Hypoglycemia in a Person with Diabetes

Medically reviewed by Drugs.com. Last updated on May 6, 2024.

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AMBULATORY CARE:

Hypoglycemia

is a serious condition that happens when your blood glucose (sugar) level drops too low. The blood sugar level is usually too high in a person with diabetes, but the level can also drop too low. It is important to follow your diabetes management plan to keep your blood sugar level steady.

What increases your risk for hypoglycemia:

• Binge eating, eating large amounts of carbohydrates in processed foods such as potato chips
• A missed meal, or a meal eaten later than usual
• Vomiting
• Certain medicines, including insulin or other diabetes medicine
• More exercise than usual, without extra food
• Alcohol use
• Pregnancy, older age
• Decreased liver or kidney function
• Not knowing your symptoms are symptoms of hypoglycemia

Common signs and symptoms include the following:

• Headache, hunger, or shakiness
• Trouble thinking or moodiness
• Sweating, or a pounding heartbeat
• Forgetfulness, confusion, or double vision
• Weakness or trouble walking
• Numbness and tingling around your mouth
• Seizures, coma, or loss of consciousness

Have someone call your local emergency number (911 in the US) if:

• You have a seizure or pass out.
• Your blood sugar is less than 50 mg/dL and does not respond to treatment.
• You feel you are going to pass out.
• You have trouble thinking clearly.

Call your doctor or diabetes care team provider if:

• You have had symptoms of low blood sugar several times.
• You have questions about the amount of insulin or diabetes medicine you are taking.
• You have questions or concerns about your condition or care.

How to check your blood sugar level:

• A glucose meter is a machine used to test a drop of blood. Your care team will show you how to do this.
• A continuous glucose monitor (CGM) is a device that is worn at all times. The CGM checks your blood sugar every 5 minutes. It sends results to an electronic device such as a smart phone.

Manage hypoglycemia:

Always carefully follow your healthcare provider's instructions on how to treat low blood sugar levels. The following are general guidelines:

• Check your blood sugar level right away if you have symptoms of hypoglycemia. Hypoglycemia usually happens when your blood sugar level is 70 mg/dL or below. Ask your diabetes care team provider what blood sugar level is too low for you.
• If your blood sugar level is too low, eat or drink 15 grams of fast-acting carbohydrate. Examples are 4 ounces (½ cup) of fruit juice or regular soft drink, or 2 tablespoons of raisins. You may instead use 1 tube of glucose gel. Check your blood sugar level 15 minutes later. Sit still as you wait. If the level is still low (less than 100 mg/dL), have another 15 grams of carbohydrate. When the level returns to 100 mg/dL, eat a meal if it is time. If your meal time is more than 1 hour away, eat a snack. This will help prevent another drop in blood sugar. The snack should contain carbohydrates, such as the following:
  • ¾ cup of cereal
  • 1 cup of skim or low fat milk
  • 6 soda crackers
  • ½ of a turkey sandwich
  • 15 fat-free chips
  
  
• Always carry a source of fast-acting carbohydrate. If you have symptoms of hypoglycemia and you do not have a blood glucose meter, have a source of fast-acting carbohydrate anyway. Avoid carbohydrate foods that are high in fat. The fat content may make the carbohydrate take longer to increase your blood sugar level. Ask your provider if you should carry a glucagon kit. Glucagon is a medicine that is injected when you develop severe hypoglycemia and become unconscious. Check the expiration date every month and replace it before it expires.
• Teach others how to help you if you have symptoms of hypoglycemia. Tell them about the symptoms of hypoglycemia. Ask them to give you a source of fast-acting carbohydrate if you cannot get it yourself. Ask them to give you a glucagon injection if you have signs of hypoglycemia and you become unconscious or have a seizure. Ask them to call the local emergency number (911 in the US) . This is an emergency. Tell them never to try to make you swallow anything if you faint or have a seizure.
• Wear medical alert jewelry or carry a card that says you have diabetes. Ask where to get these items.

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• glucagon
• GlucaGen
• Proglycem
• Baqsimi
• Gvoke

View more treatment options

Prevent hypoglycemia:

• Check your blood sugar level as directed. You may need to check the level at least 3 times each day. Ask when and how often to check. Ask your healthcare provider what your blood sugar levels should be before and after you eat. Record your blood sugar level results and take the record with you when you see your care team. They may use it to make changes to your medicine, food, or exercise schedules.
• Take diabetes medicine as directed. Take your medicine at the right time and in the right amount. Do not double the amount of medicine you take unless instructed by your diabetes care team provider. You may need oral diabetes medicine, insulin, or both to help control your blood sugar levels. Your provider will teach you how and when to take oral diabetes medicine. You will also be taught about side effects oral diabetes medicine can cause. Insulin may be added if oral diabetes medicine becomes less effective over time. Insulin may be injected, or given through a pump or pen. You and your care team will discuss which method is best for you.
  • An insulin pump is an implanted device that gives your insulin 24 hours a day. An insulin pump prevents the need for multiple insulin injections in a day. A pump connected to a CGM is called an automated insulin delivery (AID) system.
  • An insulin pen is a device prefilled with the right amount of insulin.
• Eat meals and snacks as directed. Talk to your dietitian or provider about a meal plan that is right for you. Do not skip meals.
• Check your blood sugar level before you exercise. Physical activity, such as exercise, can decrease your blood sugar level. If your blood sugar level is less than 100 mg/dL, have a carbohydrate snack. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of nonfat or 1% milk, or 4 ounces (½ cup) of juice. If you will be active for more than 1 hour, you may need to check your blood sugar level every 30 minutes. Your provider may also recommend that you check your blood sugar level after your activity.
• Know the risks if you choose to drink alcohol. Alcohol can cause your blood sugar levels to be low if you use insulin. Alcohol can cause high blood sugar levels and weight gain if you drink too much. Women 21 years or older and men 65 years or older should limit alcohol to 1 drink a day. Men aged 21 to 64 years should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

Follow up with your doctor or diabetes care team provider as directed:

You may need your insulin or diabetes medicine changed if you continue to have hypoglycemia episodes. Write down your questions so you remember to ask them during your visits.

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