Hypoglycemia masquerading as acute psychosis in young age


The classic presentation of hypoglycemia includes tachycardia, anxiety, extreme hunger, tremor, palpitations, pallor, weakness and an altered level of consciousness. The hypoglycemic patient’s presentation may also lead to suspect another condition such as cerebrovascular accident, seizure, head injury or acute psychosis.

A clinical study was done to determine whether there is a correlation between the manifestations of hypoglycemia and the patient’s age.


We studied 191 prehospital patients in the period from February 1998 to September 1999. For each patient we studied: the level of blood glucose, age and clinical manifestations of hypoglycemia.


99 (51.4%) patients presented with coma, 24 patients (12.6%) presented with focal neurological deficit or seizure activity, 56 (29.2%) were confused and 12 (6.8%) presented as acute psychosis.

We found out that there existed a statistically important difference in patient’s age between clinical manifestations of hypoglycemia (Table).


In our study we found out that psychosis as a manifestation of hypoglycemia presents in significantly younger patients than other manifestations (Student t-test <0.05). In elderly patients hypoglycemia presents more often with focal neurological deficit, seizure, confusion and coma. Our cases illustrate the importance of considering hypoglycemia in all patients who present with alterations in mental status even when the clinical findings seem to be explained initially by other etiologies. Emergency physicians must be aware of such a presentation of hypoglycemia and the need for rapid testing, since testing is easily performed and therapy is most often curative with a good outcome.


ChooseLife : Carey Reams described how many people (he believed Hypoglycaemia was the biggest cause of divorce) were unaware of their Hypoglycaemia or tendency towards this state. He described how in many he saw the fall in sugars as being what he called “the Hell zone” or words to this effect. Moreless, when queried on the causes of Depression, simply said “Prolonged low blood sugar”.

In these days, of heightened sensitivity amongst the world populace, especially the West where we are more prone to diets excessively high in refined sugars, knowing these dynamics and acting by avoiding the Demon fuels as best we may, is a Devine inspired teaching.

These past few years, saw first the explosion of the Vegan movement, which has beautiful ethical backgrounds, however for most this means fuelling this fight or flight demon, if not undertaken with the greatest of care not to over stimulate this delicate balance.

The Omega3 fats, appear crucial in buffering this situation, as a long term vegetarian my stance is to have the Budwig mixture daily of Quark and Flaxoil. To be mindful when I escalate my sugars, of allowing the subsequent emotional storm not to set into my being, resist refuelling this demon by simply charging back up on simple sugars, we crave sugars as our bodies know that most of the essential nutrients are bound to sugar chains, fuelling the body with these nutrients, dampens these Demons call towards us.

It is no surprise at all, to see a flourishing of the “Meat only diet”, and similar other forms, though this is beset with a different side of this storm mankind faces these times.

Smile, ‘Tis your choice.

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