that occurs during pregnancy, is diagnosed by repeat testing of expectant mothers. Upon delivery, routine blood sugar levels are taken from the infant until blood sugar levels are normal.

People who are known to experience hypoglycemia should keep a snack or drink containing sugar available at all times to take as soon as symptoms appear. If symptoms do not improve in 15 minutes, additional food should be eaten. A glucagon kit is available by prescription for episodes of hypoglycemia that respond poorly to other types of treatment.

Update Date: 8/1/2005 Updated by: Nikheel S. Kolatkar, MD, Clinical and Research Fellow, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Review provided by VeriMed Healthcare Network.


So, this is what hypoglycemia is all about.....

Till now, the doctor actually don't know how hypoglycemia happened as it is stated above "Sometimes the cause of hypoglycemia is unknown (idiopathic). In these cases, people who are not diabetic and who do not have another known cause of hypoglycemia experience these symptoms." .... Ridhwan was in the ICU for nearly 11 days and later warded to the paeds ward for another 10 days....that was also the most painful days I had to go through as I was still in confinement/pantang and the room was sooooo cold and there I was shivering like mad on the bed every night and the stiches somehow was a bit unbearable, probably due to my emotions and exhaustion to what I had to go through...though luckily hubby was there to warm me up...hehee..



However, with what had happened to Ridhwan, I am very thankful to Allah for allowing Ridhwan to get well quickly and be able to come home into our arms....what Ridhwan had gone through had to be the worse experience an infant or a baby had to endure...the time in ICU had to be the worse time of my entire life and each visit there was very devastating...what Ridhwan went through was even worse as he had needles poking into him on every part of his body, and the constant sound of the heart rate monitor on the pc attached to the wires to Ridhwan had to be the scariest sound a mother had to hear.....

I try not to look back on what happened and wonder how it could even have happened....and as usual, a mother's guilt is always there, wondering if I was the cause to all his pain....but maybe I was..or maybe I wasn't cause thinking about it would only bring me down and probably destroy myself....and so I try to think in a positive way as now he is a very healthy and active baby boy who cannot get enough attention of me! hehee..manja anak mama nie...and an intelligent one to...he is a very active boy always looking around and enjoys smilling and laughing nowdays...I thank Allah for giving me strentgh to pray hard inside my heart and hope for the best throughout his time in the ICU...and as my sis-in-law constantly told me....'miracles happens reenaz..' ...and it did...I never stopped believing that Allah will help me ...and my baby was a born fighter too....as they say 'kun faya kun' ..but 'tawakal Alallah', 'la takhzan la takhof, innallah maa'na...' and yes, I truly believe in that... Well... this blog entry may have some impact on the readers...yet, my advice to mothers out there..do watch what you eat while conceiving or pregnant cause with the world as it is nowdays, we don't know what we are eating or using and how it may affect our little baby inside us..or even that is out of our tummy and happily living in our world...another note of advice, which I plan to do when I deliver my next baby, Insya-Allah....do as much test as you want on your newborn as we can never know if our baby might be low in glucose or whatever ailments he is experiencing...and my last advice, never ever stop praying to Allah for His blessings and forgiveness, as no matter what happens, how hard life is or how great life is, Allah is always there and he is just a doa away...may this blog entry be a 'pedoman' to those who read it...and may Allah always bless my baby and all the babies in the world...

My happy baby boy!