Blood glucose, or blood sugar, is the main sugar in your blood. Blood sugar comes from the foods you eat. The blood carries glucose to the cells in your body, where they are used for energy. Hypoglycemia is the medical term for low blood sugar. Low blood sugar may make you feel shaky, sweaty, and/or hungry. Hypoglycemia requires immediate treatment. If blood sugar levels drop too low, it can be dangerous, causing more severe symptoms. Low blood sugar is often associated with diabetes treatment, although other medications or conditions can cause low blood sugar in individuals who do not have diabetes. Continue reading to learn more about low blood sugar, its symptoms, and treatment.
Low blood sugar is a common health condition primarily associated with diabetes mellitus.
Early signs of low blood sugar include sweating, shaking, dizziness, and hunger.
Severe symptoms of low blood glucose, such as seizures, require immediate medical attention.
You may be at risk for developing low blood sugar symptoms if you have diabetes. Low blood sugar is most often caused by insulin or certain oral diabetes medicines, but there are other possible causes.
Low blood sugar requires a medical diagnosis—most often, it is related to diabetes.
Symptoms of hypoglycemia require treatment. They typically resolve within several minutes of treatment.
Treatment of low blood sugar may include consuming fast-acting carbohydrates in food (such as Smarties or glucose tablets) or drinks such as apple juice or orange juice.
Untreated low blood sugar could result in complications like seizures and coma.
Save on prescriptions for low blood sugar, such as Baqsimi, with a free SingleCare prescription discount card and save up to 80%.
People who test their blood sugar regularly, or wear a continuous glucose monitor (CGM), will be able to see their blood sugar—and when it falls—by testing their blood sugar (or checking the receiver or mobile app, for those with a CGM).
Early signs of low blood sugar may include:
Confusion
Dizziness
Fast heartbeat
Hunger
Irritability
Nervousness or anxiety
Shaking
Sweating
Many individuals will start to have symptoms when their blood sugar drops below 70 mg/dl. However, this is different for everyone. Some people may begin to have symptoms of low blood sugar levels before their blood glucose level drops to 70 mg/dl. Others have something called hypoglycemic unawareness, which is when you do not realize your blood sugar is low. It is important to check your blood sugar as directed by your healthcare professional, so you know if it is too low, too high, or in the target range.
The American Diabetes Association provides a list of blood sugar symptoms, increasing in order of severity. If treated quickly, low blood sugar and related symptoms will resolve within a few minutes, and you may only feel mild symptoms.
Shaking
Nervousness/anxiety
Sweating, chills, clamminess
Irritability
Confusion
Fast heartbeat
Lightheadedness/dizziness
Hunger
Nausea
Pale skin
Sleepiness
Weakness
Lack of energy
Blurry vision
Numbness and tingling
Headaches
Incoordination
Nightmares
Seizures
Mild hypoglycemia occurs when blood sugar levels are between 54 mg/dl and 69 mg/dl. It is best to treat low blood sugar right away. Your doctor will give you a treatment plan, so you know how much to eat when your blood sugar is in this range. Generally, healthcare professionals recommend patients eat about 15 grams of fast-acting carbohydrates such as glucose tablets or apple juice, and recheck blood sugar in 15 minutes, repeating the process if necessary.
Moderate hypoglycemia occurs when blood glucose levels are less than 54 mg/dl.
People with severe hypoglycemia cannot talk, eat, or function because of mental or physical changes caused by low blood sugar. They will need another person to help treat the low blood sugar.
If you do not yet have a diagnosis but are experiencing low blood sugar symptoms, consult your healthcare provider. You can start with your primary care provider, or go to an endocrinologist. Usually, low blood sugar occurs as a result of treating diabetes, so you may already have taken these steps. In some cases, low blood sugar could be due to something besides diabetes, so it is best to see your doctor for a diagnosis. If you have diabetes and have episodes of low blood sugar, follow your treatment plan. In some cases, if you have hypoglycemia fairly often, you may need a change to your insulin or oral diabetes medication. Keep an open line of communication with your doctor, so they can help you manage your blood sugar appropriately. Get emergency medical help (or make sure family members and caregivers know to call for emergency help) if you feel like you are going to pass out, if you have seizures, if you are unconscious, or if you need emergency glucagon administered.
The good news is that it is easy to eat some fast-acting carbohydrates to raise blood sugar right away. However, left untreated, low blood sugar can be dangerous. If blood sugar falls, and continues to fall, the brain does not get enough glucose and stops functioning properly, which can lead to blurry vision, difficulty concentrating, confusion, slurred speech, numbness, and drowsiness. Blood sugar that stays too low for too long can cause seizures, coma, and in very rare cases, death.
If you have diabetes, your doctor will give you a detailed treatment plan. It will have a lot of information, including what to do if you have low blood sugar. Typically, if blood sugar falls below 70 mg/dl, you will treat the low blood sugar right away to bring your number back into the target range, or normal range, and prevent your blood sugar from falling even more.
If you have low blood sugar symptoms but do not know what your blood sugar is (for example, if you went out and forgot your meter), it is safer to treat the low blood sugar. Treat the low blood sugar as quickly as possible—keep low blood sugar treatments with you at all times, so you never waste time looking for food or a drink.
For blood sugar between 55 and 69 mg/dl, many healthcare professionals advise consuming 15 grams of fast-acting carbohydrates, then testing blood sugar again in 15 minutes. This is known as the 15-15 rule. Examples of fast-acting carbohydrates include:
Glucose tablets or other glucose products, such as glucose gummies or gel
Fruit juices
Regular soda (not diet soda)
Smarties
Skittles
Gummy bears
You can check the label ahead of time to know how much to eat or drink. For example, a 4-ounce apple juice box generally contains 15 grams of carbohydrates—or you can eat 2 and ½ packs of Smarties for 15 grams of carbohydrates.
When using carbohydrates to treat low blood sugar, it’s important to use the kinds of foods and drinks mentioned above. Carbohydrates that contain fat, fiber, or protein, such as ice cream, french fries, or chocolate, will not raise blood sugar as quickly as the fast-acting carbohydrates listed above. Fast-acting carbohydrates work quickly to raise blood sugar.
Your doctor may advise you to have a healthy meal or snack after your blood sugar returns to normal, to help keep your number in the normal range and prevent another drop in blood sugar.
Blood sugar less than 55 mg/dl is considered severely low blood sugar. You may not be able to check your blood sugar or treat low blood sugar by yourself. Your family members and caregivers may help you treat low blood sugar with glucagon (injectable or nasal spray). Make sure your family members and close friends know where your glucagon is and how to use it. Your doctor will give you more information about using glucagon.
Those with low blood sugar that is not associated with diabetes will require treatment for the condition that is causing low blood sugar. For example, if a certain medication is causing low blood sugar, the doctor may prescribe a different drug instead. Or, if a tumor is causing low blood sugar, the tumor will need to be treated.
If you are at risk for low blood sugar, here are some tips to always be prepared:
Be aware of low blood sugar symptoms, such as hunger, shakiness, and dizziness.
Always carry fast-acting carbohydrates with you. Better yet, keep a supply in a few places, such as purses or backpacks, work, and school.
Check your blood sugar levels as directed by your healthcare provider. Consider looking into a CGM, which eliminates finger sticks. With a CGM, you wear a sensor, which transmits your blood sugar to a receiver or mobile app, and updates every one to five minutes, depending on which CGM you use.
Make sure your family members, close friends, and caregivers know your low blood sugar symptoms, so they can help you if needed. They should also know where you keep your glucagon, and how to use it on you, in case of a medical emergency.
Keep in regular contact with your healthcare provider, so they can make changes to your treatment plan if needed. For example, you may need less daily insulin if you have frequent low blood sugar. Your healthcare provider can make changes if needed.
Most importantly, low blood sugar symptoms are manageable—especially if you are prepared. You can put together a backpack or travel bag with your necessary supplies. For example, in your bag, you can have a blood glucose meter, extra strips and lancets, a lancing device, alcohol wipes, extra batteries, sources of fast-acting sugar such as juice boxes, regular (not diet) soda, glucose tablets, Smarties, Skittles, and gummy bears.
Include emergency contact information and an emergency low blood sugar treatment such as Baqsimi or a glucagon injection. However, emergency treatments only work if you know how to use them, so make sure you can show your family and caregivers how to administer your emergency low blood sugar treatment—and make sure they know where it is located. Keep this bag with you at all times. If your blood sugar starts to drop, you can quickly reach into your bag and eat or drink something to increase your blood sugar right away, rather than panicking and searching for food or standing in a line somewhere. Being prepared eliminates panic and allows you to treat yourself quickly. Wear a medical identification such as a medical ID bracelet or necklace. This will alert first responders to your medical condition in an emergency.
Finally, always be sure you understand your diabetes treatment plan and ask your healthcare provider if anything is unclear or if you have any questions. Your healthcare provider will help you learn how to manage symptoms of low blood sugar quickly and effectively.
The most common cause of low blood sugar is taking too much insulin. This can happen in people with Type 1 diabetes, because all individuals with Type 1 diabetes need insulin. This can also happen in people with Type 2 diabetes who use insulin to manage their blood sugar. Some oral diabetes medications can also commonly cause low blood sugar.
People with diabetes, especially those who use insulin or take certain types of diabetes medications, are at risk for low blood sugar. In some cases, people who do not have diabetes may have low blood sugar. In these cases, low blood sugar may be caused by:
Drinking alcohol
Insulinoma (a rare tumor in the pancreas that makes too much insulin, which lowers blood sugar)
Certain hormone deficiencies (such as cortisol, growth hormone, or thyroid hormone)
Severe heart failure, kidney failure, or liver failure
Certain types of weight-loss surgery (low blood sugar may occur 5 years or more after the surgery
Other medications, such as certain antibiotics or drugs used to treat heart conditions
Yes. Although diabetes is the most common condition associated with low blood sugar, other conditions (such as the ones listed in the answer above) may cause low blood sugar. Having low blood sugar may cause symptoms, regardless of the cause. If you have symptoms of low blood sugar, consult your healthcare provider for medical advice and a diagnosis.
Blood glucose (sugar) test, Cleveland Clinic
Blood glucose testing and management, American Diabetes Association
How to treat low blood sugar (hypoglycemia), Centers for Disease Control and Prevention (CDC)
Hypoglycemia (low blood glucose), American Diabetes Association
Treating low blood sugar, University of California San Francisco Health
Clinical trials, American Diabetes Association
Clinical trials for diabetes, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Diabetes, National Library of Medicine MedlinePlus
Diabetes treatments and medications, SingleCare
How many types of diabetes are there?, SingleCare
Type 2 diabetes treatments and medications, SingleCare
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