Handling Hypoglycemia

Overview

Hypoglycemia means your blood sugar is too low. Blood sugar, or glucose, is your body's main fuel. When it drops below the level your body needs, you can feel shaky, confused, or very tired. It is most common in people with diabetes who take medicines that lower blood sugar, but it can happen for other reasons too.

It is common in people with diabetes, especially those who use medicines that can cause low blood sugar. It is much less common in people without diabetes.

Anyone can be affected, but it is most likely in people with diabetes, people taking certain diabetes medicines, and sometimes people with other health conditions, heavy alcohol use, or poor nutrition.

Symptoms

Common symptoms

• Shaking or trembling
• Sweating and clammy skin
• Feeling very hungry
• Dizziness or lightheadedness
• Fast heartbeat
• Pale skin
• Tingling lips or tongue
• Blurred vision
• Headache
• Feeling tired, irritable, or anxious
• Confusion or trouble concentrating

Symptoms in children

• Crying or tantrums that are unusual for your child
• Being very sleepy or hard to wake
• Pale, sweaty skin
• Shaking or trembling
• Behavior changes or clinging
• Feeling very hungry

Symptoms in older adults

• Confusion or memory problems
• Dizziness or falls
• Weakness
• Feeling very drowsy
• Less sweating or shaking than younger people
• Behavior changes that are not usual

Causes

Main causes

• Taking too much diabetes medicine for your needs
• Skipping or delaying meals
• Being more active than usual without adjusting food or medicine
• Drinking alcohol, especially on an empty stomach
• Some other medicines or health conditions that affect blood sugar
• Illness, poor nutrition, or hormone problems (less common)

Risk factors

• Having diabetes and taking medicines that can lower blood sugar
• Previous low blood sugar episodes
• Kidney or liver problems
• Eating less or skipping meals
• Heavy alcohol use
• Strenuous exercise without planning
• Being older or having memory problems
• Pregnancy (in some cases)

When to see a doctor

See a doctor urgently if:

• You have had a severe low blood sugar episode
• Low blood sugar happens often or at night
• You no longer get warning symptoms
• Your blood sugar is hard to control
• You have new confusion, weakness, or falls

Book a routine appointment if:

• You want to review your care plan
• You are planning exercise, travel, or pregnancy
• You need help teaching family or coworkers
• You want to check your blood sugar meter technique

Diagnosis

Your clinician will ask about your symptoms, when they happen, what you ate, and what medicines you take. They may check your blood sugar during symptoms. The key is to show a low blood sugar level at the time of symptoms and see it improve after treatment.

Tests that may be done

• Blood sugar check during symptoms
• Home blood sugar records
• Blood tests to look for other causes
• Review of medicines and meal timing
• Sometimes a supervised fasting test or continuous glucose monitor

What to expect at your appointment

You may be asked to keep a diary of symptoms, meals, activity, and readings. Your care team will use this to find patterns and adjust your plan.

Treatment

Treatment depends on whether you are awake and able to swallow. If you are, the first step is fast-acting sugar, then recheck and eat a snack or meal if needed. If you are not able to swallow or are unconscious, this is an emergency — someone should call emergency services and use any rescue treatment your clinician has prescribed.

Self-care at home

• Learn your early warning signs
• Carry fast-acting sugar with you at all times
• Teach family, friends, and coworkers what to do
• Never give food or drink to someone who is unconscious or cannot swallow
• Check blood sugar before driving or risky activity
• Keep a record of low episodes
• Eat meals on a regular schedule
• Plan ahead for exercise and alcohol
• Wear medical ID

Medical treatments

Your care team may adjust your diabetes medicines, meal plan, or activity plan. They may prescribe an emergency rescue treatment for severe lows and teach someone close to you how to use it. They will also help you set personal blood sugar targets and make a step-by-step plan.

When is surgery considered?

Surgery is not a treatment for low blood sugar. If you need surgery, tell your care team about your low blood sugar history so your medicines can be planned safely.

Living with this condition

Day to day, the goal is to spot lows early, treat them quickly, and prevent them from happening again. Keep your supplies with you and review your plan regularly.

Lifestyle tips

• Eat regular meals and snacks
• Check blood sugar before and after exercise
• Limit alcohol or drink with food
• Keep fast sugar in your bag, car, and bedside
• Wear medical ID
• Teach others what to do
• Review your medicines with your clinician

Diet and exercise

Food and activity both affect blood sugar. Regular meals and planned snacks can help. Exercise is healthy, but it can lower blood sugar for hours afterward. Check your levels and follow your care plan.

Mental health and emotional wellbeing

Low blood sugar can be scary, and worry about having another low is common. It can affect sleep, mood, and confidence. Talk with your care team if anxiety is building. If you feel in crisis or unsafe, call your local emergency number or a local crisis service right away.

Prevention

Many lows can be prevented by matching food, activity, and diabetes medicines, and by checking blood sugar regularly. Not all lows can be avoided, so it is important to be ready to treat one.

Vaccines

Vaccines do not prevent low blood sugar. Staying up to date with routine vaccines is still part of general health care.

Screening programmes

Routine screening for low blood sugar is not done for everyone. If you have diabetes or symptoms, your clinician may check your blood sugar and review your medicines.

Complications

If left untreated

• Seizures
• Loss of consciousness
• Injuries from falls or accidents
• Confusion or behavior changes
• Rarely, serious brain or heart problems

Long-term outlook

Most people recover quickly when low blood sugar is treated. With a clear plan, regular check-ins, and support from your care team, you can live well and lower your risk of severe episodes.

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