Sever hypoglycemia when blood glucose level <54 mg/dl is a grave condition and patients manifest with impaired cognitive function. Glucose is the key energy source for brain. In normal physiological condition glucose metabolized aerobically to produce energy in the form of ATP after glycolysis. In hypoglycemia like in condition of starvation or in any pathologically low blood glucose level, brain depends on ketone bodies to fulfill its energy requirement. In cancer patients due to Warburg effect there is aerobic fermentation of glucose leads to production of ketone bodies and lactic acid, which fulfill the energy requirement of brain and patients doesn't show symptoms of hypoglycemia
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