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Hypoglycemia (Low blood glucose)

  • Hypoglycemia happens from time to time to everyone who has diabetes.
  • Check blood glucose levels to determine when your level is low.
  • Learn to identify the symptoms of hypoglycemia so you can treat it quickly.
  • Treat hypoglycemia by raising your blood glucose level with some form of sugar.

Hypoglycemia, sometimes called an insulin reaction, can happen even during those times when you're doing all you can to manage your diabetes. So, although many times you can't prevent it from happening, hypoglycemia can be treated before it gets worse. For this reason, it's important to know what hypoglycemia is, what symptoms of hypoglycemia are, and how to treat hypoglycemia. You may also be interested in our book, 487 Really Cool Tips for Kids with Diabetes.

How do I know when my blood glucose is low?

Part of managing diabetes is checking blood glucose often. Ask your doctor how often you should check and what your blood glucose levels should be. The results from checking your blood will tell you when your blood glucose is low and that you need to treat it.

You should check your blood glucose level according to the schedule you work out with your doctor. More importantly though, you should check your blood whenever you feel low blood glucose coming on. After you check and see that your blood glucose level is low, you should treat hypoglycemia quickly.

If you feel a reaction coming on but cannot check, remember this simple rule: When in doubt, treat.

What are the symptoms of hypoglycemia?

Symptoms of hypoglycemia include the following:

  • Shakiness
  • Dizziness
  • Sweating
  • Hunger
  • Headache
  • Pale skin color
  • Sudden moodiness or behavior changes, such as crying for no apparent reason
  • Clumsy or jerky movements
  • Seizure
  • Difficulty paying attention, or confusion
  • Tingling sensations around the mouth


How do I treat hypoglycemia?

The quickest way to raise your blood glucose and treat hypoglycemia is with some form of sugar.  Many people with diabetes like to carry glucose tablets. You gan get glucose tablets at any drugstore and at many other stores as well.

Other sources of sugar or simple carbohydrates also work well to treat hypoglycemia, such as fruit juice, hard candies, or pretzels or crackers.  The important thing is to get at least 15-20 grams of sugars or carbohydrates. A food's nutrition label can tell you how much you need to eat of that food to get enough to treat an episode of hypoglycemia.  To treat hypoglycemia you should stick with something that is mostly sugar or carbohydrates. Foods that have a lot of fat as well as sugars and carbohydrates, such as chocolate or cookies, do not work as quickly to raise blood glucose levels.

Foods with 15 grams carbohydrates:

  • 4 oz (1/2 cup) of juice or regular soda
  • 2 tablespoons of raisins
  • 4 or 5 saltine crackers
  • 4 teaspoons of sugar
  • 1 tablespoon of honey or corn syrup

Ask your health care professional or dietitian to list foods that you can use to treat low blood glucose. Then be sure you always have at least one type of sugar with you.

Once you've checked your blood glucose and treated your hypoglycemia, wait 15 or 20 minutes and check your blood again. If your blood glucose is still low and your symptoms of hypoglycemia don't go away, repeat the treatment. After you feel better, be sure to eat your regular meals and snacks as planned to keep your blood glucose level up.

What if it goes untreated?

It's important to treat hypoglycemia quickly because hypoglycemia can get worse and you could pass out. If you pass out, you will need immediate treatment, such as an injection of glucagon or emergency treatment in a hospital.

Glucagon raises blood glucose. It is injected like insulin. Ask your doctor to prescribe it for you and tell you how to use it. You need to tell people around you (such as family members and co-workers) how and when to inject glucagon should you ever need it. For more information about glucagon, view this training video.

If glucagon is not available, you should be taken to the nearest emergency room for treatment for low blood glucose. If you need immediate medical assistance or an ambulance, someone should call the emergency number in your area (such as 911) for help. It's a good idea to post emergency numbers by the telephone.

If you pass out from hypoglycemia, here are some DOs and DON'Ts for friends, families and co-workers:

  • DO NOT inject insulin.
  • DO NOT provide food or fluids.
  • DO NOT put hands in your mouth.
  • DO inject glucagon.
  • DO call for emergency help.

What is hypoglycemia unawareness?

Hypoglycemia unawareness is when you lose consciousness without ever knowing your blood glucose levels were dropping or that you were showing other symptoms of hypoglycemia. It tends to happen to people who have had diabetes for many years, but it doesn't happen to everyone. It is more likely in people who have neuropathy (nerve damage), people on tight glucose control, and people who take certain heart or high blood pressure medicines.

As the years go by, many people continue to have symptoms of hypoglycemia, but the symptoms change. In this case, someone may not recognize a reaction because it feels different.

These changes are a good reason to check your blood glucose often, and to alert your friends and family to your symptoms of hypoglycemia. Treat low or dropping sugar levels even if you feel fine. And tell your team if your blood glucose ever drops below 50 mg/dl without any symptoms.

How can I prevent low blood glucose?

Your best bet is to practice good diabetes management and learn to detect hypoglycemia so you can treat it early—before it gets worse.

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