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.
What Happens If My Blood Sugar Is Too Low At Night
It is possible to experience hypoglycemia, often known as low blood sugar, while you are asleep. This might wake you up in the middle of the night, give you a headache in the morning, make you feel fatigued, or cause your sheets to get moist from sweat. If your blood sugar level is less than 3.5 millimoles per liter or if you are experiencing hypo symptoms, follow these steps:
Causes Not Related To Diabetes
According to the Endocrine Society, non-diabetes-related hypoglycemia is rare but can occur. There are two types:
- fasting hypoglycemia, often associated with an underlying condition
- reactive hypoglycemia, which occurs within a few hours of a meal
Causes of fasting hypoglycemia may include:
- binge drinking or heavy alcohol consumption
- liver, heart, or kidney disease
- tumors that affect the pancreas
- low hormone levels
- certain medications, such as salicylates or sulfa
Causes of reactive hypoglycemia include:
- a person with prediabetes
- enzyme deficiency
- stomach surgery
Doctors are still not clear about what exactly causes reactive hypoglycemia. However, they know people with this condition tend to have excessive insulin in their blood.
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Causes Of Low Blood Sugar
Low blood sugar is common for people with type 1 diabetes and can occur in people with type 2 diabetes taking insulin or certain medications. The average person with type 1 diabetes may experience up to two episodes of mild low blood sugar each week, and thats only counting episodes with symptoms. If you add in lows without symptoms and the ones that happen overnight, the number would likely be higher.
What Are The Signs And Symptoms Of Hypoglycemia
Hypoglycemia tends to present as a cluster of symptoms, and they often occur together. The most common signs of dangerously low blood sugar include:
- Dizziness, disorientation, light-headedness, and an inability to think clearly
- Hunger, especially if youve just eaten
- Heightened irritability, confusion, and anxiety
- Clamminess and sweating, with cold hands and feet
- Drastic mood swings
If you have one or more of these symptoms contact your doctor.
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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 bodyâs cells, which makes the level of sugar in the blood go down.
But sometimes itâs 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:
Each one of these can affect the other. For instance, eating more might mean a kid needs more insulin. And exercising might create the need for an extra snack. Again, a grown-up can help you learn how to juggle those three activities so you keep feeling good.
Some things that can make low blood sugar levels more likely to happen are:
- skipping meals and snacks
- not eating enough food at a meal or snack
- exercising longer or harder than usual without eating something extra
- getting too much insulin
- not timing the insulin doses properly with meals, snacks, and exercise
- taking a long bath or shower right after an insulin shot
Now Lets Hear From Jessie
My biggest sign of a low blood sugar is that of impending doom. I start to feel a weighted amount of anxiety that is greater than at any other time. I start to shake, and find it hard to concentrate. If Im feeling hopeless, depressed and anxious about something, I check my blood sugar. I am most always trending low when I feel the nervousness set in.
At other times in my life, I have not felt a thing. I will not feel the least bit tired or off, and I will feel like I have some energy. Then, boom! Out of nowhere it hits me, and I have little time to react. I go straight to confusion, not being able to move, and having big floaters in my field of vision. Im grateful to my husband when it hits like that. He knows exactly what to do. Its rather scary.
Im late for things all of the time because of my diabetes, and low blood sugars. Sometimes Im afraid people may think I am just using it to get out of things, but its really quite severe.
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How Does High Blood Sugar Affect The Body
High sugar in the blood can lead to a number of other symptoms and complications. Here are just a few.
Urination and thirst: High blood sugar goes into the kidneys and urine. This attracts more water, causing frequent urination. This can also lead to increased thirst, despite drinking enough liquids.
Weight loss: High blood sugar can cause sudden or unexplained weight loss. This occurs because the bodys cells are not getting the glucose they need, so the body burns muscle and fat for energy instead.
Numbness and tingling: High blood sugar can also cause numbness, burning, or tingling in the hands, legs, and feet. This is due to diabetic neuropathy, a complication of diabetes that often occurs after many years of high blood sugar levels.
Low Blood Sugar And Driving
Having a low blood sugar while driving could be dangerous for you and others.
You can usually still drive if you’re at risk of low blood sugar. But you’ll need to take extra precautions to reduce the chance of this happening while driving.
You also need to tell the Driver & Vehicle Agency and your car insurance company about your condition.
For more information, see:
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When Should I See A Doctor
“To diagnose hypoglycemia, your doctor will do a physical exam and ask you questions about your health and any medicines you take,” advises University of Michigan Health. “You will need blood tests to check your blood sugar levels. Some tests might include not eating and watching for symptoms. Other tests might involve eating a meal that could cause symptoms of low blood sugar several hours later. The results of these types of tests can help diagnose the cause. You may also need tests to look for or rule out health problems that could be affecting your blood sugar levels.”
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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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 doesnât always cause symptoms, but when it does the symptoms may include blurry vision, extreme thirst, and a lot of urination.
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Managing Blood Sugar Levels
Many people with diabetes must check their blood sugar levels daily with a glucose meter. This device takes a drop of blood, usually from a finger, and displays the sugar level within a few seconds.
People with type 1 diabetes will need to take insulin as their doctor recommends, usually several times a day.
Those with type 2 diabetes or gestational diabetes may need to change their diet and exercise habits. They may also need to take oral medications or insulin.
A number of strategies can help prevent hyperglycemia.
- check their blood sugar levels as their doctor advises and take the correct amount of insulin, if they have type 1 diabetes
- speak to their healthcare provider or dietitian about which foods to eat or avoid, how much to eat, and how often
- take precautions to avoid infections, for example, through regular hand washing, as illness, such as a cold, can trigger a rise in blood pressure
- plan their food intake and exercise to balance blood sugar levels
- minimize stress, as far as possible, for example, through exercise, getting enough sleep, and stress-reducing activities such as meditation or yoga
Low blood sugar, or hypoglycemia, can happen when a person:
- has certain medical conditions
- does a lot of exercise
- skips meals or eats too little
It can also be a side effect of diabetes medicines. Taking too much insulin can result in low blood sugar levels.
Symptoms of low blood sugar may include:
- visit a doctor regularly
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Treating An Episode Of Hypoglycaemia
The immediate treatment for hypoglycaemia is to have some sugary food or drink to end the attack.
For example, this could be:
- a glass of fruit juice or non-diet soft drink
- between three and five dextrose tablets
- a handful of sweets
At first you should avoid fatty foods and drinks, such as chocolate and milk, because they don’t usually contain as much sugar and the sugar they do contain may be absorbed more slowly.
After having something sugary, you should have a longer-acting carbohydrate food, such as a few biscuits, a cereal bar, a piece of fruit or a sandwich.
It will usually take around 15 minutes to recover from a mild episode of hypoglycaemia. If you have a blood glucose meter, measure your blood sugar again after 15 to 20 minutes. If it’s still too low , you should have some more sugary food or a drink before testing your levels again in another 15 to 20 minutes.
When treating someone else with hypoglycaemia, if the above treatment isn’t effective, you may be able to help them by applying glucose gel to the inside of their cheeks, and gently massaging the outside of their cheeks.
It may take 10 to 15 minutes before they feel better. This shouldn’t be done if the person is drowsy or unconscious because of the risk of choking.
Slurred Speech And Clumsiness
Your sugar-starved brain may change the way you sound. Slurred speech is a common symptom associated with blood sugar levels that drop below 40 mg/dL, according to University of Michigan Health Systems. Combined with clumsiness another sign of low blood sugar you may seem as though you’ve had a few too many cocktails, even if you haven’t touched a drop, according to the National Health Service.
For more on managing low blood sugar, check out Diabetes Daily’s article “How to Treat Lows Without Sabotaging Your Diet!“
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Low Blood Sugar Levels In Diabetes
People with diabetes can have low blood sugar levels because of the medicines they have to take to manage their diabetes. They may need a hormone called 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 body’s cells, which makes the blood sugar level go down. But sometimes it’s a tricky balancing act and blood sugar levels can get too low.
People with diabetes need to keep their blood sugars from getting too highor too low. Keeping blood sugar levels in a healthy range means balancing when and what they eat, and when they exercise with when they take medicines.
What Else Can You Do To Control Blood Sugar Levels
Yes. People with diabetes should wear identification stating they have diabetes and whether they have recurrent low blood sugar. Those at risk for the health condition should be counseled on checking blood sugars before they drive a car, operate heavy machinery, or do anything physically taxing. In addition, it is important to carry a quick-acting glucose source at all times, and keep a source in their car, office, and by their bedside. Efforts should be made to minimize the hypoglycemic effects of drug regimens and to avoid variable surges in exercise, activity, and drinking alcohol.
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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.
Examples Of Appropriate Snacks May Be:
- 6 saltine crackers
- 1 slice toast and 1/2 cup milk
- 1 cup milk
The food eaten for a reaction need not be subtracted from a meal plan.
Obtain a blood sugar when symptoms occur if you are able. If symptoms are severe, treat the reaction first and then obtain a blood sugar. Do not drive nor operate equipment if you feel your blood sugar is low.
If your blood sugar drops low enough for you to become unconscious, you must be taken to the hospital and/or treated with glucagon.
Glucagon is a hormone that causes the blood sugar to rise. It can only be given by injection. It is used to treat a low blood sugar if a person becomes semi-conscious or unconscious due to a severe low blood sugar. Please ask your nurse for instruction on glucagon. Your doctor will need to write a prescription for glucagon so you can have it available at home.
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Signs Of Hypoglycemic Unawareness
Some people have no symptoms of low blood sugar. The only symptom you may have is confusion. Or you may become unconscious before anyone realizes you have low blood sugar.
You may have hypoglycemic unawareness if you:
- Cannot tell by your symptoms that your blood sugar is low.
- Have low blood sugar several times a week.
- Have type 1 diabetes, or have had type 2 diabetes for a long time.
If you have hypoglycemic unawareness, test your blood sugar often, especially before activities like driving a car. Keep quick-sugar foods with you. If you take insulin, carry a glucagon emergency kit. You can also give friends and family instructions to treat low blood sugar.
Low Blood Sugar Without Diabetes
Low blood sugar is uncommon in people who don’t have diabetes.
Possible causes include:
- eating large carbohydrate-based meals this is called “reactive hypoglycaemia”
- binge drinking
- fasting or malnutrition
- having a gastric bypass
- other medical conditions including Addison’s disease a non-cancerous growth in the pancreas or a problem with the liver, kidneys or heart
- some medicines, including quinine
See your GP if you think you keep getting low blood sugar. They can arrange some simple tests to check if your blood sugar level is low and try to find out what’s causing it.
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Does Everyone Have Symptoms From Hypoglycemia
Some people dont have symptoms or dont notice them. Healthcare providers call that situation hypoglycemia unawareness. People with such a challenge arent aware when they need to do something about their blood sugar. Theyre then more likely to have severe episodes and need medical help. People with hypoglycemia unawareness should check their blood sugar more often.
Knowing Your High And Low Blood Sugar Symptoms Allows You To Test
Once you understand symptoms of high and low blood sugar, it is possible to test quickly and avoid serious problems.
Keeping to a clear target range is one of the key goals of diabetes management, and knowing when you have the symptoms of high or low blood sugar levels allows you to test your blood sugar and make a correction.
It can be important to recognise the difference between low and high blood sugar symptoms. Being able to spot when youre high or low and sugar can help you to manage your diabetes.
Where possible, its best to check with your blood glucose meter, whether you are high or low, before taking any remedial action. If blood sugar is regularly high you may get recurrent episodes of thrush.
High blood sugar is serious and can result in nausea, vomiting or loss of consciousness. In type 2 diabetes, this can in the form of a condition called Hyperosmolar Hyperglycaemic State and in type 1 diabetes in the form of ketoacidosis.
It is important to seek emergency medical help.
Very low blood sugar can lead to convulsions and unconsciousness. It is important to seek emergency help if the person with diabetes is unable to bring their sugar levels back to normal.
The University of Birminghams Medical School states that if the body becomes used to being low on sugar, hypo symptoms can become less noticeable. Loss of symptoms of low blood sugar in particular can be dangerous.
If you have difficulty recognising the symptoms of hypoglycemia, speak to your doctor.
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