Low Blood Sugar (Hypoglycemia): What It Is and How to Treat It Fast

Low blood sugar, also known as hypoglycemia, occurs when the level of glucose (sugar) in your blood drops too low. Glucose is your body's main source of energy, so when its levels are insufficient, it can lead to a variety of symptoms. While commonly associated with diabetes, hypoglycemia can affect anyone. Understanding the causes, symptoms, and treatments of hypoglycemia is crucial for managing your health effectively.

What is Hypoglycemia?

Hypoglycemia is clinically defined as a blood glucose level below 70 mg/dL (milligrams per deciliter). It's a condition where your brain and other organs don't receive enough fuel to function properly. This can range from mild symptoms to severe complications if left untreated. For people with diabetes, hypoglycemia often occurs as a side effect of insulin or other diabetes medications used to lower blood sugar. However, it can also occur in individuals without diabetes due to various other factors, which we will explore further.

Causes of Hypoglycemia

The causes of hypoglycemia vary depending on whether you have diabetes or not.

Hypoglycemia in People with Diabetes

• Excessive Insulin or Medication: Taking too much insulin or other diabetes medications (like sulfonylureas or meglitinides) relative to food intake can cause a rapid drop in blood sugar.
• Skipping Meals or Eating Too Little: Not eating enough carbohydrates at meals or skipping meals altogether can lead to a deficiency in glucose.
• Increased Physical Activity: Exercise increases glucose uptake by muscles. If you don't adjust your insulin dose or eat additional carbohydrates before or after exercise, it can cause hypoglycemia.
• Drinking Alcohol: Alcohol can interfere with the liver's ability to release glucose into the bloodstream, particularly when consumed without food.

Hypoglycemia in People Without Diabetes

While less common, hypoglycemia can occur in individuals without diabetes. Potential causes include:

• Reactive Hypoglycemia: This occurs within a few hours after eating a meal, often high in carbohydrates. The body releases too much insulin in response to the meal, leading to a rapid drop in blood sugar.
• Fasting Hypoglycemia: This occurs after a prolonged period without eating. It can be caused by various medical conditions, including:
  • Certain Medications: Some medications, such as quinine (used to treat malaria) and salicylates (like aspirin), can cause hypoglycemia.
  • Excessive Alcohol Consumption: As mentioned earlier, alcohol can impair liver function and glucose release.
  • Liver Disease: The liver plays a critical role in storing and releasing glucose. Liver disease can disrupt this process.
  • Kidney Disease: Kidneys help regulate blood glucose levels. Kidney dysfunction can lead to imbalances.
  • Hormone Deficiencies: Deficiencies in hormones like cortisol (adrenal insufficiency) or growth hormone can contribute to hypoglycemia.
  • Insulinoma: A rare tumor in the pancreas that produces excess insulin.
  • Non-Pancreatic Tumors: Some non-pancreatic tumors can produce insulin-like substances.
• Post-Bariatric Surgery Hypoglycemia: Some individuals who have undergone bariatric surgery (weight loss surgery) may experience hypoglycemia due to rapid gastric emptying and altered hormone responses.
• Hereditary Metabolic Disorders: Rare genetic conditions affecting metabolism can impair glucose regulation.

Symptoms of Hypoglycemia

The symptoms of hypoglycemia can vary from person to person and depend on the severity of the blood sugar drop. Early symptoms are often mild but can quickly progress if not addressed.

• Mild to Moderate Hypoglycemia Symptoms:

  • Shakiness
  • Sweating
  • Dizziness or lightheadedness
  • Hunger
  • Irritability or anxiety
  • Rapid heartbeat
  • Blurry vision
  • Headache
  • Weakness
  • Difficulty concentrating

• Severe Hypoglycemia Symptoms:

  • Confusion or disorientation
  • Slurred speech
  • Seizures
  • Loss of consciousness
  • Coma

It's crucial to recognize the symptoms of hypoglycemia early to prevent it from progressing to a severe state. If you experience these symptoms, especially if you have diabetes, check your blood sugar immediately.

How to Treat Hypoglycemia Fast

The primary goal of treating hypoglycemia is to raise your blood sugar level back to a safe range (typically above 70 mg/dL) as quickly as possible. The treatment strategy depends on your level of consciousness.

If You Are Conscious and Able to Swallow:

• The 15-15 Rule: This is the standard recommendation for treating mild to moderate hypoglycemia:
  1. Consume 15 grams of fast-acting carbohydrates: Examples include:
     • 4 ounces (120 ml) of regular soda (not diet)
     • 4 ounces (120 ml) of fruit juice
     • 1 tablespoon of honey or sugar
     • Glucose tablets (follow package instructions for 15 grams)
     • Hard candies (check the nutrition label for carbohydrate content; consume enough to equal 15 grams)
  2. Wait 15 minutes and recheck your blood sugar: Use a blood glucose meter to measure your blood sugar level.
  3. If your blood sugar is still below 70 mg/dL, repeat the process: Consume another 15 grams of fast-acting carbohydrates and recheck your blood sugar in 15 minutes.
  4. Once your blood sugar is above 70 mg/dL, eat a snack or meal: This will help stabilize your blood sugar and prevent another drop. Choose a snack or meal containing complex carbohydrates and protein, such as whole-wheat crackers with peanut butter or a piece of fruit with cheese.

If You Are Unconscious or Unable to Swallow:

Severe hypoglycemia requires immediate medical attention. If you are unable to treat yourself, someone needs to assist you.

• Glucagon Injection: Glucagon is a hormone that stimulates the liver to release stored glucose into the bloodstream. If you have diabetes and are at risk of severe hypoglycemia, your doctor may prescribe a glucagon emergency kit. Family members, friends, or caregivers should be trained on how to administer the glucagon injection. Follow the kit instructions carefully.
• Call Emergency Services (911 or your local emergency number): Even after administering glucagon, it's essential to seek immediate medical help.

Prevention of Hypoglycemia

Preventing hypoglycemia involves identifying the underlying causes and taking steps to address them.

For People with Diabetes:

• Monitor Blood Sugar Regularly: Frequent blood glucose monitoring helps you identify patterns and trends, allowing you to adjust your insulin or medication doses accordingly.
• Coordinate Insulin/Medication with Meals and Exercise: Work closely with your doctor or diabetes educator to adjust your insulin or medication doses based on your meal plans and activity levels.
• Eat Regular Meals and Snacks: Avoid skipping meals or going too long between meals. Plan your meals and snacks to maintain consistent blood sugar levels.
• Carry a Fast-Acting Carbohydrate Source: Always keep a source of fast-acting carbohydrates (e.g., glucose tablets, juice) with you in case of hypoglycemia.
• Wear a Medical Alert Identification: This can alert others to your condition if you become unresponsive.
• Limit Alcohol Consumption: If you drink alcohol, do so in moderation and always consume it with food.
• Inform Friends and Family: Educate your family, friends, and coworkers about the signs and symptoms of hypoglycemia and how to help you if you experience an episode.
• Consider a Continuous Glucose Monitor (CGM): A CGM can provide real-time glucose readings and alert you when your blood sugar is dropping too low.

For People Without Diabetes:

• Identify the Underlying Cause: Work with your doctor to determine the underlying cause of your hypoglycemia. This may involve blood tests, imaging studies, or other diagnostic procedures.
• Eat Balanced Meals: Focus on consuming balanced meals that include complex carbohydrates, protein, and healthy fats. This helps to stabilize blood sugar levels.
• Avoid Sugary Drinks and Processed Foods: These can cause rapid spikes and drops in blood sugar.
• Eat Smaller, More Frequent Meals: Eating smaller, more frequent meals can help to prevent large fluctuations in blood sugar.
• Limit Alcohol Consumption: As mentioned earlier, alcohol can affect blood sugar levels.
• Manage Underlying Medical Conditions: If your hypoglycemia is caused by an underlying medical condition (e.g., liver disease, kidney disease, hormone deficiency), work with your doctor to manage the condition effectively.

When to See a Doctor

It's important to consult a doctor if you experience frequent or severe episodes of hypoglycemia, especially if you have diabetes or a history of hypoglycemia. Even if you don't have diabetes, it's essential to determine the cause of your hypoglycemia and develop a management plan. See a doctor if:

• You experience frequent or recurrent episodes of hypoglycemia.
• You have severe symptoms of hypoglycemia (e.g., seizures, loss of consciousness).
• You are unable to manage your hypoglycemia effectively.
• You have a medical condition that may be contributing to your hypoglycemia.
• You are taking medications that may be causing hypoglycemia.

Conclusion

Hypoglycemia, or low blood sugar, is a condition that requires careful attention. By understanding the causes, recognizing the symptoms, and learning how to treat it quickly, you can effectively manage hypoglycemia and prevent serious complications. Whether you have diabetes or not, working closely with your healthcare provider is essential for developing a personalized management plan to keep your blood sugar levels in a healthy range. Proper monitoring, a healthy diet, and appropriate medication management are key to preventing and treating hypoglycemia.