Hypoglycemia: How to Prevent, Recognize, and Treat Low Blood Sugar
Although diabetes treatment is designed to avoid high blood sugar levels, sometimes your blood sugar can drop too low. Here's how to recognize hypoglycemia symptoms and treat them promptly.
According to the American Diabetes Association, everyone with diabetes experiences hypoglycemia from time to time. Because your body doesn’t produce enough insulin or use it efficiently, your blood sugar levels can fluctuate. Insulin helps regulate blood sugar and keeps its levels steady in the bloodstream. When blood sugar levels fall, you can feel shaky, faint, and seem confused. “It’s an uncomfortable feeling,” says Anuj Bhargava, MD, an endocrinologist at the Iowa Diabetes & Endocrinology Center in Des Moines.
How low blood sugar levels have to drop before hypoglycemia symptoms set in can vary from person to person, Dr. Bhargava says. “Different people have different definitions of hypoglycemia,” he explains. Most define hypoglycemia as a blood sugar level below 70 milligrams/deciliter (mg/dL). Others believe it’s below 60 mg/dL or even 50 mg/dL.
What’s most important, however, is clueing into the way you feel. Hypoglycemia can happen when you least expect it, and it’s often sudden, so you need to be prepared.
Causes of Hypoglycemia
If you have diabetes, your blood sugar levels can drop for a number of reasons. Prevent hypoglycemia by avoiding these situations:
- Not taking your medications as directed
- Skipping meals, eating too little, or making poor food choices
- Exercising too hard without refueling or properly adjusting your insulin intake
“When you’re physically active, you increase your body’s utilization of glucose — the blood sugar your muscles use to function,” says Lois Jovanovič, MD, an endocrinologist and chief scientific officer of Sansum Diabetes Research Institute in Santa Barbara, Calif. “This will lower your body’s blood glucose, which is great. But if you haven’t decreased your insulin to account for the effects of exercise, you may experience low blood sugar.”
How to Recognize Hypoglycemia Symptoms
If you know how to spot the symptoms of hypoglycemia, you can treat the condition as soon as you feel it coming on. “The number one symptom is extreme hunger — feeling like you want to eat anything and everything — and you’re likely to raid the cookie jar or refrigerator,” Dr. Jovanovič says. You may even become angry or argumentative. This is especially noticeable when such behavior is out of character for you. “The classic example is of a normally soft-spoken person becoming harsh or combative when a family member asks them to test their blood glucose," she says.
Other possible hypoglycemia symptoms include:
- Headache
- Sweating
- Tremors
- Chest pain or heart pounding
- Tingling in or around your mouth
- Anxiety
- Agitation
Most cases of hypoglycemia aren’t serious and the condition is treatable — if you recognize the symptoms in time, you can more than likely keep it from becoming dangerous. However, if your blood sugar level gets extremely low, there’s a risk of fainting or seizures — scary complications that are rare but possible. A diabetic seizure can lead to coma or even death, Jovanovič warns.
Steps to Correct Hypoglycemia
Mild hypoglycemia can be easily treated with food. “I recommend the ‘rule of 15’,” Bhargava says. “If you test your blood sugar and see that it’s low, eat or drink 15 grams of carbohydrates. Wait 15 minutes. Test your blood sugar again. If it’s still low, eat another 15 grams.” Four or five soda crackers, a half-cup of juice, or a cup of milk will provide 15 grams of needed sugar. You can also use sugar tablets, which are made for people with diabetes and sold at drugstores.
If your blood sugar level doesn’t budge, seek medical help by calling 911. Emergency personnel can give you a shot of glucagon, another hormone created by the pancreas that will increase your blood sugar, Bhargava says.
If you’re prone to episodes of hypoglycemia, carry suitable snacks or sugar tablets with you at all times. Also alert others so that if they see you struggling with symptoms of low blood sugar, they can get you help immediately.
A final word of caution: Don’t over-treat hypoglycemia. Many people with diabetes do, Jovanovič says, and they then have rebound hyperglycemia, or blood sugar levels that are too high, which will make you feel even worse. Only eat as much as you need to get your blood sugar level back to a healthy point.
Last Updated: 03/08/2013
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