If your blood sugar gets dangerously low, you may have symptoms like confusion, vision difficulties, behavioral changes, seizures, or even loss of consciousness.
Hypoglycemia can occur in those without diabetes as well. Fortunately, eating or drinking some simple carbohydrates can usually provide a quick fix—but to do that you need to be able to identify the symptoms of hypoglycemia.
Hypoglycemia Symptoms
The symptoms of hypoglycemia tend to follow a pattern that you’ll probably very quickly learn to recognize if you have diabetes.
Frequent Symptoms
Common symptoms include:
Shakiness Hunger Fast heartbeat Anxiety or panic Tingling feeling around your mouth Sweating Headache Tiredness Inability to concentrate Dilated pupils Irritability Restlessness Nausea Dizziness Weakness Loss of muscle control
Severe Symptoms
When your blood sugar becomes dangerously low—less than 54 mg/dL, as defined by the American Diabetes Association (ADA), which regards this parameter as severe or “level 2” hypoglycemia— you may have any of these symptoms as well:
Confusion Behavioral changes Slurred speech Clumsy movements, as if you’re intoxicated Blurry or double vision Seizures Loss of consciousness
Nocturnal Symptoms
During the night, you may have hypoglycemic episodes and not be aware of them. This is especially common with type 1 diabetes and a bit less common with type 2 diabetes.
Your body produces two hormones, glucagon and epinephrine, that help keep your blood sugar at normal levels. During sleep, glucagon production decreases. Added to this, type 1 diabetes tends to disrupt glucagon production and glucagon decreases with every episode as well.
Symptoms of nocturnal symptoms include:
Night sweatsNightmaresTalking or shouting in your sleepRestlessnessHeadacheNot feeling well-rested when you wake upA glucose level that’s higher than normal in the morning
To help prevent nocturnal hypoglycemic episodes, try eating a bedtime snack that’s high in complex carbohydrates such as granola, oatmeal, or dried fruit. Keep your eating plan, exercise routine, and medication consistent in the afternoon and evening as well.
Also, be careful not to overdose on your insulin in the evening, which can lead to hypoglycemia.
Hypoglycemia Unawareness
When you have diabetes and you have repeated episodes of hypoglycemia, your brain can become less able to recognize that you’re hypoglycemic because your body stops showing symptoms. This is known as hypoglycemic unawareness and it often happens at night while you’re sleeping.
It’s more common in type 1 diabetes than in type 2. Your blood sugar levels can become dangerously low if this continues, leading to a coma or even death.
Hypoglycemia Causes
Hypoglycemia has numerous causes, which are different depending on whether you have type 1 diabetes, type 2 diabetes, or don’t have diabetes.
Type 1 Diabetes
Hypoglycemia is common in type 1 diabetes. It usually happens when you take more insulin than your body needs to process your food, but other things can cause it, too, including:
Not timing your insulin dose correctly around mealsNot monitoring your blood sugar closely when exercising or drinking alcoholHot, humid weatherChanges in your schedule, such as when travelingBeing at a high altitudePubertyMenstrual periods
Because you can’t control some of those factors, it’s especially important to pay attention to the ones you can control.
Type 2 Diabtes
Hypoglycemia is less common in type 2 diabetes than in type 1. It’s often caused by:
Medications: Taking too much medication, including insulinFood: Eating too few carbohydrates compared to your insulinDrinking carbohydrates: Your body absorbs carbs from liquids faster than from solids, so your insulin timing may prove difficultPhysical activity: Exercise lowers your insulin needs
Newer insulins and diabetes medications are less likely to result in hypoglycemia.
No Diabetes
Non-diabetic hypoglycemia can be caused by many things, including:
Some medications (beta-blockers, some antibiotics, heart arrhythmia medications)Alcohol consumptioUnderlying kidney, liver, or metabolic illnessUndereatingHormonal deficienciesA rare pancreatic tumor (insulinoma) causing insulin overproductionRecent bariatric surgeryInsulin autoimmune syndromeReactive hypoglycemia
Complications
If hypoglycemia remains untreated, it can lead to any of the severe symptoms mentioned above, such as seizures, unconsciousness, and, eventually, death. This is why it’s critical to treat low blood sugar immediately, no matter the cause.
Hypoglycemia can also be a contributing factor in:
FallsMotor vehicle accidentsOther injury-causing accidents
When to See a Healthcare Provider
When to get medical help for hypoglycemia depends on whether you have diabetes.
If You Don’t Have Diabetes
If you don’t have diabetes and you have symptoms of hypoglycemia, you should see your healthcare provider right away, even if you’re able to get your symptoms to subside.
You can try to treat your hypoglycemia by eating/drinking one of the following:
4 ounces of juice or non-diet sodaA serving of jellybeans (check the package for serving size)A banana8 ounces of milk1 tablespoon of honey or corn syrup2 tablespoons of raisins
Being hypoglycemic means something else is going on and you need to find out what that is. Then, you can get treatment before your hypoglycemia becomes life-threatening.
If you still have symptoms after treating your low blood sugar with the above measures, go to the emergency room immediately.
If You Have Diabetes
If you have diabetes, you’ll most likely deal with hypoglycemia on occasion. If your blood sugar is below 70 mg/dl, try one of the remedies detailed above or take glucose tablets as directed by the package.
As long as your blood sugar goes back to normal, you can resume your regular activities. However, if you’ve treated your hypoglycemia and your blood sugar remains low and/or you still have symptoms, contact your healthcare provider as soon as possible.
Get emergency help for severe symptoms such as:
Behavioral changesConfusionVisual changesSlurred speechSeizuresUnconsciousness
It’s possible that diabetes, especially type 1 diabetes, causes changes in the way the brain uses glucose over time, which impairs the brain’s ability to respond to signs of hypoglycemia. More research is needed, though, to understand the condition.
SweatingHeadacheVision changesSudden mood changes and increased irritability
If symptoms aren’t treated, it can lead to confusion, seizures, or a loss of consciousness.
