What Is Hypoglycemia And Low Blood Sugar
Hypoglycemia is the state of having a blood glucose level that is too low to effectively fuel the bodys cells.
Glucose, which comes from carbohydrates found in foods, is a main source of energy for all of the cells of the body and, especially, the brain. While the body is quite good at extracting glucose from the foods we eat, it relies on a hormone called insulin to actually get the glucose inside the cells of specific organs: the liver, fat, and muscle.
We can think of insulin as holding the key to a cell without insulin, the glucose just remains in the blood, where its also known as blood sugar. During an episode of hypoglycemia, theres not enough glucose in the blood. The normal range is approximately 70 to 150 mg/dl .
Hypoglycemia is most common in newborns. In older children, its most often seen as a complication of insulin therapy for diabetes but can sometimes have other causes as well.
In the majority of cases, hypoglycemia is temporary, easily treated, and usually does not have serious consequences. There are several rare disorders in which hypoglycemia is recurrent and potentially life-threatening. However, with timely diagnosis and appropriate treatment, these can be effectively managed.
What To Eat When You Have Low Blood Sugar
When your blood sugar dips, it can leave you feeling hungry, shaky, and lightheaded. This can happen to anyone who hasnt eaten in several hours. When blood sugar drops below normal levels, its called hypoglycemia. In people with diabetes, hypoglycemia can be a life-threatening complication of diabetes medication, other health problems like infection, or inadequate caloric intake.
You can lower your chances of low blood sugarand treat it when it occurswith some simple steps.
How Does Hypoglycemia Occur Without Diabetes
Hypoglycemia usually happens to people living with diabetes, but its possible to have low blood sugar without diabetes.
Blood sugar, or glucose, is what your body uses for energy. After eating a meal or drinking a beverage, the hormone insulin allows sugar to enter your bodys cells, where its used for energy. Insulin is a hormone produced by your pancreas.
Hypoglycemia occurs when you have too much insulin in your bloodstream. This might happen if you dont eat for several hours, such as 8 hours or more. A drop in blood sugar means there isnt enough glucose in your bloodstream to fuel your brain and body.
Low blood sugar without diabetes can also occur if you take a medication that lowers your blood sugar. These include pain relievers like:
- some antibiotics
Other causes of low blood sugar without diabetes include binge-drinking and increased physical activity.
Plus, some medical conditions can increase the amount of insulin your pancreas produces. These include a pancreatic tumor, adrenal gland disorders, and hepatitis.
You could also experience low blood sugar if you have prediabetes, or if you eat a lot of refined carbohydrates, such as white bread, pasta, and pastries.
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What Happens If Your Blood Sugar Is Too Low
If untreated, low blood glucose can quickly become an emergency. In cases of severe hypoglycemia, you may be unable to eat something to treat the low. That’s why your healthcare provider has probably recommended that you carry a glucagon kit. When given to you by another person, this injection of the hormone glucagon quickly stimulates your body to produce the glucose you need.1
Talk to your friends and family about what signs to look for and, if needed, how to use the glucagon kit in an emergency.
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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 earlybefore it gets worse.
Monitoring blood glucose, with either a meter or a CGM, is the tried and true method for preventing hypoglycemia. Studies consistently show that the more a person checks blood glucose, the lower his or her risk of hypoglycemia. This is because you can see when blood glucose levels are dropping and can treat it before it gets too low.
If you can, check often!
- Check before and after meals.
- Check before and after exercise .
- Check before bed.
- After intense exercise, also check in the middle of the night.
- Check more if things around you change such as, a new insulin routine, a different work schedule, an increase in physical activity, or travel across time zones.
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Treating Severely Low Blood Sugar
Blood sugar below 55 mg/dL is considered severely low. You wont be able to treat it using the 15-15 rule. You also may not be able to check your own blood sugar or treat it by yourself, depending on your symptoms. Make sure your family members, friends, and caregivers know your signs of low blood sugar so they can help treat it if needed.
Injectable glucagon is the best way to treat severely low blood sugar. A glucagon kit is available by prescription. Speak with your doctor to see if you should have a kit. Be sure to learn how and when to use it. Let family members and others close to you know where you keep the glucagon kit and make sure theyve been trained in how to use it too.
Its important to contact a doctor for emergency medical treatment immediately after receiving a glucagon injection. If a person faints due to severely low blood sugar, theyll usually wake up within 15 minutes after a glucagon injection. If they dont wake up within 15 minutes after the injection, they should receive one more dose. When the person is awake and able to swallow:
- Feed the person a fast-acting source of sugar .
- Then, have them eat a long-acting source of sugar .
Its also important that friends, family, co-workers, teachers, coaches, and other people you may be around often know how to test your blood sugar and treat severely low blood sugar before it happens.
If any of the following happens, your friend, relative, or helper should call 911:
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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What Extreme Conditions Can Occur If Hypoglycemia Is Left Untreated
Although severe episodes which can trigger potentially life-threatening comas are rare, they require immediate emergency room care, so its best to make sure you are tracking your blood sugar so that you never have to worry about getting to that point. A drop in blood sugar means less fuel for your brain, so its critical for your body to receive enough glucose. Hypoglycemia that leads to extended, reduced brain function is the biggest concern, as this can lead to seizures and loss of basic bodily functions controlled by the brain, which can ultimately lead to death, explains Dr. Dyer.
If A Person Is Unconscious
If a person loses consciousness because of severe hypoglycaemia, they need to be put into the recovery position and given an injection of the hormone glucagon . The injection will raise their blood glucose level.
The injection should be carried out by a friend or family member who knows what they’re doing, or by a trained healthcare professional.
You should dial 999 to request an ambulance if:
- a glucagon injection kit isn’t available
- there’s nobody available who’s trained to give the injection
- the injection is ineffective after 10 minutes
Never try to put food or drink into the mouth of someone who’s unconscious as they could choke.
If you’re able to give a glucagon injection and the person regains consciousness, they should eat some longer-acting carbohydrate food, such as a few biscuits, a cereal bar or a sandwich.
You should continue to monitor the person for signs of recurring symptoms in case they need to be treated again.
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A Low Blood Sugar Level Without Diabetes
A low blood sugar level is uncommon in people who do not have diabetes.
Possible causes include:
- a gastric bypass
- other medical conditions, such as problems with your hormone levels, pancreas, liver, kidneys, adrenal glands or heart
- some medicines, including quinine
See a GP if you think you keep getting symptoms of a low blood sugar level. They can arrange some simple tests to check if your blood sugar level is low and try to find out what’s causing it.
High Blood Sugar Over Time Leads To:
- Kidney damage and kidney failure
- Blood vessel damage that can cause heart attacks and strokes
- Eye disease that can cause poor vision or blindness
- Nerve damage that can cause pain like pins and needles in the feet
- Sores on the feet or legs that do not heal and could lead to removal of a toe, foot, or leg
- Sexual problems, such as not being able to get an erection
Taking care of your diabetes and keeping most of your blood sugars near the normal range throughout your life lowers your chance for these long-term problems.
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How Do I Pay For These Tests And Supplies
Medicare, Medicaid and most private insurance plans pay for the A1C test and some of the cost of supplies for checking your blood sugar. Check your plan or ask your health care team for help finding low cost or free supplies. Ask your health care team what to do if you run out of test strips. For more information about Medicare and diabetes, go to .
What Happens If My Blood Glucose Level Becomes Too Low
Sometimes blood glucose levels drop below where they should be, which is called hypoglycemia. For most people with diabetes, the blood glucose level is too low when it is below 70 mg/dL.
Hypoglycemia can be life threatening and needs to be treated right away. Learn more about how to recognize and treat hypoglycemia.
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Swollen Or Bleeding Gums Which Increase Your Infection Risk
Gum disease is a complication of diabetes, notes the National Institute of Diabetes and Digestive and Kidney Disease. It can also make diabetes harder to control, because the bodys response to infection is to release more glucose into the bloodstream, according to the ADA.
Your saliva contains glucose and the more it contains, the more there is to feed the bacteria that combine with food in your mouth to form plaque and cause gum disease. Symptoms can include red or inflamed gums at first. If they are unaddressed, they can progress to periodontitis, which can cause your gums to pull away from your teeth, the appearance of pus or ulcers, or even tooth loss, notes the Mayo Clinic. Get your blood sugar under control and see a dental professional to prevent damage to your gums and teeth.
Additional reporting by Diana Rodriguez and Andrea Peirce.
Healthiest Fruits For People With Diabetes
All fruits have vitamins, phytochemicals, and other things that make them good for you. But some are more likely to lower your chances of chronic disease:
- Blackberries. One cup of raw berries has 62 calories, 14 grams of carbohydrates, and 7.6 grams of fiber.
- Strawberries. One cup of whole strawberries has 46 calories, 11 grams of carbohydrates, and 3 grams of fiber.
- Tomatoes. One cup of sliced or chopped tomatoes has 32 calories, 7 grams of carbohydrates, and 2 grams of fiber.
- Oranges. One medium orange has 69 calories, 17 grams of carbohydrates, and 3 grams of fiber.
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Treating Someone Having A Seizure
Follow these steps if someone has a seizure due to low blood sugar:
Tell your diabetes care team if you ever have a severe hypo that caused you to have a seizure.
High Blood Sugar Causes
You may be thinking that hyperglycemia can happen just from eating a super-sugary food, but its not really as simple as that. Sure, eating a lot of sugar or carbs can elevate your blood sugar level, but thats typically when your pancreas kicks into gear and creates insulin to move that glucose into cells throughout the body.
But when someone has diabetes, this finely tuned system gets thrown out of whack. In type 2 diabeteswhich accounts for 90% to 95% of diabetes in adults, according to the CDCthe body either cant make enough insulin or cant utilize insulin well, according to the NIDDK. If someone has prediabetes, their blood glucose will be higher than normal but not quite in the type 2 diabetes range yet, per the NIDDK. And in type 1 diabetes, the body does not make insulin or makes very little.
In any case, the result is extra sugar hanging around the bloodstream, making you feel like total crap in the short term and putting your health at risk in the long term.
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When To Call Your Doctor
If youre older than 45 or have other risks for diabetes, its important to get tested. When you spot the condition early, you can avoid nerve damage, heart trouble, and other complications.
As a general rule, call your doctor if you:
- Feel sick to your stomach, weak, and very thirsty
- Are peeing a lot
- Have a bad belly ache
- Are breathing more deeply and faster than normal
- Have sweet breath that smells like nail polish remover
Cleveland Clinic: Diabetes: Frequently Asked Questions and What Is Diabetes?Ã Ã¢â¬ÅDiabetes: Preventing Complications,Ã¢â¬ï¿½ Ã¢â¬ÅHyperglycemia .Ã¢â¬ï¿½
University of Michigan Health System: Type 1 Diabetes.
National Diabetes Information Clearinghouse: Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes.
Baylor Scott & White Healthcare: Urinary Frequency and Diabetes and Diabetic Neuropathy Hard-to-Heal Wounds.
Sutter Health: Question & Answer: Is Sudden Weight Loss a Sign of Diabetes? If So, Why?
Neithercott, T. Diabetes Forecast, August 2013.
University of Rochester Medical Center: Diabetic Skin Troubles.
Joslin Diabetes Center: Diseases of the Eye and Diabetic Neuropathy: What You Need to Know.
The Nemours Foundation: When Blood Sugar Is Too High.
Virginia Mason Medical Center: Complications.
Carolinas Health System: Diabetes: Yeast Infections and Diabetes: What You Should Know.
Geisinger Health: Ã¢â¬Å3 reasons diabetic wounds are slow to heal.Ã¢â¬ï¿½
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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How Is Hypoglycemia Diagnosed
If you suspect you have low blood sugar, its important to check your blood sugar right away. If you dont have a blood glucose meter and youre on diabetes medications that increase insulin, talk with your doctor about getting a meter.
If you experience low blood sugar often say, a few times a week see your doctor right away to find out why. Your doctor will begin your visit by requesting your medical history, asking questions about your eating habits, and learning more about the symptoms youre experiencing.
If you dont have diabetes but suspect you have hypoglycemia, talk with your doctor about your symptoms. Your doctor will use three criteria, sometimes referred to as Whipples triad, to diagnose low blood sugar:
- Signs and symptoms of low blood sugar. Your doctor may require you to fast, or abstain from drinking and eating for an extended period of time, so they can observe your low blood sugar signs and symptoms.
- Documentation of low blood sugar when your signs and symptoms occur. Your doctor will order a blood test to analyze your blood sugar levels in a laboratory.
- Disappearance of the signs and symptoms of low blood sugar. Your doctor will want to know whether the signs and symptoms go away when your blood sugar levels are raised.