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While there is some degree of variability among people, most will usually develop symptoms suggestive of hypoglycemia when blood glucose levels are lowered to the mid 60's. The first set of symptoms are called adrenergic (or sympathetic) because they relate to the nervous system's response to hypoglycemia. Patients may experience any of the following;
* intense hunger,
* palpitations, and
* often have trouble speaking.
Anyone who has experienced an episode of hypoglycemia describes a sense of urgency to eat and resolve the symptoms. And, that's exactly the point of these symptoms. They act as warning signs. At this level, the brain still can access circulating blood glucose for fuel. The symptoms provide a person the opportunity to raise blood glucose levels before the brain is affected.
If a person does not or cannot respond by eating something to raise blood glucose, the levels of glucose continue to drop. Somewhere in the 50 mg/dl range, most patients progress to neuro-glyco-penic ranges (the brain is not getting enough glucose). At this point, symptoms progress to confusion, drowsiness, changes in behavior, coma, and seizure.