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Hypoglycemia is a condition in which the glucose level present in the blood drops to a level below the normal range. It can develop both in type 1 diabetes mellitus and type II diabetes mellitus. Frequently, this is a very severe health issue in diabetics and has severe effects. The physician may be able to identify and treat diabetic ketoacidosis and diabetic non-ketotic coma early, but hypoglycemia turns out to be a serious problem as it is often not recognized in diabetes. In certain cases, hypoglycemia occurs suddenly, and by the time one recognizes that they are hypoglycemic; it may be too late to take control of the situation. If hypoglycemia is left untreated for a long time, especially in a diabetic, the chances of permanent brain damage are very high. Hypoglycemia is also associated with several cardiovascular disorders such as heart attacks, stroke, cardiac failure and arrhythmias, myocardial ischemia, etc. In elders, the risk of losing consciousness and developing seizures is especially high. Associated injuries that develop during the hypoglycemic-associated complications such fractures, injuries to the legs, etc, may be especially problematic to heal in diabetics. Hypoglycemia in elders is responsible for causing visual and coordination problems. In elders, hypoglycemic symptoms are often perceived as symptoms of ischemia, both by the relatives and the healthcare professionals. This difficulty in recognizing the symptoms worsens the outcome of the disorder. As age increases, the symptoms of hypoglycemia become less severe, and are often altered by the addition of certain atypical symptoms and the absence of the regular ones. In younger individuals, physical symptoms of hypoglycemia develop earlier than that compared to loss of cognitive functions. Hence, the individual may have sufficient time to treat the condition. Besides, if the glucose levels in the blood fall to a very low level, it cannot be restored to normal by administering glucose orally. Usually a close relative or the spouse can recognize the symptoms of hypoglycemia by noting that the patient looks at a distance or demonstrates several other symptoms such as repeated blinking, loss of speaking skills, deep breathing, aggressiveness, etc. It may be considered that individuals with greater control over their diabetes are also in good control of hypoglycemia. Hypoglycemia can occur during fasting and even after consumption of food (as a reactionary mechanism). Hypoglycemia can occur following several drug therapies such as along with steroids, beta-blockers, ethanol, insulin, disopyramide, etc. Hypoglycemia can evidently lead to neuroglycemia. Although, 50 mg/dl of blood is considered to be hypoglycemia, symptoms are produced at 40 mg/dl, and coma and seizures frequently occur at 20 mg/dl. As hypoglycemia can occur frequently and has a high rate of mortality as well as morbidity, the importance of identifying and treating it should be explained to the patient and his/her relatives. The individual should be warned of the symptoms that could develop during the mild (confusion, light-headedness, etc), moderate (headache, behavior alternations, etc) and serious (seizures, coma, unconsciousness) stages of hypoglycemia. The individual should also be told of the situations in which hypoglycemia can commonly develop such as excessive consumption of anti-diabetic medications, excessive use of insulin, reduced consumption of foods, additional exercises or physical activity, alcohol consumption, etc. The individual should be advsied of the hypoglycemic symptoms that can develop during sleep (such as sweating, nightmare, hunger, etc). Thus it can be seen that hypoglycemia is a frequent complication especially in diabetes. It should be adequately controlled utilizing some simple precautions. In case the individual develops hypoglycemia, immediate recognition and emergency treatment is essential in order to prevent the development of neuroglycemia and serious complications like permanent brain damage. References: Boyle, P. J. (2000). Hypoglycemia, In. Leahy, N. L. , Clark, N. G. , and Cefalu, W. T. (Ed. ), Medical Management of Diabetes Mellitus, New York: Marcel-Dekher. Mangione, R. A. (1996). Recognition and Management of Hypoglycemia, Retrieved 14 Janaury, 2007, from US Pharmcist Web site: http://care.diabetesjournals.org/cgi/content/full/28/12/2948