What To Do When Your Blood Sugar Levels Drop Too Low
People who use insulin and other diabetes medications are at risk for hypoglycemia. Keep this action plan handy so you’re prepared.
If you take insulin or diabetes medication, you may be at risk of developing hypoglycemia, or low blood sugar. Without quick attention, hypoglycemia can lead to serious complications, so its important to know what to do if it happens to you or someone close to you.
In very severe cases, hypoglycemia can lead to seizures or loss of consciousness, says a clinical assistant professor of medicine, endocrinology, gerontology, and metabolism at Stanford Health Care, and chief of the Stanford Endocrine Clinic.
It’s possible to have hypoglycemia but have no symptoms, according to the National Institute of Diabetes and Digestive and Kidney Diseases . On the other hand, symptoms can also come on rapidly. While symptoms vary from person to person, if you develop mild to moderate low blood sugar you may:
- Feel shaky or jittery
- Have a headache or be lightheaded
- Turn pale
- Be irritable or combative
- Have blurred vision or see double
Some people feel tingling or numbness in their extremities too, says Rodolfo Galindo, MD, an assistant professor of medicine in the division of endocrinology, metabolism, and lipids at the Emory University School of Medicine in Atlanta, and chair of the inpatient diabetes taskforce.
Who Gets Type 2 Diabetes
There are people who are healthy and get type 2 diabetes and there are people who are unhealthy and get type 2 diabetes, says Dr. Christofides. Its a bit like lung cancer in that not everyone who smokes gets lung cancer, and some people get lung cancer who have never smoked.
Type 2 diabetes is multifactorial, explains Sharon Bergquist MD, meaning that a persons genes, environment, and lifestyle work together to lead to the disease. Some of the increased risk may be attributed to genetic susceptibility, but a higher percentage is likely due to environment and lifestyle, which can be influenced by culture and socioeconomics.
How Is Hypoglycemia Treated If I Lose Consciousness
Severe blood sugar drops can cause you to pass out. This is more likely in people with type 1 diabetes but can also happen in people with type 2 diabetes treated with insulin. This can be a life-threatening. Its important to educate your family, friends, and even coworkers on how to administer a glucagon injection if you lose consciousness during a hypoglycemic episode. Glucagon is a hormone that stimulates the liver to break down stored glycogen into glucose. Talk to your doctor to see if you need a prescription for a glucagon emergency kit.
The best way to avoid hypoglycemia is by following your treatment plan. A diabetes control plan to prevent hypoglycemic and hyperglycemic episodes includes managing:
If one of these is off balance, hypoglycemia can occur.
The only way to know your blood sugar levels is to test your blood sugar. If you use insulin to control your blood sugar, you should check blood sugar levels four or more times per day. Your healthcare team will help you decide how often you should test.
If your blood sugar levels arent in the target range, work with your team to change your treatment plan. This will help you identify what actions might lower your blood sugar suddenly, such as skipping a meal or exercising more than usual. You shouldnt make any adjustments without notifying your doctor.
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How Do I Treat A Low Blood Sugar
Treating a low blood sugar might seem easy: simply eat something with carbohydrates. Unfortunately, if you were to simply grab any food item that contains carbohydrates, you might be choosing something that will take twice as long to digest and therefore, twice as long to raise your blood sugar.
Great Sources of Carbohydrates for a Low Blood Sugar.
These sources of carbohydrates are all dextrose and glucose, therefore they are broken down and in your system within 10 minutes. Glucose is what your body naturally breaks all carbohydrates down to, therefore your body doesnt have to spend time taking care of the process. Dextrose is very similar to glucose in terms of its molecular structure, which makes it a fast source of carbohydrate for a low.
- Glucose gels
- Cookies and Ice cream
How Can I Prevent Hypoglycemic Episodes
The key to preventing hypoglycemic events is managing diabetes:
- Follow your healthcare providers instructions about food and exercise.
- Track your blood sugar regularly, including before and after meals, before and after exercise and before bed.
- Take all your medications exactly as prescribed.
- When you do have a hypoglycemic event, write it down. Include details such as the time, what you ate recently, whether you exercised, the symptoms and your glucose level.
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What If The 15
If you dont feel better after three tries, or if your symptoms get worse, call your healthcare provider or 911. Healthcare providers can use a medication called glucagon. They inject it with a needle or squirt it up your nose. Glucagon is also available for home use. Your healthcare provider can prescribe it and teach a family member or friend how to use it in the event of severe hypoglycemia.
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.
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Treating Mild To Moderate Hypoglycemia
If you start feeling any of the symptoms listed above, check your blood sugar as soon as possible, then follow the chart below to treat low blood sugar. If you have any concerns, or cant test immediately, its best to treat first and check when possible.
If your blood sugar is
What to do next
51 to 70 mg/dL
10 to 15 grams of fast-acting carbs, such as 4 ounces of fruit juice, 6 to 8 hard candies, or 3 to 4 glucose tablets.
Test your blood sugar again in 15 minutes. Repeat the treatment if necessary.
Under 50 mg/dL
Eat 20 to 30 grams of fast-acting carbs, such as 8 ounces of fruit juice, 12 to 16 hard candies, or 6 to 8 glucose tablets.
Test your blood sugar again in 15 minutes. Repeat the treatment if necessary.
Ut University Health Services
For some people, a blood sugar below 90 mg/dL can make them feel like this. For others, it takes a lower blood sugar to cause these symptoms.
You must watch your blood sugar level closely. Regular testing of your blood sugar may allow you to detect and treat hypoglycemia before it causes serious symptoms. You may be able to prevent ever having low blood sugar.
Some high blood pressure medicines called beta blockers hide the symptoms of hypoglycemia. If you are taking medicine for high blood pressure, ask your healthcare provider if the medicines you are taking could have this effect.
You should know the difference between the symptoms of low blood sugar and high blood sugar . High blood sugar doesn’t always cause symptoms, but when it does the symptoms may include blurry vision, extreme thirst, and a lot of urination.
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What Is The A1c Test
The A1C test is a simple blood test that measures your average blood sugar levels over the past 2 or 3 months. The test is done at a lab or your doctors office in addition tonot instead ofregular blood sugar testing you do yourself.
A1C testing is part of the ABCs of diabetesimportant steps you can take to prevent or delay health complications down the road:
- A: Get a regular A1C test.
- B: Try to keep your blood pressure below 140/90 mm Hg .
- C: Manage your cholesterol levels.
- s: Stop smoking or dont start.
The A1C goal for most adults with diabetes is between 7% and 8%, but your goal may be different depending on your age, other health conditions, medicines youre taking, and other factors. Work with your doctor to establish a personal A1C goal for you.
When Should I Check My Blood Sugar
How often you check your blood sugar depends on the type of diabetes you have and if you take any diabetes medicines.
Typical times to check your blood sugar include:
- When you first wake up, before you eat or drink anything.
- Before a meal.
- Two hours after a meal.
- At bedtime.
If you have type 1 diabetes, have type 2 diabetes and take insulin, or often have low blood sugar, your doctor may want you to check your blood sugar more often, such as before and after youre physically active.
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Treating Lows With The Appropriate Amount Of Carbohydrates
- mild lows may only need 5 to 8 grams of carbohydrates.
- moderate lows . Most mild-to-moderate low blood sugars only need approximately 10 to 15 grams of carbohydrate in order to bring your blood sugar level back up to a safe and healthy level.
- severe lows will often require as much as 20 to 30 grams of carbohydrates.
All of these rules of thumb can change dramatically based on exercise youre performing, food youve eaten, or insulin active in your system. A mild low can require significantly more carbohydrates if you suspect or know that your blood sugar will continue to dive down.
To learn how many carbohydrates are in the food youre eating, you can either look at the nutrition panel on the box or package of the item, or you can search for any food at websites like CalorieKing.com.
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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Choosing The Right Low Blood Sugar Foods For You
Treating low blood sugars with the right foods comes down to creating good habits. Whether you choose foods on this list or not, what matters most is that youre taking a moment to think about what food youre going to consume. Impulsively gorging yourself on the first food that catches your eye will probably lead to roller coaster blood sugars, weight gain, guilt, and a great deal of frustration.
Instead, try choosing specific foods that you will keep in certain places that you will think of as medicine. It also helps to use foods that are easy to measure so you are able to consume exactly the amount of carbohydrates you need, such as 4 gummy Lifesavers or 15 raisins or 3 dried apricots.
And then, sit on your hands, take a deep breath and wait at least 15 minutes before considering consuming any more food. Once your glucose has returned to a normal level, eating a high-protein and low-carb snack can help to maintain your glucose level, such as a handful of nuts or a piece of string cheese.
If youre concerned about your blood sugar, let someone nearby know or call a friend. If you are not confident that you can successfully treat the low or are having trouble thinking, call 911 or ask someone else to call 911 for you.
Low Blood Sugar Symptoms
Hypoglycemia happens when blood glucose levels drop too low. Low blood sugar can be caused by many things including the two different types of diabetes, certain medications, alcohol, endocrine disorders, eating disorders, pregnancy , and disorders of the liver, kidneys, or heart.
Here are some of the most common symptoms that someone with low blood sugar might experience:
- Tingling lips
If your blood sugar is low you might start to feel some of the first signs of hypoglycemia like dizziness, lightheadedness, or sweating. The only way to know for sure if your blood sugar is low is to test it with a glucose meter or other glucose monitoring device.
If you dont have access to these tools and start to feel the symptoms of low blood sugar, consume 15 grams of carbs or take a quick dissolve glucose tablet to raise your blood sugar levels and avoid further symptoms, according to the American Diabetes Association . Once your blood sugar is back in its target range, you can have a snack or meal to make sure it doesnt drop again.
Here are some other lifestyle and medicinal treatments that can help treat hypoglycemia:
- Eat a healthy diet full of whole foods that are minimally processed.
- Take prediabetes or diabetes medications as recommended by your healthcare provider.
- Use a glucagon kit in emergencies. Glucagon is a hormone that raises blood sugar levels quickly.
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When To Call The Doctor
If signs of low blood sugar do not improve after you have eaten a snack that contains sugar, have someone drive you to the emergency room or call your local emergency number . DO NOT drive when your blood sugar is low.
Get medical help right away for a person with low blood sugar if the person is not alert or cannot be woken up.
How Can I Pay For Tests And Diabetes Supplies
Medicareexternal icon, Medicaid, and most private insurance plans pay for the A1C test and fasting blood sugar test as well as some diabetes supplies. Check your plan or ask your health care team for help finding low-cost or free supplies, and see How to Save Money on Diabetes Care for more resources.
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Are Some People More Likely To Develop Type 2 Diabetes Than Others
A person who has a highly inflammatory diet and carries excess adiposity around their central organs is more likely to get type 2 diabetes, says Dr. Christofides. Excess weight and obesity are risk factors for type 2 diabetes, but how your body stores and manages weight can also be an early indicator of risk.
Research has shown that people who carry too much fat around their middle are more prone to health risks such as type 2 diabetes. Certain communities also show a greater propensity for developing type 2 diabetes, including people who are Black, Latinx, Asian, and Indigenous.
Factors that can put you at an increased risk for developing type 2 diabetes include:
- Genetic predisposition
- Family history of diabetes and cardiovascular disease
- High blood pressure
- A diet high in processed foods and added sugars
- History of heart disease or stroke
- Elevated triglyceride levels in your blood
- Higher waist to hip ratio
- Systemic inflammation
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 Can You Do If Your Blood Sugar Levels Are Too Low
It is important to react quickly enough and eat or drink something, like dextrose sugar or a sugary drink .
If someone has severe hypoglycemia they may feel drowsy and confused, and might even become unconscious. People who have type 1 diabetes often carry a pre-filled syringe on them in case that happens, containing the hormone glucagon. Glucagon makes the liver release sugar into the bloodstream. Someone else can then inject the hormone if necessary. If this is not possible, it is important to call the emergency services immediately and ask for medical help.
If your blood sugar levels keep on dropping too low, you should see your doctor. It could then be a good idea to change your lifestyle or medication.