What A Low Blood Sugar Feels Like
Across the board, a low blood sugar seems to be considered as anything under 70 mg/dL. Revisiting the American Diabetes Associations website this morning offers up a list of symptoms of low blood sugar, like:
- Shakiness
- Nightmares or crying out during sleep
- Seizures
- Unconsciousness
The what happens if a low blood sugar goes untreated answer is short, and to the point: If left untreated, hypoglycemia may lead to a seizure or unconsciousness . In this case, someone else must take over.
When my daughter hears my Dexcom beeping, she understands the difference between the alert signaling a high blood sugar and the alert signaling a low. If the high alarm goes off, she doesnt react, but if the low alarm goes off, she perks up immediately and asks me if I need a glupose tab. The immediacy and seriousness of low blood sugars is noticed by my three year old because shes seen me go from normal, functional Mom to confused, sweaty, and tangled-in-my-own-words Mom in a matter of minutes.
The symptoms of low blood sugars dont just vary from PWD to PWD, but often vary within the PWDs own lifetime. When I was very small, my low blood sugar tell was when my mouth would go numb and my face felt like Id had Novocaine hours earlier and it was just starting to wear off, with that tingly, prickly feeling. Over the years, Ive had a lot of lows with varying symptoms:
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Examples Of Easily Digestible Carbohydrates
- 1/2 cup of juice or regular soda
- 1 tablespoon of honey
- 4 or 5 saltine crackers
- 3 or 4 pieces of hard candy or glucose tablets
- 1 tablespoon of sugar
Very low blood sugar is a medical emergency. If you or someone else with diabetes is experiencing severe symptoms, such as unconsciousness, its important to administer a medication called glucagon and contact emergency services immediately.
If youre at risk for low blood sugar, its important to talk with your doctor about getting a prescription for glucagon.
You should never give an unconscious person anything by mouth, as it could cause them to choke. If you have diabetes, make sure your family and friends know not to do this if you lose consciousness.
Low blood sugar can occur for a number of reasons. Its usually a side effect of diabetes treatment.
How Common Is Low Blood Glucose
Low blood glucose is common among people with type 1 diabetes and among people with type 2 diabetes who take insulin or some other diabetes medicines. In a large global study of people with diabetes who take insulin, 4 in 5 people with type 1 diabetes and nearly half of those with type 2 diabetes reported a low blood sugar event at least once over a 4-week period.2
Severely low blood glucose, defined as when your blood glucose level drops so low you cant treat it yourself, is less common. Among U.S. adults with diabetes who take insulin or some diabetes medicines that help the pancreas release insulin into the blood, 2 in 100 may develop severely low blood glucose each year.3
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Low Blood Glucose During Sleep
Your blood glucose level can drop while you sleep and stay low for several hours, causing serious problems.7 Symptoms of low blood glucose while you sleep can include
- crying out or having nightmares
- sweating enough to make your pajamas or sheets damp
- feeling tired, irritable, or confused after waking up
Although you may not wake up or notice any symptoms, low blood glucose can interfere with your sleep, which may affect your quality of life, mood, and ability to work. Having low blood glucose during sleep can also make you less likely to notice and respond to symptoms of low blood glucose during the day.
Too Much Insulin Or Diabetes Medications
Many people take diabetes medications to manage their blood sugar levels. Out of all the available diabetes medicines, injectable insulin carries the greatest risk of low blood sugar, especially rapid-acting insulin.
Because insulin lowers blood sugar, taking too much insulin or other diabetes medications can cause hypoglycemia.
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Watch Out For The Infamous Dawn Phenomenon
It’s not uncommon to wake up to a high blood sugar reading, even if your number was in the green zone when you went to bed. You may be experiencing the “dawn phenomenon,” which occurs when the body preps for waking up by releasing cortisol and other hormones, between 2 and 8 a.m., according to the Mayo Clinic.
These hormones make the body less sensitive to insulin, and in people with diabetes, can contribute to a morning blood sugar spike. Alternatively, you may start the day with a low glucose level if, for example, you’re taking too much insulin or medication at night or not eating enough in the evening, McDermott says. She notes that eating a small, protein-rich, low-carb snack at bedtime can sometime help by shortening the fast .
If you see a trend in your morning readings or they’re highly erratic from day to day you’ll want to work with your doctor or diabetes educator to identify the problem so you can take steps to correct it, says Bonsignore.
How We Care For Hypoglycemia
At Boston Childrens Hospital, we treat hypoglycemia in our General Endocrinology Program, a multi-disciplinary program dedicated to the treatment of a wide range of endocrinological disorders. Caring for more than 7,000 patients each year, our division is one of the largest pediatric endocrinology practices in the country. We provide state-of-the-art diagnosis, treatment, and clinical management for children with hypoglycemia and related disorders.
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Rebound Hypoglycemia After Eating
If sugar comes from the food you eat, why would blood sugar be low after eating? It may be due to a phenomenon called reactive hypoglycemia. This refers to low levels of blood glucose that react to high levels. According to Mayo Clinic, it can occur within 4 hours of eating a meal.
Say breakfast includes pancakes, syrup, and fruit juice. The meal is full of carbs: starch in the pancakes, added sugar in the syrup, and natural sugar in the fruit juice. Those carbohydrates get absorbed fast.
Blood sugar can skyrocket, especially in people who have prediabetes or diabetes. You may feel a sugar high, or burst of energy, within minutes to an hour of eating. Thenthe crash. The higher they fly, the harder they fall, is spot-on for blood sugar. If it went up, up, up, it will go down, down down, possibly below normal levels and into the range of hypoglycemia.
Preventing Low Blood Sugar Levels
Here are some other tips to help you avoid low blood sugar levels:
- Eat all your meals and snacks on time and try not to skip any.
- Take the right amount of insulin.
- If you exercise longer or harder than usual, have an extra snack.
- Don’t take a hot bath or shower right after an insulin shot.
- Stick to your diabetes management plan.
- Check your blood sugar levels regularly, so you can tell if your blood sugars are running too low and your treatment plan needs adjustment.
- Carry something containing sugar with you at all times and take it right away if you have symptoms. Don’t wait to see if the symptoms will go away they may get worse!
Alcohol and drugs can cause major problems with your blood sugar levels, so avoiding them is another way to prevent diabetes problems. Drinking can be particularly dangerous even deadly for people with diabetes because it messes up the body’s ability to keep blood glucose in a normal range. This can cause a very rapid drop in blood glucose in people with diabetes. Drug or alcohol use is also dangerous because it may affect someone’s ability to sense low blood sugar levels.
Learning how to recognize the signs of low blood sugar levels and get them back to normal is an important part of caring for diabetes. Keeping track of your blood sugar levels and recording lows when they occur will help you and your diabetes health care team keep your blood sugar levels in a healthy range.
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A Low Blood Sugar Level And Driving
You may still be allowed to drive if you have diabetes or you’re at risk of a low blood sugar level for another reason, but you’ll need to do things to reduce the chance of this happening while you’re driving.
You also need to tell the Driver and Vehicle Licensing Agency and your car insurance company about your condition.
For more information, see:
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 body’s 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.
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Your Diabetes Devices And Hypoglycemia
Several insulin pumps are now available that make managing blood sugar levels easier, particularly when connected to a glucose meter or a CGM.
Some of the most important advantages of CGM devices are the improved insulin control and the ability to detect trends and lows early. With improved technology, it is now possible for parents to track blood sugar trends in their kids even when they are hundreds of miles apart .
In addition, automated insulin delivery systems, also known an artificial pancreas or a hybrid closed-loop system, will automatically adjust insulin to match your bodys need to help you spend more time in your target range.
Resources that provide people with T1D and their families with more detailed information about pumps and CGM devices are available through JDRF here. For people looking for a deeper understanding of technology that helps people with T1D better manage their blood sugar, JDRF resources are available here.
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Parents Of Children With Diabetes
If your child has diabetes and shows symptoms of hypoglycemia, it’s important to check their blood glucose level with a glucometer. If this is not possible, it is best to treat them as if they have hypoglycemia by giving them carbohydrates to prevent symptoms from getting worse.
Your child should have a safety plan in place for when they are not in your care, such as when they are at school, friends homes, or daycare. The plan should include whom they should talk to if they are not feeling well.
Talking to your child about their diabetes and the symptoms to be aware of helps keep them safe. When your child is aware that how theyre feeling is related to their blood sugar levels and diabetes management, they can learn to both self-identify and verbalize or signal to their parents when they need treatment.
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How Do I Treat An Episode Of Hypoglycemia
The American Diabetes Association recommends the 15-15 rule for an episode of hypoglycemia:
- Eat or drink 15 grams of carbs to raise your blood sugar.
- After 15 minutes, check your blood sugar.
- If its still below 70 mg/dL, have another 15 grams of carbs.
- Repeat until your blood sugar is at least 70 mg/dL.
If you have symptoms of hypoglycemia but cant test your blood sugar, use the 15-15 rule until you feel better.
Note: Children need fewer grams of carbs. Check with your healthcare provider.
What Complications Can Occur Due To Nondiabetic Hypoglycemia
If low blood sugar is not treated quickly, it can lead to more serious problems such as:
- Seizures
- Loss of consciousness
- Death
Some of the symptoms can also contribute to getting hurt including falls, motor vehicle accidents, and other injuries. If you have hypoglycemia you also increase your risk of dementia too.
Hypoglycemia unawareness, which is when you have recurrent episodes so often that your body stops producing a response to hypoglycemia, can also be a cause for concern.
The lack of awareness can cause low blood sugar to go unnoticed and untreated, which can lead to the more serious problems mentioned earlier.
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Artificial Sweeteners May Alter Blood Sugar Response
Many people with diabetes reach for diet drinks as a substitute for regular soda or juice because they assume that sugar-free beverages won’t raise their blood sugar. But a review published in January 2021 in Frontiers in Nutrition suggested that artificial sweeteners may not be completely neutral after all, and may contribute to impaired glucose homeostasis.
But the research isn’t definitive most government and medical institutions maintain that most artificial sweeteners have no effect on blood sugar. So what could be going on? Mayo Clinic suggests that people can experience a rebound effect when consuming artificial sugars. They consider the sugar-free food healthy, so end up consuming excessive amounts or eating other carb-filled foods because they think the diet drink lets them afford it. The clinic also notes that some noncaloric sweeteners can cause diarrhea, which can contribute to dehydration.
“If you drink a lot of diet soda then you might want to cut back and see if it has an impact on your blood glucose,” says Patty Bonsignore, RN, CDCES, a nurse educator at the Joslin Diabetes Center in Boston. Keep things sugar-free by turning to water or seltzer as opposed to regular soda or juice.
How To Treat Someone Who’s Having A Seizure Or Fit
Follow these steps if someone has a seizure or fit caused by a low blood sugar level:
Tell your diabetes care team if you ever have a severe hypo that caused you to have a seizure or fit.
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What Is The Outlook For People With Hypoglycemia
Hypoglycemia can be managed when you and your healthcare provider understand what causes your blood sugar to go down. Give your healthcare provider as much information as possible about any hypoglycemic episodes. Fixing the problem may be as simple as changing the times you take medication, eat and exercise. Minor changes to the types of food you eat may also help.
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.
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What Are The Complications Associated With Hypoglycemia
Its important to manage your hypoglycemia because it can cause long-term health problems. Your body needs glucose to function. Without the right level of glucose, your body will struggle to perform its normal functions. As a result, you may have difficulty thinking clearly and performing even simple tasks.
Insufficient Sleep Can Throw Blood Sugar Out Of Whack
Restless nights hurt more than your mood and energy they may also spell trouble for your blood sugar. A review published in December 2015 in Diabetes Therapy concluded that a lack of sleep may hinder glucose control and insulin sensitivity in people with type 2 diabetes.
“Sleep is restorative,” Bonsignore says. “Not getting enough sleep is a form of chronic stress on the body, and anytime you have added stress, you’re going to have higher blood sugar levels.”
Unfortunately, people with type 2 diabetes commonly report troubles sleeping, McDermott says. Those with high body-mass indexes are at particular risk for sleep apnea, in which breathing frequently starts and stops during sleep.
To improve your sleep quality and duration, work to get into a consistent sleep routine where you go to bed and wake at the same time every day. Your goal: Nab seven to nine hours of sleep per night, per recommendations from the National Sleep Foundation. If you continue to have sleep troubles or suspect you have sleep apnea , reach out to a sleep medicine specialist for support, Bonsignore says.
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The Causes Of Low Blood Sugar
Low blood sugar levels can happen to kids with diabetes because of the medicines they have to take. Kids with diabetes may need a hormone called insulin and/or diabetes pills to help their bodies use the sugar in their blood. These medicines help take the sugar out of the blood and get it into the bodys cells, which makes the level of sugar in the blood go down.
But sometimes its a tricky balancing act, and blood sugar levels can get too low. Kids with diabetes need to keep their blood sugar levels from getting too high or too low. How do they do it? With help from grown-ups, they keep three things in balance:
- not timing the insulin doses properly with meals, snacks, and exercise
- taking a long bath or shower right after an insulin shot