Hypoglycemia is the acute crash that follows hard exertion on too little food, particularly in the cold. The body’s reserves of quickly available fuel are exhausted faster than fat can be mobilized to replace them, and the brain — which runs almost exclusively on sugar — fails before any other organ. It is the form of starvation that strikes in minutes rather than weeks.
Symptoms
Sudden trembling and weakness in the hands and knees, cold sweat in the absence of heat, a sense of gnawing hunger out of proportion to the time since the last meal, racing pulse, irritability, and difficulty concentrating. Vision may blur or briefly dim.
Progression
If sugar is not restored, the victim slips into confusion, slurred speech, stumbling, and finally seizure or unconsciousness. Death is uncommon if a companion is on hand to feed the victim, but a hypoglycemic collapse alone in cold or wilderness is often fatal through secondary causes — exposure, drowning, a fall.
Treatment
- Eat or drink something sweet at once — honey, dried fruit, sweetened wine
- Follow within the hour with a proper meal of bread, meat, or porridge to stabilize
- Rest until the trembling fully stops; do not attempt heavy work for some hours
- In the field, never skip the morning meal before a long march in cold or thin air