What is Hypoglycemia

Hypoglycemia is a condition in which the level of glucose (sugar) in the blood is too low. It can be dangerous, especially if it happens while you’re driving or doing other activities that require concentration and coordination. If you have diabetes, you can suffer from hypoglycemia if your blood sugar levels are not being monitored properly. The word hypoglycemia means “low blood sugar.”

How does hypoglycemia happen?

Hypoglycemia occurs when the level of blood glucose drops below a certain threshold. This can happen for several reasons, but in most cases, it’s because you have too little food in your system. If you’ve had too much exercise and not enough food, or if your body is using more energy than it’s taking in from your diet, your blood sugar will drop and cause symptoms like confusion and weakness. In essence, there is an imbalance between your blood glucose and insulin levels in the blood.

What are the signs and symptoms of hypoglycemia?

  • Dizziness
  • Confusion
  • Sweating
  • Hunger
  • Shakiness
  • Nausea
  • Weakness and fatigue

If you’re experiencing these symptoms, you may have hypoglycemia.

Who is at risk for hypoglycemia?

People with diabetes are at the highest risk for hypoglycemia.

Other people at increased risk include those with thyroid disease; surgery or injury to the head, neck, or brain; infection; stroke; and heart attack.

How do I know if I have hypoglycemia?

The best way to know if you have hypoglycemia is to check your blood sugar level. If you have diabetes, it’s a good idea to monitor your blood sugar levels regularly. If you don’t have diabetes but are worried that perhaps your symptoms could be caused by low blood sugar, then it’s also a good idea to test your blood sugar just in case.

If you don’t know what your normal range is for glucose levels and want to find out what the normal range for an individual may be (in other words: how high or low is “too high” or “too low”), ask one of these people:

  • Your doctor or nurse during office hours
  • The person who draws your blood at home (if this is possible)

How is hypoglycemia treated?

If you have low blood sugar, there are several options for treatment. The best way to treat hypoglycemia is to eat something sweet (15 grams of carbohydrate). This can be any food that contains carbohydrates and includes glucose tablets (3-4 tablets), honey (a full tablespoon), juice (4 oz or half a cup), soda (4 oz or half a cup). Recheck your blood sugar in 15 minutes, if it continues to remain below 70mg/dl, treat again with any of these options. This is typically known as “The Rule of 15s” by endocrinologists and diabetes educators. If you are using a continuous glucose meter (CGM), remember that if your blood sugar is changing rapidly, your CGM readings may lag behind what is really happening in your blood. I usually tell my diabetes patients to recheck their blood sugars using a regular fingerstick (blood glucose meter) after treating an episode of hypoglycemia. In my experience, patients who continue to rely on CGM readings after the initial treatment of hypoglycemia are likely to notice persistent low blood sugar and inadvertent attempts are re-treating. This usually results in a huge spike in blood sugars within 1-2 hours. This is a simple rule of thumb that is often missed by a lot of my pump patients.

If your blood sugar remains below 70 mg/dL after an attempted treatment, contact your doctor immediately for further instructions on how long it might take for your body to recover from the condition.

Losing consciousness during hypoglycemia

Losing consciousness during a hypoglycemic spell is a frightening experience. Having a CGM with hypoglycemia alert features, a hybrid closed-loop insulin pump with “suspend before low” features is likely to prevent this catastrophic complication of diabetes. It will be imprudent of rescuers to attempt to shove any food or liquid in the mouth of a patient suffering from a severe hypoglycemic event. You may inject glucagon into the skin or thigh muscles. For rescuers with “needle phobia” — fear of needles, recent versions of glucagon that can be administered via the nasal route are available.

Glucagon for Hypoglycemia

Glucagon is a hormone that raises blood sugar. Glucagon can help people with diabetes when their blood sugar gets too low (a condition called hypoglycemia). Glucagon is needed to raise your blood sugar back to normal after it has dropped too low. For people with diabetes who take insulin, glucagon can be used by someone else who has been instructed in its use. If you need help, call 9-1-1 or get to an emergency room right away.

How can I prevent hypoglycemia?

  • Eat regular meals. Don’t skip meals or go too long between them.
  • Eat healthy food. Make sure you eat a balanced diet and get enough protein, fat, and fiber in your diet. Also, avoid foods with high glycemic indexes (for example, foods like white rice).
  • Don’t drink too much alcohol. Alcohol can lower blood sugar for several hours after drinking it, so if you drink alcohol in the evening or at night when you’re trying to sleep (as many people do), then this can cause hypoglycemia during sleep time.
  • Be mindful of the glucose-lowering effects of exercise. You might need a snack before, during, or at the end of the exercise activity.


Hypoglycemia is a dangerous medical condition that can lead to coma and death if left untreated. Fortunately, there are many ways to prevent low blood sugar levels and treat them when they do occur. If you think that you might be at risk for hypoglycemia due to diabetes or another medical condition, talk with your doctor about how best to manage it.

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About the Author MyEndoConsult

The MyEndoconsult Team. A group of physicians dedicated to endocrinology and internal medicine education.

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