Hypoglycemia: How to identify symptoms and treat low blood sugar

You may already be familiar with the symptoms of low blood sugar or hypoglycemia—feeling hungry, dizzy, sweaty, or just a little bit "off.”¹ If you’re a person with diabetes experiencing these signs, you will want to take appropriate action to help yourself feel better and avoid any emergencies. 

For most people, low blood sugar refers to anything below 70 mg/dL, though keep in mind that your number may be different.² 

Low blood sugar, also known as hypoglycemia, can be caused by taking too many medications, not eating enough, or exercising.³ Instead of feeling frustrated with yourself for making choices that might have caused this to happen, focus on getting your blood sugar back in the appropriate range. Then you can consider what might have caused your low blood sugar to help prevent it next time.

The three most common signs of hypoglycemia are hunger, trembling or shaking, and a fast heartbeat.³ But there are many other signs of low blood sugar or hypoglycemia that you should be aware of: 

• Lightheadedness or dizziness
• Headache
• Numb lips or fingers
• Sweating
• Weakness
• Crying
• Irritability
• Lack of concentration

If you believe you have the symptoms of low blood sugar, you will want to confirm with a blood glucose test, then follow the 3-step “15-15” rule once results have indicated that your blood sugar is low. ³

The 3-Step “15-15” Rule³

1. Eat or drink 15 grams of fast-acting carbs.
2. Wait 10 to 15 minutes.
3. Check your blood glucose levels, and if they’re still low, repeat the 3 steps.

What is the best thing to eat when your blood sugar is low?

For 15 grams of carbohydrates when your blood glucose is low, try³ :

• 1/2 cup of fruit juice or regular (non-diet) soda
• 1 tablespoon of sugar or honey
• Jellybeans or hard candies — check the package to determine how many you need to get 15 grams of carbohydrates
• Premeasured glucose tabs or gel

Once your blood glucose levels have stabilized to a safe range, you should eat longer-acting carbohydrates such as a sandwich, yogurt, or fruit.⁴

In some cases, people with diabetes don't feel any warning symptoms of hypoglycemia. This is known as "hypoglycemia unawareness.³ If you are unable to feel the signs of low blood glucose, talk to your healthcare provider about how to carefully monitor your blood glucose levels and fine-tune your insulin therapy to help you avoid hypoglycemia.

If your low blood sugar goes untreated, it can quickly become an emergency.⁵ In cases of severe hypoglycemia, you may find yourself unable to eat something that could help raise your blood sugar levels. 

That’s why your healthcare provider may have recommended that you carry a glucagon kit.⁶ When administered by another person, this injection of the hormone glucagon will quickly stimulate your body to produce the glucose you need.³ 

Take time to talk to your friends and family about what signs of low blood sugar to be aware of and, if needed, how to use the glucagon kit in case of an emergency.

Last but not least, if you frequently experience hypoglycemia, be sure to consult your healthcare provider.

Resources

1. ElSayed NA, Aleppo G, Aroda VR, et al. 6. Glycemic Targets: Standards of Care in Diabetes—2023. Diabetes Care. 2022;46(Supplement_1):S97-S110. doi:10.2337/dc23-S006

2. ElSayed NA, Aleppo G, Aroda VR, et al. 6. Glycemic Targets: Standards of Care in Diabetes—2023. Diabetes Care. 2022;46(Supplement_1):S97-S110. doi:10.2337/dc23-S006

3. Hypoglycemia-Signs, Symptoms & Treatment |ADA. Accessed November 23, 2023. https://diabetes.org/living-with-diabetes/treatment-care/hypoglycemia

4. Evert AB. Treatment of Mild Hypoglycemia. Diabetes Spectr. 2014;27(1):58-62. doi:10.2337/diaspect.27.1.58

5. Martín-Timón I, Del Cañizo-Gómez FJ. Mechanisms of hypoglycemia unawareness and implications in diabetic patients. World J Diabetes. 2015;6(7):912-926. doi:10.4239/wjd.v6.i7.912

6. Lowe RN, Williams B, Claus L. Diabetes: how to manage patients experiencing hypoglycaemia. Drugs Context. 2022;11:1-12. doi:10.7573/dic.2021-9-11