Hypoglycemia Signs: What to Do When Your Blood Sugar Is Too Low

Hypoglycemia, often called low blood sugar, can be a frightening experience for both those who have it and those around them. Understanding the hypoglycemia signs, how to recognize them, and what to do when they occur is crucial, especially for individuals with diabetes but also for those with certain other medical conditions. This comprehensive guide provides a detailed look at hypoglycemia, its symptoms, causes, and practical steps to take when your blood sugar levels dip too low.

What is Hypoglycemia?

Hypoglycemia occurs when the level of glucose (sugar) in your blood drops below normal. Glucose is the primary source of energy for the body, and when it's too low, the body can't function correctly. For most people with diabetes, this means a blood sugar level below 70 mg/dL. It's crucial to remember that everyone's body reacts differently, so understanding your personal hypoglycemia threshold is important.

Recognizing Hypoglycemia Signs: Know the Symptoms

Recognizing the hypoglycemia signs is the first step in managing this condition effectively. Symptoms can range from mild to severe and can vary from person to person. Here’s a detailed breakdown of what you might experience:

Mild to Moderate Hypoglycemia Signs:

Shakiness or Trembling: This is one of the most common and early signs of low blood sugar.
Sweating: Often occurs suddenly and can be profuse.
Rapid Heartbeat: The heart races as the body tries to compensate for the lack of glucose.
Anxiety or Nervousness: Feeling jittery or on edge.
Irritability or Mood Changes: Sudden shifts in mood, often unexplained.
Confusion: Difficulty thinking clearly or making decisions.
Lightheadedness or Dizziness: A sensation of being off-balance or about to faint.
Hunger: An intense craving for food, especially something sweet.
Blurred Vision: Changes in eyesight can occur due to the brain not getting enough glucose.
Tingling or Numbness of the Lips, Tongue, or Cheeks: This can be a less common but still important sign.

Severe Hypoglycemia Signs:

If left untreated, mild to moderate hypoglycemia can progress to severe hypoglycemia, which is a medical emergency. Signs include:

Loss of Consciousness: The person becomes unresponsive.
Seizures: Uncontrolled muscle spasms and jerking.
Difficulty Speaking: Slurred speech or inability to communicate.
Coma: A prolonged state of unconsciousness.

It's extremely important to seek immediate medical attention if someone is experiencing severe hypoglycemia. Severe hypoglycemia can be life-threatening.

What Causes Hypoglycemia?

Understanding the causes of hypoglycemia can help you prevent future episodes. Several factors can contribute to low blood sugar, including:

Diabetes Medications: Insulin and certain oral diabetes medications (like sulfonylureas) can sometimes cause blood sugar to drop too low, especially if the dose is too high, or food intake isn't aligned with the medication's action.
Skipping or Delaying Meals: Not eating regularly or skipping meals can lead to a drop in blood sugar.
Intense Exercise: Physical activity uses up glucose, and if you don't compensate with extra carbohydrates, you can experience hypoglycemia.
Alcohol Consumption: Alcohol can interfere with the liver's ability to release glucose into the bloodstream, especially if consumed on an empty stomach.
Certain Medical Conditions: Kidney disease, liver disease, and hormone deficiencies can affect blood sugar regulation.
Insulinoma: A rare tumor in the pancreas that produces excess insulin.
Reactive Hypoglycemia: Occurs a few hours after eating, particularly after consuming a high-carbohydrate meal.
Post-Bariatric Surgery Hypoglycemia: Sometimes individuals who have undergone weight loss surgery can experience hypoglycemia due to altered digestion and hormone regulation.

What to Do When You Suspect Hypoglycemia

If you or someone you’re with exhibits hypoglycemia signs, it's crucial to act quickly. Here’s a step-by-step guide on what to do:

Check Blood Sugar (If Possible): If the person is conscious and able to cooperate, check their blood sugar level using a glucose meter.
Administer Fast-Acting Carbohydrates: If the blood sugar is below 70 mg/dL, or if you suspect hypoglycemia and can't check blood sugar immediately, give them 15-20 grams of fast-acting carbohydrates. Good options include:
- Glucose tablets (follow package instructions)
- 4 ounces (120 ml) of fruit juice
- 4 ounces (120 ml) of regular (non-diet) soda
- 1 tablespoon of honey or sugar
Wait 15 Minutes, Then Recheck Blood Sugar: After 15 minutes, recheck the blood sugar level. If it's still below 70 mg/dL, repeat step 2.
Eat a Longer-Acting Carbohydrate and Protein: Once the blood sugar is above 70 mg/dL, have the person eat a snack that contains both carbohydrates and protein to help stabilize blood sugar levels and prevent another drop. Good choices include:
- Peanut butter and crackers
- Cheese and whole-grain crackers
- A small sandwich
Seek Medical Attention if Necessary: If the person becomes unconscious, has a seizure, or their condition doesn't improve after two rounds of fast-acting carbohydrates, call for emergency medical assistance immediately. Do not attempt to give food or liquid to an unconscious person.

Hypoglycemia Unawareness: A Hidden Danger

Some individuals with diabetes may develop "hypoglycemia unawareness," meaning they no longer experience the warning signs of low blood sugar. This can happen if someone frequently experiences hypoglycemia, as the body becomes less sensitive to low blood sugar levels over time. Hypoglycemia unawareness can be dangerous because it increases the risk of severe hypoglycemia. If you suspect you have hypoglycemia unawareness, talk to your doctor. They may recommend more frequent blood sugar monitoring or adjustments to your diabetes management plan.

Preventing Hypoglycemia: Practical Strategies

Prevention is key when it comes to managing hypoglycemia. Here are some strategies to help keep your blood sugar levels stable:

Monitor Blood Sugar Regularly: If you have diabetes, regular blood sugar monitoring is essential. Work with your healthcare team to determine the best monitoring schedule for you.
Follow a Consistent Meal Schedule: Eat meals and snacks at regular times each day. Avoid skipping or delaying meals.
Balance Carbohydrate Intake: Work with a registered dietitian to learn how to balance your carbohydrate intake with your medications and activity levels.
Adjust Medications as Needed: Your doctor may need to adjust your diabetes medication doses based on your blood sugar levels, activity levels, and eating habits.
Carry a Source of Fast-Acting Carbohydrates: Always have a source of fast-acting carbohydrates with you, such as glucose tablets or juice, in case you experience hypoglycemia.
Inform Others About Your Condition: Let family members, friends, and coworkers know that you have diabetes and how to recognize and treat hypoglycemia. Consider wearing a medical ID bracelet or necklace.
Be Cautious with Alcohol: If you choose to drink alcohol, do so in moderation and always consume it with food.
Monitor Blood Sugar During and After Exercise: Check your blood sugar before, during, and after physical activity, and adjust your carbohydrate intake as needed.
Keep a Hypoglycemia Log: Tracking episodes of low blood sugar, including the date, time, symptoms, and blood sugar level, can help you identify patterns and work with your doctor to prevent future episodes.

The Importance of Glucagon

Glucagon is a hormone that helps raise blood sugar levels by stimulating the liver to release stored glucose into the bloodstream. Glucagon kits are available by prescription and can be life-saving in cases of severe hypoglycemia when someone is unable to take oral carbohydrates.

Who Should Have a Glucagon Kit?

People with diabetes who are at risk of severe hypoglycemia, especially those with a history of severe episodes or hypoglycemia unawareness.
Parents of children with type 1 diabetes.
Partners or caregivers of individuals with diabetes.

How to Use a Glucagon Kit:

Call for Emergency Medical Assistance.
Administer the Glucagon: Follow the instructions on the kit carefully. The glucagon is typically injected into the thigh, arm, or buttocks.
Turn the Person on Their Side: After giving the glucagon, turn the person on their side in case they vomit.
Monitor the Person: Once the person regains consciousness and is able to swallow, give them a source of longer-acting carbohydrates and protein.

Hypoglycemia and Non-Diabetics

While hypoglycemia is commonly associated with diabetes, it can also occur in people who don't have diabetes, although it's less common. This is often referred to as non-diabetic hypoglycemia or reactive hypoglycemia. Possible causes can include the aforementioned reactive hypoglycemia and post-bariatric surgery hypoglycemia, but could also be related to other medical conditions. Symptoms and treatment are similar to hypoglycemia in diabetics; however, identifying and treating the underlying cause is essential.

Final Thoughts

Knowing the hypoglycemia signs and understanding how to respond is essential for anyone at risk. By taking proactive steps, such as monitoring blood sugar levels, adhering to a consistent meal schedule, and adjusting medication dosages as needed, you can minimize your risk of experiencing low blood sugar episodes. If you have diabetes or any other medical condition that puts you at risk for hypoglycemia, work closely with your healthcare team to develop a comprehensive management plan tailored to your individual needs.

This article is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any questions or concerns about your health.