What Causes A Low Blood Sugar Level
In people with diabetes, the main causes of a low blood sugar level are:
- the effects of medicine especially taking too much insulin, medicines called sulfonylureas , medicines called glinides , or some antiviral medicines to treat hepatitis C
- skipping or delaying a meal
- not eating enough carbohydrate foods in your last meal, such as bread, cereals, pasta, potatoes and fruit
- exercise, especially if it’s intense or unplanned
- drinking alcohol
Sometimes there’s no obvious reason why a low blood sugar level happens.
Very occasionally, it can happen in people who do not have diabetes.
Exercise Food And Alcohol
For people with type 1 diabetes, maintaining the correct blood glucose level involves balancing how much insulin you inject, the amount of food you eat, and how much energy you burn during exercise.
Hypoglycaemia may occur if you’ve taken your dose of insulin as usual, but your carbohydrate intake is lower than normal or has been used up more quickly. This may happen if you delay or miss a meal or snack, don’t eat enough carbohydrate, or exercise more than usual.
People with diabetes who’ve drunk too much alcohol, or drank alcohol on an empty stomach, can also get hypoglycaemia.
However, it’s not always possible to identify why a particular episode of hypoglycaemia has occurred, and sometimes it happens for no obvious reason.
What Causes Low Blood Sugar Without Diabetes
While its less common, low blood sugar can impact people without diabetes.
Low blood sugar usually isnt life-threatening. However, in some cases, it can become serious and lead to injury.
Keep reading to find out what causes low blood sugar without diabetes, and how to treat and prevent it.
Preventing and treating low blood sugar is similar regardless of whether you have diabetes, and is the most important part of low blood sugar management.
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High Or Low Blood Sugar
Nausea is a symptom of both high and low blood sugar, so it is important to check your levels at home with your glucometer before deciding on your next steps. If you are experiencing blood glucose highs and lows regularly or more frequently than usual, tell your healthcare provider. They can help determine the cause and a plan of action to keep your blood sugar levels within the normal range.
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How Can I Check My Blood Sugar
Use a blood sugar meter or a continuous glucose monitor to check your blood sugar. A blood sugar meter measures the amount of sugar in a small sample of blood, usually from your fingertip. A CGM uses a sensor inserted under the skin to measure your blood sugar every few minutes. If you use a CGM, youll still need to test daily with a blood sugar meter to make sure your CGM readings are accurate.
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Questions Caregivers Should Ask
As a family member, friend, or caregiver, you want to do your best to keep your loved one, friend, or patient safe from severe hypoglycemia. But knowing whats best can be overwhelming. Here are some questions to help you get started.
- What are my loved ones/friends/patients chances for severe hypoglycemia?
- How often should my loved one/friend/patient check their blood glucose?
- What should I do if there is no change after giving the glucagon?
- What would be the best food or drink to give my loved one/friend/patient once they wake up?
- Should I talk with a diabetes educator?
- How can I help treat their hypoglycemia?
THE DEVELOPMENT OF THESE RESOURCES WERE MADE FROM THE GENEROUS SUPPORT OF LILLY DIABETES AND XERIS PHARMACEUTICALS, INC.
Preventing Low Blood Sugar
Eating regular meals and snacks is the best way to keep blood sugar on an even keel. Here are some guidelines for those who have had recurring bouts of hypoglycemia:
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Try not to skip or delay meals. Dont go more than three hours without eating something.
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Avoid drinking alcohol on an empty stomach. Alcohol can cause blood sugar to drop.
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Have a light snack before exercising. Good choices are crackers and peanut butter, yogurt and fruit, half a turkey sandwich, or a bowl of whole grain cereal with milk. A snack at bedtime can help keep blood sugar levels normal during the night.
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If you have diabetes, you need to match your carbohydrate intake to your diabetes medications to avoid low blood sugar. A dietitian or diabetes educator can help you put together an eating plan. If you take mealtime insulin like insulin aspart , insulin lispro , or insulin glulisine , make sure you eat the right amount of carbohydrates at your meal to match your insulin dosage. Skipping meals or not eating enough carbohydrates can cause your blood sugar level to dip significantly.
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How Is It Treated
If you often have symptoms of hypoglycemia, you should see your healthcare provider. Your provider can help you determine the cause. Your provider will also give you guidelines for treating low blood sugar when you are having symptoms.
When you see your provider, be sure to take your notebook or glucose meter with all of the results of your recent blood sugar checks. This helps your provider know whether you are on the right medicines and are taking the right dose at the right time of day. Without this record, it is harder for your provider to help you figure out the cause of your symptoms.
Here are some examples of guidelines your provider may give you:
- If you have diabetes and you think your blood sugar may be too low, check it with your home meter before treatment, if possible.
- Always carry some form of sugar you can eat as soon as you have any symptoms of hypoglycemia. The following amounts and types of foods will bring your blood sugar level up:
- 2 to 5 glucose tablets
- 1/2 cup fruit juice
- 1/2 cup regular soda
- 6 to 8 ounces of skim milk
- 1/4 to 1/3 cup of raisins
- 5 to 7 pieces of hard candy like Lifesavers
- a tube of glucose in gel form
- 1 tablespoon of molasses, corn syrup, or honey
Nighttime Low Blood Sugar
While low blood sugar can happen at any time during the day, some people may experience low blood sugar while they sleep. Reasons this may happen include:
- Having an active day.
- Being physically active close to bedtime.
- Taking too much insulin.
- Drinking alcohol at night.
Eating regular meals and not skipping them can help you avoid nighttime low blood sugar. Eating when you drink alcohol can also help. If you think youre at risk for low blood sugar overnight, have a snack before bed.
You may wake up when you have low blood sugar, but you shouldnt rely on that. A continuous glucose monitor can alert you with an alarm if your blood sugar gets low while youre sleeping.
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How Do You Treat Nondiabetic Hypoglycemia
The treatment for low blood sugar will depend on the underlying cause. If low blood sugar is caused by a medication, your doctor may switch you to a different medication.
If low blood sugar is caused by an underlying medical condition, your doctor will treat the condition. If low blood sugar is caused by diet or alcohol consumption, you will need to make some lifestyle changes.
You can also treat a hypoglycemic episode by eating or drinking something that contains sugar and carbohydrates such as fruit juice, candy, glucose tablet, glucose gel, or honey.
Eat or drink 15 to 20 grams of these foods or drinks and then check your blood sugar levels after 15 minutes. If your level of sugar is still low, you can have another dose of high-sugar food or drinks.
Continue these steps until your blood sugar levels are above 70 mg/dL and then eat a snack or meal to help maintain these levels. Also, call your doctor if you frequently have low blood sugar.
What Is Low Blood Sugar
A healthy persons blood sugar levels are primarily regulated by their pancreas, liver, and several hormones. Your pancreas releases insulin to lower blood sugar when its high, and your liver releases stored sugar to help prevent low blood sugar.
A normal blood sugar range falls between 70-140 mg/dL . Low blood sugar, or hypoglycemia, occurs when your blood sugar drops below 70 mg/dL.
Low blood sugar can be mild, moderate, or severe. Severe hypoglycemia can become life-threatening if it isnt treated quickly.
Low blood sugar usually affects people with diabetes taking medications to help lower their blood sugar. Insulin and sulfonylureas are the two main diabetes medications that can cause low blood sugar. However, you can get low blood sugar even if you dont have diabetes.
There are different levels of hypoglycemia, which correlate with the severity of low blood sugar.
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How Is Hypoglycemia Treated
Your doctor will need to identify the cause of your hypoglycemia to determine the right long-term therapy for you.
Glucose will help boost your blood sugar levels in the short term. One way to get additional glucose is to consume 15 grams of carbohydrates.
Drinking fruit juice is an easy way to get extra glucose into your bloodstream. These sources of glucose often briefly correct hypoglycemia, but then another drop in blood sugar often follows.
Eating foods that are high in complex carbohydrates, such as pasta and whole grains, will sustain blood sugar levels after a period of hypoglycemia.
Symptoms of hypoglycemia can become so severe that they interfere with daily routines and activities. If you have severe hypoglycemia, you might need to carry glucose tablets or injectable glucose .
When Your Blood Sugar Gets Low
Check your blood sugar whenever you have symptoms of low blood sugar. If your blood sugar is below 70 mg/dL, treat yourself right away.
1. Eat something that has about 15 grams of carbohydrates. Examples are:
- 3 glucose tablets
- One half cup of fruit juice or regular, non-diet soda
- 5 or 6 hard candies
- 1 tablespoon or 15 mL of sugar, plain or dissolved in water
- 1 tbsp of honey or syrup
2. Wait about 15 minutes before eating any more. Be careful not to eat too much. This can cause high blood sugar and weight gain.
3. Check your blood sugar again.
4. If you do not feel better in 15 minutes and your blood sugar is still lower than 70 mg/dL , eat another snack with 15 g of carbohydrates.
You may need to eat a snack with carbohydrates and protein if your blood sugar is in a safer range — over 70 mg/dL — and your next meal is more than an hour away.
Ask your provider how to manage this situation. If these steps for raising your blood sugar do not work, call your doctor right away.
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What Is Severe Hypoglycemia
Hypoglycemia can be mild, moderate, or severe based on the persons blood glucose and condition. Here are the levels:
- Level 1 hypoglycemia: Blood glucose is less than 70 mg/dL but is 54 mg/dL or higher.
- Level 2 hypoglycemia: Blood glucose is less than 54 mg/dL.
- Level 3 hypoglycemia: A person is unable to function because of mental or physical changes. They need help from another person. In this case, blood glucose is often below 40mg/dL.
Whats The Link Between Diabetes And Hypoglycemia
Hypoglycemia is most common, by far, in people with diabetes. Treatment for the diseaseoften involves taking medication to increase insulin. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance.
Common pitfalls for people with diabetes include:
- Being more active than usual.
- Drinking alcohol without eating.
- Eating late or skipping meals.
- Not balancing meals by including fat, protein and fiber.
- Not eating enough carbohydrates.
- Not timing insulin and carb intake correctly .
Also, if someone with diabetes uses the wrong insulin, takes too much or injects it incorrectly, that can cause hypoglycemia.
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The Dangers Of Low Blood Glucose
At some time, most people with diabetes experience the sweating and shakiness that occurs when blood glucose levels fall below 70 mg/dl a condition known as hypoglycemia. The average person with type 1 diabetes may experience symptoms of low blood glucose up to two times a week. However, not all are aware that these symptoms can rapidly progress to seizures, coma and even death if hypoglycemia is severe. Though hypoglycemia can be common and occur repeatedly in some people with diabetes, symptoms of low blood glucose should always be taken seriously. People with diabetes and their families, friends or coworkers should be prepared to act quickly and responsibly at the earliest signs of low blood glucose.
Severe Low Blood Sugar
As your low blood sugar gets worse, you may experience more serious symptoms, including:
- Having difficulty walking or seeing clearly.
- Acting strange or feeling confused.
- Having seizures.
Severe low blood sugar is below 54 mg/dL. Blood sugar this low may make you faint . Often, youll need someone to help you treat severe low blood sugar.
People with diabetes may experience low blood sugar as often as once or twice a week, even when managing their blood sugar closely. Knowing how to identify and treat it is important for your health. Learn how to treat low blood sugar.
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How Do Carbs Affect Blood Sugar
Carbs in food make your blood sugar levels go higher after you eat them than when you eat proteins or fats. You can still eat carbs if you have diabetes. The amount you can have and stay in your target blood sugar range depends on your age, weight, activity level, and other factors. Counting carbs in foods and drinks is an important tool for managing blood sugar levels. Make sure to talk to your health care team about the best carb goals for you.
Why Am I Having Lows
If you are experiencing low blood glucose and youre not sure why, bring a record of blood glucose, insulin, exercise, and food data to a health care provider. Together, you can review all your data to figure out the cause of the lows.
The more information you can give your health care provider, the better they can work with you to understand what’s causing the lows. Your provider may be able to help prevent low blood glucose by adjusting the timing of insulin dosing, exercise, and meals or snacks. Changing insulin doses or the types of food you eat may also do the trick.
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Check Your Blood Sugar
You can check your blood sugar with a glucometer even if you dont have diabetes. Glucometer kits can be purchased over the counter and can be useful for identifying blood sugar trends.
Checking your blood sugar when you start to feel symptoms can help you identify and treat the low early.
Combining blood sugar readings along with a food and symptom log/journal can help you identify the causes of your low blood sugar.
How Can I Prevent Hypoglycemia
You may need to change what and when you eat to prevent low blood sugar levels. Follow the meal plan that you and the dietitian have planned. The following guidelines may help you keep your blood sugar levels under control.
- Eat 5 to 6 small meals each day instead of 3 large meals. Eat the same amount of carbohydrate at meals and snacks each day. Most people need about 3 to 4 servings of carbohydrate at meals and 1 to 2 servings for snacks. Do not skip meals. Carbohydrate counting can be used plan your meals. Ask your healthcare provider or dietitian for information about carbohydrate counting.
- Limit refined carbohydrates. Examples are white bread, pastries , regular sodas, syrups, and candy.
- Do not have drinks or foods that contain caffeine. Examples are coffee, tea, and certain types of sodas. Caffeine may cause you to have the same symptoms as hypoglycemia, and may cause you to feel worse.
- Limit or do not drink alcohol. Women should limit alcohol to 1 drink a day. Men 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. Do not drink alcohol on an empty stomach. Drink alcohol with meals to avoid hypoglycemia.
- Include protein foods and vegetables in your meals. Some foods that are high in protein include beef, pork, fish, poultry , beans, and nuts. Eat a variety of vegetables with your meals.
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What Are Blood Sugar Targets
A blood sugar target is the range you try to reach as much as possible. These are typical targets:
- Before a meal: 80 to 130 mg/dL.
- Two hours after the start of a meal: Less than 180 mg/dL.
Your blood sugar targets may be different depending on your age, any additional health problems you have, and other factors. Be sure to talk to your health care team about which targets are best for you.