Hypoglycemia can be a very serious condition, with extreme cases causing seizures, coma, and even death. It occurs when blood sugar levels drop too low, and it is most often experienced by people with diabetes.
As you learn about diabetes management, being well versed in low blood sugar symptoms will enable you to detect the signs of impending hypoglycemia and act quickly to head it off or minimize its impact.
Diabetes Type and Hypoglycemia Risk
Hypoglycemia risk varies across the three different types of diabetes:
Type 1 Diabetes People with type 1 diabetes experience hypoglycemia most often, as their diabetes management often requires a lot of attention and careful planning. The average person with type 1 diabetes who is attempting aggressive disease control may still experience low blood sugar symptoms frequently, and a full-blown case of hypoglycemia will require close medical attention.
“When it comes to type 1 diabetes, the body can’t make insulin on its own, so it must be administered,” notes Erin Palinski-Wade, RD, CDE, Everyday Health contributor and author of Belly Fat for Dummies. Paying close attention to your diet is important, too. “If the correct amount of insulin is given based on the amount of carbohydrates consumed, blood sugar levels can remain in a healthy range.”
Type 2 Diabetes These patients experience hypoglycemia less frequently than people with type 1 diabetes; the rate of hypoglycemia for type 2 diabetes patients taking insulin is about one-third that of type 1 diabetes patients. But research shows that the frequency of hypoglycemia in people with type 2 diabetes increases as the disease becomes more advanced.
“In people with type 2 diabetes, the body may produce adequate insulin, yet the cells are resistant to it, making the insulin ineffective at transferring blood glucose into the cells to be used as energy,” says Palinski-Wade.
People with both types of diabetes should aim to eat complex carbohydrates. “Avoiding refined carbohydrates and simple sugars is key in reducing insulin resistance, so that the body can better process blood glucose levels,” she says.
Gestational Diabetes This type of diabetes only happens during pregnancy, and occurs when your pancreas can’t make enough insulin, often due to changes in hormones. Gestational diabetes patients may experience hypolgycemia even if they take insulin during their pregnancy. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), your chances of getting this type of diabetes is higher if you’re overweight, though there are other factors, too.
Low Blood Sugar Symptoms
The warning signs of hypoglycemia may vary from person to person, but it’s important to know about and be alert to all of them, including:
- Feeling very shaky or trembling
- Weakness or dizziness
- Sweating or feeling cold and clammy
- Extreme hunger pangs
- Trouble keeping your balance or staggering when you walk
- Pale or gray skin
- A bad headache
- Becoming confused and unable to think or concentrate
- Feeling uncharacteristically moody or cranky
- A tingling sensation around your mouth
- Double vision or vision that has grown blurry
- A quickening heartbeat
Some people will experience an episode of hypoglycemia in their sleep. Signs of nocturnal hypoglycemia include:
- Waking up with your pajamas or sheets soaked with sweat
- Feeling cranky, irritable, tired, or confused after waking up
- Having nightmares or crying out in your sleep
People with extreme hypoglycemia may pass out or experience seizures as a result of low blood sugar. These people are in danger of lapsing into a coma and could die if not treated.
What You Should Do
Still, there are steps you can take to help prevent your blood sugar from dropping too low. “Take the time to schedule frequent meals and snacks,” advises Palinski-Wade. “Going long periods of time without eating, especially after physical activity, is one of the main reasons for drops in blood sugar levels. If you’re prone to frequent lows, testing blood sugar levels often is also an effective way to prevent this.”
If you have diabetes and think you’re experiencing hypoglycemia, you should test your blood sugar levels as soon as possible using a glucose meter. Levels below 70 milligrams per deciliter will require immediate treatment.
The best way to treat hypoglycemia is to eat some form of sugar. The American Diabetes Association (ADA) recommends getting between 15 and 20 grams (g) of sugars or carbohydrates with each snack, and between 40 and 65 g at each meal.
Although the ADA recommendation can offer a helpful framework, Palinski-Wade notes that counting and restricting carbs isn’t a one-size-fits-all approach. “Someone who is more prone to hypoglycemia may have different per-meal carbohydrate goals than another individual,” she says. “Getting 15 to 30 g of carbs per snack and 45 to 60 g per meal is a good starting point, but you should work together with your diabetes treatment team to see what carbohydrate goals work best for your own individual needs.”
If your blood sugar drops drastically, you can take a few immediate steps to address the situation. “Once you know your blood sugar is low, use the 15/15 rule,” Palinski-Wade says. “Consume 15g of quick acting carbs (such as orange juice), wait 15 minutes, and retest your blood sugar. Continue to repeat this until your blood sugar levels are within a healthy range.” By following this advice, Palinski-Wade says you may be better able to prevent yourself from eating too many carbs at once, which may spike blood sugar levels. Some other quick-acting sources of carbs include:
- Fruit juice, 1/2 cup
- Regular (non-diet) soda, 1/2 cup
- Milk, 1 cup
- Hard candy, 5 or 6 pieces
- Saltine crackers, 4 or 5
- Raisins, 2 tablespoons (tbsp)
- Sugar or honey, 1 tbsp
- Glucose tablets, 3 or 4
- Glucose gel, 1 serving
If you pass out or experience seizures, you need to see your doctor or call 911 to get to an emergency room for treatment.
To help manage diabetes and keep hypoglycemia from occurring, Palinski-Wade recommends staying focused on eating a diet high in fiber, vegetables, fruits, whole grains, lean proteins, and healthy fats, and limiting large amounts of added sugars and saturated fats. Also, “frequently testing blood glucose levels and tracking carbohydrate intake, exercise, stress levels, and sleep patterns — and sharing this data with your diabetes care team — is the most effective way to help you best manage diabetes and prevent spikes and crashes in blood glucose levels,” she says.