Hypoglycemia

Hypoglycemia is a state in which your body’s blood glucose (also known as blood sugar) falls to a critically low level. It is most often experienced by people with diabetes, but it can also happen to nondiabetics in certain circumstances.

All foods contain glucose in varying amounts. It is your body’s primary source of fuel. If you do not have enough of it available to maintain your body’s functions (70 mg/dl or 4 mmol/l), your body struggles to perform normally.

Low blood sugar causes a variety of cognitive and neurological symptoms like shaking and lightheadedness. It also alters your body’s ability to support critical organs like your muscles and brain.

The most common symptoms of hypoglycemia include weakness and behavioral changes. Other early symptoms include:

If the condition progresses, you can experience neurological issues like confusion and seizures.

Never ignore symptoms of hypoglycemia. They indicate that your body is in urgent need of more fuel. If symptoms arise, always stop what you are doing and take steps to bring your blood sugar back up.

Hypoglycemia Complications

If you do not treat hypoglycemia as soon as possible, you may experience life-altering complications. The most serious are:

Hypoglycemia does not go away without action, and it only gets worse if left untreated. No one should ignore presenting symptoms of hypoglycemia.

When to Seek Medical Attention

The time to seek medical help for hypoglycemia is when symptoms show up and do not abate after eating or drinking something sugary.

There is too much at stake to put off a visit to an urgent-care facility, including potential permanent brain damage. If you find yourself dealing with symptoms outside of regular clinic hours, go to the nearest emergency room or call 9-1-1 for emergency help. Do not wait for the next day to get treatment.

Hypoglycemia Unawareness

Hypoglycemia unawareness is when someone fails to notice that they are experiencing symptoms of low blood sugar. They may not realize the need to take action until after their symptoms become severe or they see a too-low blood sugar reading on one of their routine tests.

Hypoglycemia unawareness is most common in people who have Type 1 diabetes, but it can happen to anyone who experiences hypoglycemia. Researchers are still investigating how best to help people avoid it.

Some potential approaches include offering more information on hypoglycemia, providing people with strategies to improve their bodily awareness, and prescribing medication that makes hypoglycemia symptoms more obvious.

The main cause of hypoglycemia is when something goes wrong with your body’s natural blood-sugar regulation processes.

Each time you eat, your body breaks food down into its component parts, including glucose. Your body responds by releasing insulin and using some glucose as fuel to maintain healthy blood sugar levels.

One of the many important actions of insulin is to allow cells to take up glucose where it can be used immediately as fuel or it can be converted to glycogen or fatty acids for storage.  After several hours without food, your body begins to run out of fuel, and your blood sugar drops. In response, your body releases another hormone, glucagon.

Glucagon tells your liver to turn glycogen reserves into glucose for needed fuel. If you don’t have enough stored glycogen to meet your needs, your body can utilize stored fats and amino acids to produce fuel in the form of fatty acids and glucose. 

Causes for People with Diabetes

Most people who experience hypoglycemia also have diabetes.  The reason for this is that Type 1 and type 2 diabetes are frequently treated with insulin, a hormone that regulates blood sugar. About 10% of people with type 1 diabetes account for 70% of hypoglycemia episodes.

Because people who take insulin for diabetes cannot easily alter their dose to accommodate dietary changes or extra exercise, it is easy for them to take too much. Doing so causes blood sugar levels to drop unexpectedly, leading to hypoglycemia.

Doctors also treat type 2 diabetes with metformin, a medication that reduces the amount of glucose your body produces and absorbs. Metformin can very rarely lead to hypoglycemia if the dosage is too high or if food intake is abnormally low.

Causes for People Without Diabetes

People who do not have diabetes can also experience hypoglycemia symptoms. This can happen because of a variety of medical conditions and lifestyle factors.

Nondiabetic hypoglycemia is rare, but it is just as serious as the hypoglycemic episodes that someone with diabetes experiences.

Always discuss any symptoms of hypoglycemia with your doctors. They may recommend getting tested for some of the conditions described above.

Treating hypoglycemia requires getting your blood sugar to normal levels. To do this, follow the 15-15 rule: Take 15-20 grams of carbohydrates, then wait 15 minutes. You can also give yourself a shot of glucagon if your doctor prescribed it for you. Your symptoms should go away after either treatment. If possible, test your blood sugar to verify that it worked.

Because hypoglycemia is a severe problem that often goes ignored, many healthcare providers treat it by training people to recognize hypoglycemic symptoms and by outlining actions to take to avert an emergency.

Researchers are exploring new ways to determine who is most at risk for hypoglycemic episodes. Your health information will allow doctors to provide these people with additional information on hypoglycemia, its symptoms and its potential complications. This may help increase engagement in this population and motivate them to manage their blood sugar levels more carefully before hypoglycemic episodes happen.

The medical community is also working on making hypoglycemia rarer by improving insulin delivery mechanisms. For example, many adults and children with type 1 diabetes use insulin pumps with automatic sensors to treat their condition.

Pumps continually monitor your blood sugar levels and regulate the amount of insulin they deliver based on those readings. They will automatically stop dispensing insulin when your blood sugar dips too low, preventing many instances of hypoglycemia.

Preventing hypoglycemia is difficult without identifying an underlying cause. Tell your doctors if you have experienced hypoglycemic symptoms in the past. They likely will recommend diabetes testing.

Depending on the results of that test, they may investigate other potential health problems.

You may also need to moderate the amount of exercise you do while taking insulin. Discuss your activity levels with your doctor so they can prescribe the right amount of insulin for your lifestyle.