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In the elderly, hypoglycemia can produce focal stroke-like effects or a hard-to-define malaise. [medical citation needed] The symptoms of a single person do tend to be similar from episode to episode. In the large majority of cases, hypoglycemia severe enough to cause seizures or unconsciousness can be reversed without obvious harm to the brain.
Recurrent mild hypoglycemia may fit a reactive hypoglycemia pattern, but this is also the peak age for idiopathic postprandial syndrome, and recurrent "spells" in this age group can be traced to orthostatic hypotension or hyperventilation as often as demonstrable hypoglycemia. [citation needed] Insulin-induced hypoglycemia
When individuals take insulin without needing it, to purposefully induce hypoglycemia, this is referred to as surreptitious insulin use or factitious hypoglycemia. [ 3 ] [ 2 ] [ 24 ] Some people may use insulin to induce weight loss, whereas for others this may be due to malingering or factitious disorder , which is a psychiatric disorder . [ 24 ]
Fasting hypoglycemia is often the most significant problem in GSD I, and typically the problem that leads to the diagnosis. Chronic hypoglycemia produces secondary metabolic adaptations, including chronically low insulin levels and high levels of glucagon and cortisol. Lactic acidosis arises from impairment of gluconeogenesis.
Usually this hypoglycemia can easily be treated with more frequent feedings or medical doses of glucose. Rarely (<5%) children with BWS will continue to have hypoglycemia after the neonatal period and require more intensive treatment. [5] Such children may require tube feedings, oral hyperglycemic medicines, or a partial pancreatectomy.
Hypoglycemia can be problematic if it occurs while driving as it can affect a person's thinking process, coordination, and state of consciousness. [ 56 ] [ 57 ] Some patients are more prone to hypoglycemia as they have reported fewer warning symptoms, and their body released less epinephrine (a hormone that helps raise BG). [ 58 ]
Hypoglycemia is the most common metabolic problem in newborns. [2] Neonatal hypoglycemia is hypothesized to occur in between 1 in 3 births out of every 1,000 births, but the true number is not known since there is no international standard for measurement. It often occurs in premature and small babies and babies of diabetic mothers.
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