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What Causes Low Blood Sugar In Diabetics


No Symptoms Be Alarmed

Surprisingly, the most dangerous episodes of hypoglycemia occur with little or no warning. When low blood glucose occurs on a regular basis, the body can become used to the warning signs and the person may stop noticing symptoms. This is a particularly dangerous condition known as hypoglycemic unawareness. People with this condition might not realize they have low blood glucose until it’s dangerously low seizures and coma are sometimes the first indication of a problem. The good news is that this condition can often be reversed allowing people to once again notice the signs of low blood glucose if hypoglycemia is avoided for a few weeks through careful monitoring of blood glucose.

If A Person Is Unconscious


If a person loses consciousness because of severe hypoglycaemia, they need to be put into the recovery position and given an injection of the hormone glucagon . The injection will raise their blood glucose level.

The injection should be carried out by a friend or family member who knows what they’re doing, or by a trained healthcare professional.

You should dial 999 to request an ambulance if:

  • a glucagon injection kit isn’t available
  • there’s nobody available who’s trained to give the injection
  • the injection is ineffective after 10 minutes

Never try to put food or drink into the mouth of someone who’s unconscious as they could choke.

If you’re able to give a glucagon injection and the person regains consciousness, they should eat some longer-acting carbohydrate food, such as a few biscuits, a cereal bar or a sandwich.


You should continue to monitor the person for signs of recurring symptoms in case they need to be treated again.

How To Recognize Hypoglycemia

The first signs of hypoglycemia include feeling sweaty, shaky, and hungry. However, not everyone has these symptoms or notices them in time to prevent low blood sugar from getting worse. Its also important to know that your symptoms of hypoglycemia will change the longer you have T1D. 

As hypoglycemia gets worse, symptoms can include:


  • Feeling weak  
  • Having difficulty walking or seeing clearly  
  • Acting strange or getting disoriented  
  • Having seizures  

Severe hypoglycemia may make you faint or pass out. This is dangerous if you are driving, climbing stairs, or doing other activities where you need to stay aware of things around you.

Hypoglycemia can happen at night. If it does, you are likely to wake up, but its important not to rely on your body to wake you up. A continuous glucose monitor, or CGM, can alert you and those around you with an alarm to let you know if your blood sugar starts getting low while you are sleeping.

Its a good idea to check your blood sugar often when lows are likely, such as in hot weather or when you travel. Your CGM can also let you know when your blood sugar is getting lower. 

Watch out for hypoglycemia unawareness.

You might not have early warning signs of low blood sugar. This is called hypoglycemia unawareness, and it raises the risk of having severe lows. It is more likely if:


  • You have had diabetes longer than 5 or 10 years  
  • You have frequent episodes of hypoglycemia  
  • You take certain medicines, such as beta blockers for high blood pressure  

Low Blood Sugar Levels In Diabetes

People with diabetes can have low blood sugar levels because of the they have to take to manage their diabetes. They may need a hormone called or diabetes pills to help their bodies use the sugar in their blood.

These medicines help take the sugar out of the blood and get it into the body’s cells, which makes the blood sugar level go down. But sometimes it’s a tricky balancing act and blood sugar levels can get too low.

People with diabetes need to keep their blood sugars from getting too highor too low. Keeping blood sugar levels in a healthy range means balancing when and what they eat, and when they exercise with when they take medicines.


Where Can I Find Support

16 best Nursing (Blood Sugar) images on Pinterest ...

The Hypoglycemia Support Foundation, established nearly 40 years ago, is a national group that offers many resources, including advocacy. They offer salons so that you can personally connect with people like you who are also dealing with bouts of low blood sugar.

Occasionally blood sugar crashes are so extreme they require emergency room care for an immediate dextrose IV treatment. If you have diabetes, wear a medical bracelet that does TK thing? What will this bracelet have on it? A number of one of your contacts? Can you answer and smooth out with this line? have a circle of people who serve as close contacts and are aware of your condition and how to help.

Does Everyone Have Symptoms From Hypoglycemia


Some people dont have symptoms or dont notice them. Healthcare providers call that situation hypoglycemia unawareness. People with such a challenge arent aware when they need to do something about their blood sugar. Theyre then more likely to have severe episodes and need medical help. People with hypoglycemia unawareness should check their blood sugar more often.

What Are The Complications Of Low Blood Glucose

Mild-to-moderate low blood glucose can be easily treated. But severely low blood glucose can cause serious complications, including passing out, coma, or death.

Repeated episodes of low blood glucose can lead to


  • high blood glucose levels, if worry or fear of low blood glucose keeps you from taking the medicines you need to manage your diabetes8
  • hypoglycemia unawareness, a condition in which you dont notice any symptoms of low blood glucose until your blood glucose level has dropped very low

How Common Is Low Blood Glucose

Low blood glucose is common among people with type 1 diabetes and among people with type 2 diabetes who take  or some other diabetes medicines. In a large global study of people with diabetes who take insulin, 4 in 5 people with type 1 diabetes and nearly half of those with type 2 diabetes reported a low blood sugar event at least once over a 4-week period.2

Severely low blood glucose, defined as when your blood glucose level drops so low you cant treat it yourself, is less common. Among U.S. adults with diabetes who take insulin or some diabetes medicines that help the  release insulin into the blood, 2 in 100 may develop severely low blood glucose each year.3

When To See A Doctor


Early warning signs and symptoms of hypoglycemia include:

  • Anxiety
  • Shakiness
  • Sweating

If you are experiencing these symptoms and suspect they could be related to your medications, reach out to your provider to see if an adjustment is needed. If you believe your symptoms are from poor food intake, try consuming complex carbohydrates more consistently to maintain normal blood sugar levels.

Doing an intense workout on an empty stomach can produce hypoglycemia thats easy to fix. In this case, you can treat hypoglycemia at home with a sports drink or snack, and no further medical help is needed.

When left untreated, severe hypoglycemia can lead to intense symptoms, like jerky movements, inability to eat or drink, muscle weakness, slurred speech, blurry or double vision, seizures, or unconsciousness. For any of these symptoms, contact your healthcare professional immediately.

Since hypoglycemia can cause you to pass out, you should alert the people who you spend time with about your condition so they know what to do in an emergency. Let your coworkers, family, and friends know when they should call 911. You can also wear a medical alert bracelet that notifies others of your health concerns.


How Can I Prevent Hypoglycemic Episodes

The key to preventing hypoglycemic events is managing diabetes:

  • Follow your healthcare providers instructions about food and exercise.
  • Track your blood sugar regularly, including before and after meals, before and after exercise and before bed.
  • Take all your medications exactly as prescribed.
  • When you do have a hypoglycemic event, write it down. Include details such as the time, what you ate recently, whether you exercised, the symptoms and your glucose level.

What Should I Do If I Experience A Hypoglycemia

Low blood sugar can be treated quickly with fast-acting glucose. If you are at risk for lows, you should always have something fast and sweet with you. Glucose tabs, for example, are available at any pharmacy, are relatively affordable, and are designed to digest quickly and raise blood glucose fast.


Other options are fruit juice, regular soda, candies , or other . It is important that whatever you use to treat the low does not contain a lot of fat or fiber, which slows digestion and takes longer to raise blood sugar.

The general guidelines are to eat 15-20 grams of glucose or simple carbohydrates then check your blood sugar again in 15 minutes. If you are still low, repeat.

If you experience low blood sugars often, talk to your doctor. Together, you’ll be able to figure out why they are happening and then make adjustments, so they don’t happen so often.

Hypoglycemia Tests And Diagnosis


To diagnose nondiabetic hypoglycemia, your doctor will do a physical exam and ask questions about any medicines you take. Theyâll want to know all about your health and any history of diseases or surgery.

Theyâll check your blood glucose level, especially when you are having symptoms. Theyâll also check to see if you feel better when your sugar goes back to a normal level.

If your doctor suspects hypoglycemia, you may have to fast until you start to have symptoms. Theyâll test your blood glucose level at different times throughout the fast.

To check for reactive hypoglycemia, you may have to take a test called a mixed-meal tolerance test . For this, you take a special drink that raises your blood glucose. The doctor will check your blood glucose levels over the next few hours.


What Are The Signs And Symptoms Of Hypoglycemia

Effects of Low Blood Sugar on the Body

Everyone reacts differently to low blood sugar. Thats why its important for you to know your own signs and symptoms, so that you can recognize a low and treat it quickly. The common signs and symptoms of hypoglycemia can include any of the following:

  • Feeling shaky: this may include shaking or tremors in the hands, trembling
  • Feeling light-headed or dizzy: this may include feeling unsteady or off balance or feeling slightly faint
  • Sweating: also known as perspiration, the body secretes fluid through the skin from the sweat glands
  • Feeling hungry: a feeling of discomfort caused by a lack of food
  • Headache: a continuous pain in the head
  • Rapid heartbeat: this may be noticed by having a fast pulse
  • Feeling irritable or anxious: you may become bad-tempered, fearful or uneasy
  • Pale skin: the skin may appear lighter in colour
  • Clumsiness or jerky movements: you may become awkward with movement
  • Numbness or tingling in your mouth and tongue: this could range from no feeling to a slight pricking or stinging sensation
  • Tingling in your hands: usually a slight pricking feeling

You can learn more about hypoglycemia symptoms here. 

Exercising Without Adjusting Insulin Doses And Carbs

Going for a walk after lunch, for example, can cause a severe low blood sugar if you took your full dose of insulin for your lunch. The addition of the walk increases the rate at which your body is burning up the glucose from the meal you ate, causing a low blood sugar.

TIP: Learn, learn, learn, and study, study, study how the body reacts to different types of exercise in Christel Oerums Fit with Diabetes guide, or Sheri Colbergs .

What Is The Outlook For People With Hypoglycemia

Hypoglycemia can be managed when you and your healthcare provider understand what causes your blood sugar to go down. Give your healthcare provider as much information as possible about any hypoglycemic episodes. Fixing the problem may be as simple as changing the times you take medication, eat and exercise. Minor changes to the types of food you eat may also help.

Exercise Food And Alcohol

For people with type 1 diabetes, maintaining the correct blood glucose level involves balancing how much insulin you inject, the amount of food you eat, and how much energy you burn during exercise.

Hypoglycaemia may occur if you’ve taken your dose of insulin as usual, but your carbohydrate intake is lower than normal or has been used up more quickly. This may happen if you delay or miss a meal or snack, don’t eat enough carbohydrate, or exercise more than usual.

People with diabetes who’ve drunk too much alcohol, or drank alcohol on an empty stomach, can also get hypoglycaemia.

However, it’s not always possible to identify why a particular episode of hypoglycaemia has occurred, and sometimes it happens for no obvious reason.

Certain Antibiotics To Address Infections Such As Utis And Pneumonia

A class of antibiotics called fluoroquinolones, used to treat illnesses like and urinary tract infections , has been shown to cause both very low and high blood sugar, a study published in October 2013 in the journal Clinical Infectious Diseases found. In addition, , an antimicrobial drug used to treat a certain kind of pneumonia, can also cause a rise in blood sugar.

When Your Blood Sugar Gets Low

Check your blood sugar whenever you have symptoms of low blood sugar. If your blood sugar is below 70 mg/dL, treat yourself right away.

1. Eat something that has about 15 grams of carbohydrates. Examples are:

  • 3 glucose tablets
  • One half cup of fruit juice or regular, non-diet soda
  • 5 or 6 hard candies
  • 1 tablespoon or 15 mL of sugar, plain or dissolved in water
  • 1 tbsp of honey or syrup

2. Wait about 15 minutes before eating any more. Be careful not to eat too much. This can cause high blood sugar and weight gain.

3. Check your blood sugar again.

4. If you do not feel better in 15 minutes and your blood sugar is still lower than 70 mg/dL , eat another snack with 15 g of carbohydrates.

You may need to eat a snack with carbohydrates and protein if your blood sugar is in a safer range — over 70 mg/dL — and your next meal is more than an hour away.

Ask your provider how to manage this situation. If these steps for raising your blood sugar do not work, call your doctor right away.

Possible Causes With Diabetes

affects your bodys ability to use insulin. Think of insulin as the key that unlocks your cells, letting glucose in for energy.

People with diabetes use a variety of treatments to help their bodies use the glucose in their blood. Among these are oral medications that increase insulin production and insulin injections.

If you take too much of these types of medications, your blood sugar may drop too low. People also sometimes experience low blood sugar when planning to eat a big meal, but then they do not eat enough.

Skipping meals, eating less than normal, or eating later than normal but taking your medication at your normal time can also lead to low blood sugar levels.

Unplanned excess physical activity without eating enough can also cause a drop in blood sugar levels.

Drinking alcohol when youre on these medications can also lead to low blood sugar, especially if it replaces food. When the body is trying to get rid of alcohol it becomes worse at managing blood sugar levels.

Make Sure You Have A Glucagon Kit

For the very worst lows when youre unconscious or when youre sick and you cant keep food down a glucagon kit can save your life. If you dont have one, or the one you have is expired, ask your doctor for a new prescription. Keep it in somewhere in your house or at work or in your gym bag, and make sure others know where it is and how to use it!

Corticosteroids To Lower Inflammation In Arthritis Asthma Allergies And Joint Injuries

Hypoglycemia low blood sugar symptoms

These drugs are used to treat many conditions associated with inflammation, including arthritis, asthma, allergies, and joint injuries. used in inhalers or skin creams arent likely to affect blood glucose because they dont enter the blood stream in great enough quantities. But those that are injected or ingested by mouth can significantly increase blood glucose, says Timothy In-Chhu Hsieh, MD, chief endocrinologist at the Kaiser Permanente West Los Angeles Medical Center in California.

“If it’s only a short-term treatment, there won’t be too long of an effect and it may not influence things a great deal, but if it’s being used for several days or weeks, then the sugar level can go higher and be a significant problem,” he says. If thats the case, you can work with your doctor to adjust your diabetes medication to keep glucose under control.

RELATED: Treating Type 2 Diabetes From the Inside Out: Tips for Self-Care, Medication, and Insulin

A Low Blood Sugar Level Without Diabetes

A low blood sugar level is uncommon in people who do not have diabetes.

Possible causes include:

  • a gastric bypass
  • other medical conditions, such as problems with your hormone levels, pancreas, liver, kidneys, adrenal glands or heart
  • some medicines, including quinine

See a GP if you think you keep getting symptoms of a low blood sugar level. They can arrange some simple tests to check if your blood sugar level is low and try to find out what’s causing it.

When Should I Check My Blood Sugar During The Night

  • After a day with lots of exercise, such as swimming or sports
  • If your blood sugar was low before bedtime
  • When you are sick, especially if you have vomiting or diarrhea
  • If you have been waking up high every morning for 3 or more days
  • When your long-acting insulin dose has increased

The best times to check your blood sugar during the night is about 3 to 4 hours after your bedtime snack, then again about 3 to 4 hours after that.

What Are The Symptoms Of Low Blood Sugar

There are several telltale signs that your blood sugar has dropped below a safe level. The American Diabetes Association lists the following as symptoms of low blood sugar:

  • Feeling shaky
  • Color draining from the skin
  • Feeling Sleepy
  • Feeling weak or having no energy
  • Blurred/impaired vision
  • Tingling or numbness in the lips, tongue, or cheeks
  • Headaches
  • Nightmares or crying out during sleep
  • Seizures

You may experience other symptoms beyond this list. For example, in my body, if Im walking on a treadmill and my blood sugar is low, my thighs start to feel numb and tingly. 

Everyone has their own classic symptoms of low blood sugar figure out which symptoms you feel the soonest so you can catch lows sooner than later!

How To Treat Seizures Or Someone With Seizures

If you have seizures due to hypoglycemia, follow these steps:

Stay with them so they dont get hurt. Place them on a soft surface and move them away from hazardous areas .

If the seizure lasts more than 5 minutes, call 999 for the ambulance.

Offer a sweet snack after the seizure has stopped.

Tell your diabetes care team if you have seizures or severe low blood pressure that causes seizures.

What Extreme Conditions Can Occur If Hypoglycemia Is Left Untreated

Although severe episodes which can trigger potentially life-threatening comas are rare, they require immediate emergency room care, so its best to make sure you are tracking your blood sugar so that you never have to worry about getting to that point. A drop in blood sugar means less fuel for your brain, so its critical for your body to receive enough glucose. Hypoglycemia that leads to extended, reduced brain function is the biggest concern, as this can lead to seizures and loss of basic bodily functions controlled by the brain, which can ultimately lead to death, explains Dr. Dyer.

What Is Low Blood Glucose

Low blood glucose, also called low blood sugar or hypoglycemia, occurs when the level of  in your blood drops below what is healthy for you. For many people with , this means a blood glucose reading lower than 70 milligrams per deciliter .1 Your number might be different, so check with your doctor or health care team to find out what blood glucose level is low for you.

How Serious Is Hypoglycemia

Hypoglycemic episodes can range from mild to severe.

Mild hypoglycemia can usually be treated by the individual and are to be expected to some degree in people on insulin. Mild hypos are not associated with significant long term health problems unless they are occurring very regularly or for long periods of time.

Severe hypoglycemia, however, will require treatment from someone else and may require an ambulance. Severe hypos can lead to immediate danger if not treated immediately. Whilst rare, severe hypos can potentially lead to coma and death.

Preventing Low Blood Sugar

Low Blood Sugar (Hypoglycemia)  Diabetes Daily

Preventing low blood sugar is better than having to treat it. Always have a source of fast-acting sugar with you.

  • When you exercise, check your blood sugar levels. Make sure you have snacks with you.
  • Talk to your provider about reducing insulin doses on days that you exercise.
  • Ask your provider if you need a bedtime snack to prevent low blood sugar overnight. Protein snacks may be best.

DO NOT drink alcohol without eating food. Women should limit alcohol to 1 drink a day and men should limit alcohol to 2 drinks a day. Family and friends should know how to help. They should know:

  • The symptoms of low blood sugar and how to tell if you have them.
  • How much and what kind of food they should give you.
  • When to call for emergency help.
  • How to inject glucagon, a hormone that increases your blood sugar. Your provider will tell you when to use this medicine.

If you have diabetes, always wear a medical alert bracelet or necklace. This helps emergency medical workers know you have diabetes.

Antipsychotics To Treat Mental Illnesses Such As Schizophrenia

Certain antipsychotic drugs, which are used to treat schizophrenia and other mental illnesses, can increase your blood sugar levels. Those medications are typically used for months or years at a time, so that is definitely an issue to be aware of, Hsieh says.

But a study published in May 2016 in the journal Schizophrenia Bulletin found that among patients with newly diagnosed diabetes, those who took ended up with fewer advanced diabetes complications, despite the potential for these drugs to increase blood sugar. A possible explanation is that treatment can improve the patients physical, psychosocial, and self-care functioning, thereby enhancing healthy behaviors and decreasing the risk of diabetes complications, the authors write.

RELATED: Does Diabetes Increase Your Risk of Depression?

What Are The Treatments For Hypoglycemia

Make an appointment with an endocrinologist if you feel like youre having episodes of hypoglycemia, even if youre not diabetic. Theyll talk you through treatment strategies, including:

  • Adjusting your medications. You may need to change how often you take insulin or other medications, which medications youre on, how much you take, and when you take them.
  • Working with a registered dietitian on a personalized meal plan that stabilizes blood sugar levels. Theres no one-size-fits-all hypoglycemia diet, but a nutritionist can help you figure out a consistent meal plan tailored to you, and teach you how to count carbohydrate grams to go along with your health and routine.
  • Increasing and improving self-monitoring of your blood glucose levels. Knowing your blood glucose level throughout the daywhen you get up, before meals, and after meals etc.can help you keep it from getting too low.
  • Limiting consumption of alcoholic beverages. Alcohol interferes with the way your body metabolizes glucose. If you’re prone to hypoglycemia, consider decreasing how much alcohol you consume.
  • Glucose tablets . Make sure you always have glucose tablets on hand, whether at home, school, the office, or the gym. After taking the tablet, check your blood sugar. If its still low, take another tablet. If that doesnt help, check with your doctor.

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