Hypoglycemia (Low Blood Sugar) in Pregnancy

The food that we consume is broken down into sugar that is glucose. Glucose then enters the various cells of the body and provide energy for metabolic processes that keep the body running. If there is not enough glucose in the blood, it can lead to a condition known as ‘hypoglycemia’ or low blood sugar, which means the concentration of dissolved sugar in the body is below the required amounts. This can cause mild to severe complications depending on the extent of hypoglycemia. In simple cases, it can cause lethargy and tiredness but if it is in the advanced state, it may lead to fainting or even coma. Being hypoglycemic is problematic in itself, but if it happens during pregnancy, you will have to take extreme care to control it.

What Is Hypoglycemia in Pregnancy?

Hypoglycemia occurs when the normal blood sugar range falls below 700 micrograms per millilitre in pregnancy. In contrast, the normal range for blood sugar should be between 700 and 1000 micrograms per millilitre.

Types of Hypoglycemia

If you observe any symptoms of hypoglycemia, please contact your doctor as soon as possible so you can be diagnosed and treated well in time. There are two common types of hypoglycemia that occur during a pregnancy. They are as follows:

1. Reactive Hypoglycemia

In reactive hypoglycemia in pregnancy, the levels of blood sugar tend to fall rapidly within the first couple of hours after you have had a meal. This type of hypoglycemia is more common in diabetics but is also observed in people without the condition.

2. Fasting Hypoglycemia

In fasting hypoglycemia, the blood sugar falls to dangerous levels in between your meals. This type is more common in people without diabetes.

Who Is More Prone to Hypoglycemia?

Pregnant women who are most prone to hypoglycemia in the following conditions:

• A pregnant woman is more prone to hypoglycemia during the end of the first trimester, especially between 8 and 16 weeks of pregnancy.
• If you frequently fall sick during pregnancy, it can lead to hypoglycemia.
• A history of low blood sugar or hypoglycemic attacks can also lead to hypoglycemia.

What Causes Low Blood Sugar in Pregnancy?

There are several potential causes of hypoglycemia in pregnancy. Some of them include:

1. Morning Sickness

Morning sickness or nausea and vomiting during pregnancy can cause low blood sugar. This is because you might be rejecting more food than you are consuming, leading to a caloric deficit in your daily diet. If you find that you are vomiting frequently, losing weight, and feeling faint or dizzy, please contact your doctor for advice.

2. Lifestyle

There are various lifestyle factors that affect blood sugar levels in the body. For instance, over exercising leads to excess glucose being broken down for the energy burst required. Another factor is not consuming enough food, that is less than 1800, 2200 and 2400 calories per day in the first, second and third trimester, respectively. Consuming alcohol can also lead to hypoglycemia, as it impedes with the release of blood sugar from the liver.

3. Diabetes

Hyperglycemia, or raised levels of blood sugar, is common during pregnancy. This is the result of diabetes, in which the hormone insulin does not efficiently transport blood sugar to the cells, leading to excess sugar in the bloodstream. However, hypoglycemia can occur because of diabetes medications, such as insulin injections. These insulin injections can lower the blood sugar levels in the body more than required, leading to hypoglycemia. In other cases, hormonal changes in your pregnancy can lead to hypoglycemia in women who have diabetes, even if they are not taking insulin medication. Please ensure that you consume well-balanced meals during your pregnancy as well as keep an eye on your blood sugar levels if you are pregnant and diabetic.

4. Gestational Diabetes

Gestational diabetes is a pregnancy condition, which is caused due to hormonal effects, pregnancy stress, and resistance to insulin. Due to this, your blood sugar levels can drop, leading to hypoglycemia. This is especially likely in women who have diabetes and are on medication. Approximately nine percent of women suffer from gestational diabetes during their pregnancy, but the condition resolves on its own after giving birth.

5. Medical Conditions

Several medical problems can lead to hypoglycemia in pregnancy without diabetes. As some of them might cause complications in your pregnancy and in foetal development, it is important to obtain proper treatment. These disorders include glucagon and cortisol hormone imbalances, acute hepatitis, organ failure, enzyme deficiencies, pancreatic tumours, and so on.

6. Medication

In addition to insulin, other diabetes medications can lower blood sugar levels. Oral medicines like sulfonylureas and meglitinides are used to treat diabetes and can cause hypoglycemia. Several other medicines are also used in reducing blood sugar levels, such as sulfonamides, pentamidine, quinine, and salicylates.

Signs and Symptoms of Low Blood Sugar during Pregnancy

As sugar is the source of energy for many of the body’s metabolic processes, low blood sugar will cause several symptoms to manifest. Some of them include:

• Weakness, tiredness, and fatigue can make you exhausted and cranky.
• It becomes harder to think with clarity.
• The body begins to sweat and shake uncontrollably often.
• You might experience an irregularity or an increase in your heart rate.
• Your vision might become blurry and unclear.
• You may experience fluctuations in mood and anxiety levels.
• If your hypoglycemia is severe, you might suffer from convulsions and seizures, and even lose consciousness.
• Hypoglycemia symptoms can also show up during sleep, such as
  1. Cold night sweats
  2. Frequent nightmares
  3. Tired even after a good night’s sleep
  4. Difficulty in waking up in the morning

How to Diagnose Low Blood Sugar in Pregnant Women

Gestational diabetes is usually tested during the second trimester, but if women show symptoms of diabetes, more tests might be required. If you do not have diabetes, they might suggest more to identify the cause of your hypoglycemia. Further, they might require you to furnish detailed descriptions about your medical history, diet, exercise routine, and so on.

Effects of Hypoglycemia on Pregnancy

Hypoglycemia can have an effect on both the mother and the baby during pregnancy.

1. Effect on the Mother

Severe cases of hypoglycemia might require hospitalisation. Further, gestational diabetes is known to result in complicated labours, leading to potential injuries while giving birth. Hypoglycemic attacks can occur at night during early pregnancy, where the blood sugar level can drop to 300 micrograms per millilitre. This can result in seizures and in extreme cases, a coma.

2. Effect on Baby

Low blood sugar during pregnancy can also affect the health of the baby. foetal development, such as physical and mental abnormalities, low birth weight and so on. Pregnant women with gestational diabetes have an increased risk of giving birth to . These babies often have drastically low blood sugar levels and need careful monitoring.

Treatment for Reducing the Severity of Hypoglycemia

If the case of hypoglycemia is severe, there are a few treatment methods which can be employed:

• Feeding the patient high-calorie foods such as fruit juice, sugar water, glucose tablet can help. In total, there should be approximately fifteen grams of carbohydrates. The blood sugar should normalise within fifteen minutes of eating the carbs.
• In case the patient cannot eat or drink, visit a doctor at earliest.
• During labour and delivery it is vital to monitor blood sugar level.
• In rare cases, tumours causing hormonal imbalance will need to be removed during the pregnancy.

Precautions to Take while Suffering from Hypoglycemia during Pregnancy

Pregnant women with hypoglycemia can take a few precautions to regulate the condition:

• Avoid alcohol at all costs.
• Check your blood sugar levels with a portable glucometer.
• Keep a sugary snack handy at all times.
• Eat smaller meals but more often rather than three large meals a day.
• If you are working out more on a particular day, consume more food.
• If you have been prescribed insulin, remember to take the right doses at the right time.

Hypoglycemia can occur during your pregnancy for various reasons, even if it’s skipping a single meal. If you notice any symptoms of hypoglycemia as described in this article, please consult with your doctor so they can accurately diagnose and prescribe treatment for the condition. You can also check with your doctor if you need to know how to lower blood sugar during pregnancy in case you have hyperglycemia.