Is low blood sugar due to real factors the same as low blood sugar that appears to be caused by factors that aren't real?

Are low blood sugar levels due to relative hypoglycemia identical to those caused by pseudohyposugram?

A recent case report from 2023 sheds light on a lesser-known complication of both diabetes and certain non-diabetic conditions. Pseudohypoglycemia, a condition where individuals experience symptoms of low blood sugar (hypoglycemia) despite normal glucose levels, has been linked to peripheral artery disease (PAD), Raynaud phenomenon, Eisenmenger syndrome, leukemia, and more.

In people with diabetes, pseudohypoglycemia occurs due to impaired blood glucose sensitivity, which can be caused by nerve damage, reduced blood glucose reaching the brain, or a decrease in the function of an enzyme called glucokinase. For those without diabetes, common causes include skipping meals, excessive alcohol consumption, dehydration, and low blood pressure.

The normal blood glucose range typically falls between 70 and 100 milligrams per deciliter (mg/dL). However, some definitions of pseudohypoglycemia state that people with the condition may have a blood glucose level below 70 mg/dL, even without showing any symptoms.

A 2022 review also highlights a potential link between glucose processing and cognitive function in individuals with Alzheimer's disease.

Unfortunately, pseudohypoglycemia does not have a specific treatment, and attempting to correct it by reducing blood glucose levels too far can lead to severe complications. In the intensive care unit (ICU), the least dangerous blood glucose range for a person with a critical illness remains controversial, and reducing blood glucose levels too sharply may increase the risk of pseudohypoglycemia and mortality.

Pseudohypoglycemia has been associated with an increased risk of delirium in ICU patients with critical illness and diabetes. This condition is more common in those with diabetes but can also occur in people without diabetes, even as a side effect after chemotherapy.

To manage diabetes in the ICU, medical professionals often opt for continuous insulin infusions and monitoring instead of intermittent doses to help control blood glucose levels more effectively. It's essential to understand that pseudohypoglycemia symptoms are identical to those of hypoglycemia, including anxiety, confusion, dizziness, hunger, irritability, a rapid or irregular heartbeat, shaking, sweating, tingling sensations in the lips, vision changes, and, in extreme cases, unconsciousness, seizures, and coma.

It's crucial to note that pseudohypoglycemia differs from hypoglycemia in that it refers to the body's response not aligning with the person's blood glucose level. Diabetes may also negatively affect the ability of the nerves in the brain to detect glucose levels.

In conclusion, pseudohypoglycemia is a lesser-known complication that can affect individuals beyond those with diabetes. Understanding this condition is vital for both patients and healthcare professionals to ensure proper management and avoid potential complications.