Hypoglycemia

Hypoglycemia is the medical term for low blood sugar. The American Diabetes Association (ADA) defines hypoglycemia as blood sugar levels that are low enough that you have to do something to get them back to your target range. Many times, this may happen when your blood sugar reaches around 70 or below.1

Knowing what hypoglycemia is, the causes and symptoms, its treatments, and when to see your doctor will help you manage this possible complication.

What causes hypoglycemia with type 2 diabetes?

Hypoglycemia is usually caused by diabetes treatment. This includes insulin and other blood sugar-lowering drugs. There may be other reasons that may cause low blood sugar, including:1,2

  • Skipping a meal
  • Not eating enough carbohydrates, or simply “carbs”
  • Increased exercise or activity
  • Being sick
  • Drinking too much alcohol and not eating enough food

Symptoms

Recognizing the signs and symptoms of low blood sugar will help you manage this complication quickly.

Early symptoms of hypoglycemia include:1-3

  • Shakiness or feeling jittery
  • Sweating
  • Dizziness
  • Feeling hungry
  • Fast heartbeat
  • Headache
  • Feeling confused, irritable, anxious, nervous, or moody

Late symptoms of hypoglycemia include:1-3

  • Slurred speech
  • Muscle weakness
  • Convulsions and seizures
  • Blurred vision
  • Death, though this is rare

Low blood sugar can result from exercise, especially in people with type 2 diabetes who are being treated with insulin or drugs that lower the blood sugar levels.1-3

If you have diabetes, it is important to recognize the signs and symptoms of low blood sugar and to take steps to correct it.

Can I have hypoglycemia and not know it?

Some people with type 2 diabetes may not know they have low blood sugar. Those at greatest risk include those who are:1-3

  • Taking insulin and have had diabetes for a long period of time
  • Older adults with kidney or heart disease
  • Taking beta blocker drugs, usually for treating high blood pressure

Hypoglycemia that occurs at night (called nocturnal hypoglycemia) may go unrecognized, even though it may affect sleep quality. Since hypoglycemia affects sleep quality, it increases the chances that a person will not be aware of hypoglycemia during the day.4

Treatment

Follow the suggestions from your doctor for the steps you should take if you have low blood sugar. Your doctor may suggest you eat or drink certain things in order to raise your blood sugar when you have hypoglycemia.

The American Diabetes Association recommends using the 15-15 rule: have 15 grams of carbs to raise your blood sugar and check it after 15 minutes. If it is still below 70, have another serving.1

Some drugs may be given to help increase your blood sugar. Your doctor may prescribe glucagon for this purpose. Glucagon is a hormone made in your pancreas that signals your liver to release stored glucose (sugar). This drug is an injection (shot) that should only be used under the direction of your doctor.1

Your doctor may suggest glucose (sugar) pills to increase your blood sugar. These are often available over-the-counter (OTC). Chewing 3 of these tablets equal the 15 grams of carbs needed to raise your blood sugar.

Your doctor may make adjustments to your current drug treatments in order to prevent future hypoglycemia.

When should I see a doctor for my low blood sugar?

Hypoglycemia can be very serious. It is important to talk to your doctor about the symptoms you are having. Do not hesitate to call 911 if you have severe symptoms or cannot regulate your blood sugar according to directions given to you by your doctor.1,2

Can I prevent low blood sugar?

There are things you can do to help prevent hypoglycemia. The first step is to make sure you are following the diabetes treatment plan you and your doctor have set in place. This is especially important if you take insulin or any other glucose-lowering drug. Other things you can do to prevent hypoglycemia include:2

  • Understand your blood sugar (glucose) levels
  • Recognize the signs of low blood sugar
  • Eat balanced, regular meals and snacks
  • Exercise safely. You may need to adjust your treatment plan based on your activity level and at the direction of your doctor.

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Written by: Katie Murphy | Last reviewed: March 2021.