Hypoglycemia, or low blood sugar, is something that many individuals with diabetes may experience at some point. While it can be a common part of living with diabetes, it is still an important and sometimes alarming condition that requires prompt attention. Hypoglycemia occurs when blood sugar levels drop too low, typically below 70 mg/dL (3.9 mmol/L). When blood glucose levels fall too much, it can interfere with the body’s ability to function properly. Recognizing the symptoms early and knowing how to treat and prevent hypoglycemia can help ensure that you stay safe and healthy.
What Is Hypoglycemia?
Hypoglycemia happens when blood glucose levels fall below normal. For people with diabetes, hypoglycemia is usually linked to an imbalance in the amount of insulin or other medications taken, the food consumed, and the level of physical activity. Insulin, which is a hormone used to help regulate blood sugar, can sometimes cause glucose levels to drop too low if there is too much insulin in the bloodstream relative to the amount of sugar available. People who use insulin or medications that increase insulin production are at a higher risk of experiencing hypoglycemia, but it can also happen if someone skips meals, exercises too intensely, or drinks alcohol on an empty stomach.
For individuals with diabetes, knowing when and why hypoglycemia occurs—and how to respond—is essential to prevent complications. When blood sugar levels dip too low, your body doesn’t have enough glucose for energy, leading to symptoms that can be disruptive at best and dangerous at worst.
Recognizing the Symptoms of Hypoglycemia
The symptoms of hypoglycemia can vary from mild to severe and can develop quickly. Recognizing these symptoms early is crucial for treating the condition before it worsens.
In the early stages, hypoglycemia may produce mild symptoms that can be easily overlooked but should not be ignored. Common early signs include shaking or trembling, sweating, and a rapid heartbeat. Many people also experience irritability or mood swings, feeling weak or fatigued, and a sense of hunger. Dizziness or lightheadedness can also be an early indication that blood sugar is dropping. If you experience any of these signs, it is important to check your blood sugar levels as soon as possible. Catching low blood sugar early can help you prevent it from progressing into more serious symptoms.
As hypoglycemia progresses, the symptoms can become more noticeable and harder to ignore. Moderate hypoglycemia might cause difficulty concentrating, confusion, blurred vision, and nausea. Some people may also experience slurred speech or difficulty walking due to lack of coordination. If you experience these symptoms, it’s important to act quickly to raise your blood sugar levels. Delaying treatment at this stage can cause the condition to escalate.
Severe hypoglycemia is a medical emergency. When blood sugar levels fall too low, the brain does not receive enough glucose to function, which can result in seizures or loss of consciousness. If someone becomes unconscious or unresponsive due to hypoglycemia, immediate medical help is required, and you may need to administer glucagon to raise their blood sugar.
What Causes Hypoglycemia?
Hypoglycemia can be triggered by several different factors, especially for individuals managing diabetes. It’s helpful to understand what can cause your blood sugar to drop so you can better manage your condition and prevent hypoglycemia.
One of the most common causes is taking too much insulin or other diabetes medications that stimulate insulin production. When the body gets too much insulin relative to the amount of glucose in the bloodstream, it can lower blood sugar levels too much. Similarly, skipping meals or snacks can lead to low blood sugar because your body has less glucose available to counteract the insulin in your system. If you skip meals or don’t eat enough throughout the day, your blood sugar can drop significantly.
Another common trigger is increased physical activity. Exercise uses up glucose in the body, and if you engage in more physical activity than usual without adjusting your food intake or insulin dosage, your blood sugar can dip too low. This is especially true for aerobic exercises like running or intense workouts that involve weightlifting. If you exercise more than usual or plan to do a high-intensity workout, it’s important to monitor your blood sugar levels and consider adjusting your diet or insulin accordingly.
Drinking alcohol can also be a factor in hypoglycemia, particularly if it’s consumed on an empty stomach. Alcohol interferes with the liver’s ability to release glucose into the bloodstream, which can lead to low blood sugar. If you drink alcohol, it’s best to do so with food and to monitor your blood sugar regularly to ensure it doesn’t drop too much.
Lastly, illness or infection can also play a role in causing hypoglycemia. When you’re sick, your body may experience changes in how it regulates blood sugar, whether through changes in appetite, medication, or stress levels. This can cause fluctuations in blood glucose, leading to low blood sugar if you’re not careful.
How to Treat Hypoglycemia
When hypoglycemia occurs, the key is to treat it immediately. Raising your blood sugar levels quickly is crucial to prevent more severe symptoms from developing. The most widely recommended approach for treating low blood sugar is the “15-15 rule,” which involves consuming 15 grams of fast-acting carbohydrates and then waiting 15 minutes to check your blood sugar.
Fast-acting carbohydrates are foods or liquids that the body can absorb quickly, raising blood sugar in a short period of time. Some common examples include glucose tablets (usually 1 gram of carbohydrate per tablet), a half-cup of juice or regular soda (not diet), or a tablespoon of honey or syrup. If you don’t have access to these specific items, you can also use small pieces of candy that contain sugar.
Once you’ve consumed the 15 grams of carbohydrates, wait for 15 minutes to allow your blood sugar levels to rise. After 15 minutes, it’s important to check your blood sugar again. If it remains low, repeat the process: consume another 15 grams of fast-acting carbs and wait another 15 minutes. It’s important not to overeat or consume too much sugar in one sitting, as this can cause your blood sugar to spike too high, leading to another problem.
If you are unable to treat the hypoglycemia yourself (for example, if you’re unconscious or unable to swallow), someone nearby should administer glucagon if available. Glucagon is a hormone that can raise blood sugar levels in emergencies. It is typically available as an injectable treatment, which should only be administered by someone trained to do so.
Preventing Hypoglycemia
While you can’t always predict when hypoglycemia will happen, there are steps you can take to reduce the likelihood of it occurring. Consistent blood sugar monitoring is one of the most effective strategies. By checking your blood sugar levels frequently throughout the day, you can catch low levels early and take action before they become more severe. If you’re prone to hypoglycemia, you might want to check your blood sugar before and after meals, exercise, or other activities that can impact your blood glucose.
Balancing your meals and snacks is another essential part of preventing low blood sugar. Eating regular meals that combine carbohydrates, protein, and healthy fats can help keep your blood sugar levels steady. Don’t skip meals, and be sure to carry a small snack with you if you’re engaging in physical activity or if there’s a long gap between meals. When you exercise, consider eating a snack that includes carbohydrates and protein before or after your workout to help maintain steady blood sugar levels. Depending on your activity, you might also need to adjust your insulin dosage.
If you take insulin or other diabetes medications, it’s important to work closely with your doctor to find the right balance between your medications and lifestyle. Your doctor may suggest adjusting your insulin doses, changing the timing of your medication, or switching to a different type of insulin if you’re experiencing frequent episodes of hypoglycemia.
It’s also important to be cautious about alcohol consumption. If you drink, always do so with food, and try to avoid drinking on an empty stomach. Alcohol can interfere with blood sugar regulation, so it’s best to monitor your levels before and after drinking to make sure your blood sugar doesn’t drop too low.
When to Seek Medical Help
In most cases, mild hypoglycemia can be treated effectively at home. However, there are times when medical help is needed. If you’re unable to raise your blood sugar despite following the 15-15 rule, or if symptoms are severe—such as confusion, seizures, or loss of consciousness—you should seek immediate medical attention. If you’re with someone who is unconscious or unable to treat themselves, don’t wait; administer glucagon if you have it and call for emergency assistance.
It’s Manageable
Hypoglycemia can be a frightening experience, but it’s manageable with the right knowledge and tools. Understanding the causes, symptoms, and treatment options for low blood sugar can help you respond quickly and effectively. By regularly monitoring your blood sugar, maintaining a balanced diet, and making adjustments to your medication and lifestyle, you can prevent hypoglycemia from becoming a serious issue. If you experience frequent low blood sugar or have trouble managing it, it’s always best to consult with your doctor. With the right plan in place, you can maintain better control over your diabetes and continue to live a healthy, active life.