When Blood Sugar Is Too Low
Glucose is a sugar that comes from the foods we eat, and it’s also formed and stored inside the body. It’s the main source of energy for the cells of our body, and is carried to each cell through the bloodstream. Our brains depend on glucose to function, even when we’re sleeping.
The is the amount of glucose in the blood. When these levels drop too low, it’s called hypoglycemia . Very low blood sugar levels can cause serious symptoms that need to be treated right away.
When It’s Time To Call A Doctor
If any of the symptoms mentioned have begun to impact your life, such as fatigue so severe you can’t stay awake through the day, it’s a good idea to consult your physician. Dr. Fruge warns that “unstable blood sugar levels could put you at higher risk of heart disease and stroke and it is a red flag for serious health issues” — so blood sugar issues should be taken seriously.
You should also see a doctor if you’re experiencing symptoms of hypoglycemia and haven’t been diagnosed with diabetes or any other underlying condition.
If you do have diabetes and your hypoglycemia isn’t responding to the treatments described above, that’s another good cue to call your health care provider.
If testing reveals you have Type 1 diabetes, you’ll need to continue to test your blood sugar levels as often as instructed by your physician, take insulin regularly and participate in regular exercise. This may mean you will need a new glucose monitoring system, so ask your doctor what they recommend. If you’re diagnosed with Type 2 diabetes, you’ll most likely need to do the same as for Type 1, as well as working with health care professionals to make lifestyle changes such as improving nutrition and planning workouts. Medication may be necessary as well.
Healthy eating, regular exercise and other lifestyle changes can help alleviate symptoms and possibly even reverse prediabetes.
Causes Of Low Blood Sugar
There are many reasons why you may have low blood sugar, including:
- Taking too much insulin.
- Not eating enough carbs for how much insulin you take.
- Timing of when you take your insulin.
- The amount and timing of physical activity.
- Drinking alcohol.
- How much fat, protein, and fiber are in your meal.
- Hot and humid weather.
- Unexpected changes in your schedule.
- Spending time at a high altitude.
- Going through puberty.
- Menstruation.
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When Should I Check My Blood Sugar During The Night
- After a day with lots of exercise, such as swimming or sports
- If your blood sugar was low before bedtime
- When you are sick, especially if you have vomiting or diarrhea
- If you have been waking up high every morning for 3 or more days
- When your long-acting insulin dose has increased
The best times to check your blood sugar during the night is about 3 to 4 hours after your bedtime snack, then again about 3 to 4 hours after that.
How To Recognize Hypoglycemia

The first signs of hypoglycemia include feeling sweaty, shaky, and hungry. However, not everyone has these symptoms or notices them in time to prevent low blood sugar from getting worse. Its also important to know that your symptoms of hypoglycemia will change the longer you have T1D.
As hypoglycemia gets worse, symptoms can include:
- Feeling weak
- Having difficulty walking or seeing clearly
- Acting strange or getting disoriented
- Having seizures
Severe hypoglycemia may make you faint or pass out. This is dangerous if you are driving, climbing stairs, or doing other activities where you need to stay aware of things around you.
Hypoglycemia can happen at night. If it does, you are likely to wake up, but its important not to rely on your body to wake you up. A continuous glucose monitor, or CGM, can alert you and those around you with an alarm to let you know if your blood sugar starts getting low while you are sleeping.
Its a good idea to check your blood sugar often when lows are likely, such as in hot weather or when you travel. Your CGM can also let you know when your blood sugar is getting lower.
Watch out for hypoglycemia unawareness.
You might not have early warning signs of low blood sugar. This is called hypoglycemia unawareness, and it raises the risk of having severe lows. It is more likely if:
- You have had diabetes longer than 5 or 10 years
- You have frequent episodes of hypoglycemia
- You take certain medicines, such as beta blockers for high blood pressure
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Manage Low Blood Glucose Early
Learn to recognise your early warning signs of having a hypo. Be alert to what these are and test your blood glucose levels if any of these symptoms develop. Also make sure to always carry your emergency treatment with you. Keep it in your bag, at work and at home so you can treat low blood glucose early before it becomes more serious.
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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Why Is It Important To Recognize A Low Blood Sugar Level
Low blood sugar levels can happen with Type 1 and Type 2 diabetes. Low levels are more likely to happen if you use insulin. Hypoglycemia can cause you to have falls, accidents, and injuries. A blood sugar level that gets too low can lead to seizures, coma, and death. Learn to recognize the symptoms early so you can get treatment quickly.
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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Dr Folasade Alli: What To Do When You Have Low Blood Sugar
Low blood sugar happens when your blood sugar levels have fallen low enough that you need to take action to bring them back to your target range. This happens when your blood sugar is less than 70 mg/dL. When this happens, youll need to speak with your endocrinologist about your sugar level and what you need to do immediately. When your blood sugar level goes below a healthy range and it is not treated, it becomes dangerous.
Its important to know the signs that show the symptoms of low blood pressure. Some of which are:
- Shakiness
- Colour drains from the skin
- Feeling sleepy
- Feeling weak or having no energy
- Blurred/impaired vision
- Tingling or numbness in the lips, tongue, or cheeks
- Headaches
- Nightmares or crying out during sleep
- Seizures
But what happens when you are not sure of whether or not you are experiencing low blood sugar? The only way to be sure is to check your blood sugar level. Alternatively, if you are experiencing any of the symptoms above and you dont have access to checking your blood pressure, then its wise to treat hypoglycemia.
When blood sugar levels are low, the goal is to get them back up quickly. To do that, you should take in sugar or sugary foods which raise the blood sugar level quickly. Your endocrinologist can suggest that you:
Sometimes, blood sugar levels can get so low that you may not be awake enough to eat or drink something to get them back up. When this happens, you may need a glucagon shot.
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 Can I Prevent Low Blood Sugar
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 sugar, 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 sugar, the lower his or her risk of hypoglycemia. This is because you can see when blood sugar 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.
How Do I Treat Low Blood Glucose

If you begin to feel one or more symptoms of low blood glucose, check your blood glucose level. If your blood glucose level is below your target or less than 70 mg/dL, follow these steps
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What Is Low Blood Glucose
Low blood glucose, also called low blood sugar or hypoglycemia, occurs when the level of glucose in your blood drops below what is healthy for you. For many people with diabetes, this means a blood glucose reading lower than 70 milligrams per deciliter .1 Your number might be different, so check with your doctor or health care team to find out what blood glucose level is low for you.
How Do I Treat Hypoglycemia
A mild case of hypoglycemia can be treated through eating or drinking 15-20g of fast acting carbohydrate such as glucose tablets, sweets, sugary fizzy drinks or fruit juice.
Some people with diabetes may also need to take 15-20g of slower acting carbohydrate if the next meal is not due.
A blood test should be taken after 15-20 minutes to check whether blood glucose levels have recovered. Severe hypoglycemia may require an ambulance, for example if loss of consciousness occurs or a seizure persists for more than 5 minutes.
Severe hypos can be treated with glucagon if a glucagon injection kit is available and in date.
- Read more detail on how to treat hypoglycemia
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How Do You Treat Hypoglycemia
Treatment for hypoglycemia involves both the immediate steps needed to raise your blood sugar level in addition with the later treatment or medication dose adjustment to prevent recurrence.
To immediately raise your blood sugar level, Dr. Shah advocates the rule of 15eating 15 grams of carbohydrates and then checking your blood sugar level 15 minutes later. Fast-acting carbohydrates include:
- 4 glucose tablets
- 4 ounces of fruit juices
Keep repeating these steps every 15 minutes until your blood sugar reaches above 70 mg/dL, he explains. Once your level has stabilized, its important to then eat a snack or even a full meal to maintain that balance, Dr. Shah adds.
If your symptoms are more severe and/or a person is unable to swallow, you may need an injection of glucagon, he says.
To prevent episodes of hypoglycemia in the future, Dr. Shah says that treatment may involve the changing of prescribed regimens and dosages or adjusting your meal plans.
What Are The Symptoms Of Hypoglycaemia
Symptoms of mild to moderate hypoglycaemia may include one or more of the following:
- looking pale
- rapid change in behaviour or irritability
- confusion
- blurred vision.
Over time you come to recognise the feelings you get when your blood glucose goes low. However, if you have had diabetes for a long time, you may not get any symptoms when your blood glucose goes low.
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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.
Treating Low Blood Glucose If You Take Medicines That Slow Down Digestion
Some diabetes medicines slow down the digestion of carbohydrates to keep blood glucose levels from rising too high after you eat. If you develop low blood glucose while taking these medicines, you will need to take glucose tablets or glucose gel right away. Eating or drinking other sources of carbohydrates wont raise your blood glucose level quickly enough.
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Low Blood Sugar For Children Age 6 And Older
A blood sugar less than 70 is too low.
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.
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Nighttime Low Blood Sugars
You may experience a low blood sugar night. The low blood sugar might wake you up and your symptoms might be similar to those you have during the day. However, the symptoms may be different. You might have nightmares, sleep poorly, perspire, or feel hot and cold. In the morning you may have a headache, feel nauseated, or feel confused. Notify your doctor if this happens. Check your blood sugar at the time you have the symptoms.
Treatment for a low blood sugar that occurs at night is the same as described earlier.
Your doctor may request that you check a 3:00 a.m. blood sugar 1 to 2 times per week in order to detect any low blood sugars during the night.
Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health care professional.