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Hypoglycemia, also called low blood sugar or low blood glucose, is a blood-sugar level below 70 mg/dL (3.9 mmol/L). [3] [5] Blood-sugar levels naturally fluctuate throughout the day, the body normally maintaining levels between 70 and 110 mg/dL (3.9–6.1 mmol/L).
[citation needed] A list of common causes: Prolonged fasting Diarrheal illness in young children, especially rotavirus gastroenteritis; Idiopathic ketotic hypoglycemia; Isolated growth hormone deficiency, hypopituitarism; Insulin excess. Hyperinsulinism due to several congenital disorders of insulin secretion; Insulin injected for type 1 diabetes
The hypothesis was postulated by the Nobel laureate Otto Heinrich Warburg in 1924. [3] He hypothesized that cancer, malignant growth, and tumor growth are caused by the fact that tumor cells mainly generate energy (as e.g., adenosine triphosphate / ATP) by non-oxidative breakdown of glucose (a process called glycolysis).
In cancer cells, major changes in gene expression increase glucose uptake to support their rapid growth. Unlike normal cells, which produce lactate only when oxygen is low, cancer cells convert much of the glucose to lactate even in the presence of adequate oxygen. This is known as the “Warburg Effect.”
Despite widely variable intervals between meals or the occasional consumption of meals with a substantial carbohydrate load, human blood glucose levels tend to remain within the normal range. However, shortly after eating, the blood glucose level may rise, in non-diabetics, temporarily up to 7.8 mmol/L (140 mg/dL) or slightly more.
Hypoglycorrhachia (low CSF glucose levels) can be caused by CNS infections, inflammatory conditions, subarachnoid hemorrhage, hypoglycemia (low blood sugar), [3] impaired glucose transport (e.g. GLUT1 deficiency syndrome), increased CNS glycolytic activity and metastatic carcinoma. [4]
In insulin-deficient diabetes (exogenous) insulin levels do not decrease as glucose levels fall, and the combination of deficient glucagon and epinephrine responses causes defective glucose counterregulation. Furthermore, reduced sympathoadrenal responses can cause hypoglycemia unawareness.
The consequent fall in blood glucose is indicated as the reason for the "sugar crash". [4] Another cause might be hysteresis effect of insulin action, i.e., the effect of insulin is still prominent even if both plasma glucose and insulin levels were already low, causing a plasma glucose level eventually much lower than the baseline level. [5]