Hypoglycemia Explained: What to Do When Your Blood Sugar Is Too Low

Hypoglycemia, or low blood sugar, is a condition that primarily affects individuals with diabetes, but it can also occur in people without diabetes in rarer cases. Understanding the symptoms, causes, and, most importantly, what to do when your blood sugar dips too low is crucial for managing your health effectively. This article will provide a comprehensive overview of hypoglycemia, giving you the knowledge to handle it confidently.

What is Hypoglycemia?

Hypoglycemia happens when the level of glucose (sugar) in your blood drops below what is healthy for you. This level varies from person to person, but generally, a blood sugar level below 70 mg/dL (3.9 mmol/L) is considered hypoglycemia. Glucose is the primary energy source for your body, especially the brain, so when it's too low, you can experience a range of symptoms, some of which can be serious if left untreated. Type 2 Diabetes A Complete Guide To Managing Your Blood Glucose

Symptoms of Hypoglycemia

Symptoms of hypoglycemia can vary from mild to severe. It’s essential to recognize these signs early so you can take action promptly.

Mild to Moderate Symptoms:

• Shakiness or trembling
• Sweating
• Dizziness or lightheadedness
• Hunger
• Irritability or anxiety
• Rapid heartbeat or palpitations
• Confusion
• Difficulty concentrating
• Blurred vision
• Headache

Severe Symptoms:

• Loss of consciousness
• Seizures
• Coma

NOTE: It’s crucial to note that some people may not experience noticeable symptoms (a condition known as hypoglycemia unawareness). Individuals with frequent episodes of hypoglycemia or those who have had diabetes for a long time may develop this.

Causes of Hypoglycemia

Understanding the causes of hypoglycemia is crucial for preventing it. Here are some common causes, particularly in individuals with diabetes:

For People With Diabetes:

• Excessive Insulin or Medication: Taking too much insulin or certain diabetes medications that stimulate insulin release (e.g., sulfonylureas) can lower blood sugar excessively.
• Skipping Meals or Delaying Meals: Not eating enough food or waiting too long between meals can cause your blood sugar to drop.
• Increased Physical Activity: Exercise increases your body's need for glucose. Without proper adjustment to medication or food intake, exercise can lead to hypoglycemia.
• Alcohol Consumption: Alcohol can interfere with the liver's ability to release glucose into the bloodstream, especially if consumed without food.
• Kidney or Liver Problems: These conditions can affect how the body processes medications and regulates blood sugar.

For People Without Diabetes (Non-Diabetic Hypoglycemia):

While less common, hypoglycemia can occur in people who do not have diabetes. Some potential causes include: The Simple Habit To Balance Your Postprandial Blood Sugar

• Reactive Hypoglycemia: This occurs after eating a meal, typically one high in carbohydrates. It’s thought to be caused by an exaggerated insulin response.
• Fasting Hypoglycemia: This happens when blood sugar drops after a period of not eating. It can be caused by various underlying medical conditions such as:
  • Tumors: Insulinomas (tumors of the pancreas that produce insulin) are a rare cause.
  • Hormone Deficiencies: Deficiencies in hormones like cortisol or growth hormone can affect blood sugar regulation.
  • Severe Liver or Kidney Disease: These conditions can impair the body's ability to store and release glucose.
• Post-Gastric Bypass Surgery: Some individuals who have had gastric bypass surgery may experience hypoglycemia due to changes in how food is absorbed.
• Certain Medications: Rarely, some medications unrelated to diabetes can cause hypoglycemia.
• Excessive Alcohol Consumption: Even without diabetes, drinking too much alcohol, especially without food, can lower blood sugar.

What to Do When Your Blood Sugar Is Too Low: The 15-15 Rule

If you suspect you have hypoglycemia, the first step is to check your blood sugar with a glucose meter, if available. If it's below 70 mg/dL (3.9 mmol/L), or if you're experiencing symptoms and can't check your blood sugar immediately, follow the 15-15 rule:

1. Consume 15 Grams of Fast-Acting Carbohydrates: These are simple sugars that your body can quickly absorb. Examples include:
   • 4 ounces (1/2 cup) of fruit juice (not low sugar)
   • 4 ounces (1/2 cup) of regular (non-diet) soda
   • 1 tablespoon of honey or sugar
   • Glucose tablets or gel (follow package instructions)
2. Wait 15 Minutes: After consuming the carbohydrates, wait for 15 minutes to allow your blood sugar to rise.
3. Recheck Your Blood Sugar: After 15 minutes, check your blood sugar again. If it's still below 70 mg/dL (3.9 mmol/L), repeat the process.
4. Eat a Meal or Snack: Once your blood sugar is back within a safe range, eat a meal or snack containing protein and complex carbohydrates to help stabilize your blood sugar levels and prevent another drop. Good options include:
   • Peanut butter crackers
   • Cheese and crackers
   • A small sandwich

If you experience severe symptoms, such as loss of consciousness or seizure, someone should administer glucagon (if available) and call emergency services immediately. Glucagon is a hormone that can rapidly raise blood sugar levels. People at risk for severe hypoglycemia should have glucagon kits available and teach their family members or close contacts how to use them.

Preventing Hypoglycemia

Prevention is key to avoiding hypoglycemia. Here are some tips to help prevent low blood sugar: Hypoglycemia Vs Hyperglycemia Knowing The Critical Difference

• Monitor Your Blood Sugar Regularly: If you have diabetes, regular blood sugar monitoring is crucial. This helps you understand how food, activity, and medications affect your blood sugar levels.
• Follow Your Meal Plan: Eat consistent meals and snacks throughout the day to maintain stable blood sugar levels. Avoid skipping meals or delaying them.
• Adjust Insulin or Medication Doses: Work closely with your healthcare provider to adjust your insulin or medication doses based on your activity level, food intake, and blood sugar readings.
• Be Mindful of Alcohol Consumption: If you drink alcohol, do so in moderation and always with food. Be aware of how alcohol affects your blood sugar levels.
• Carry a Source of Fast-Acting Carbohydrates: Always carry a source of fast-acting carbohydrates with you, such as glucose tablets or juice, in case your blood sugar drops.
• Wear Medical Identification: Consider wearing a medical ID bracelet or necklace that indicates you have diabetes or are at risk for hypoglycemia.
• Educate Family and Friends: Make sure your family, friends, and coworkers know how to recognize the symptoms of hypoglycemia and what to do in an emergency.

When to Seek Medical Attention

While you can often treat mild to moderate hypoglycemia at home, it's essential to know when to seek medical attention.

• Severe Hypoglycemia: If you experience severe symptoms, such as loss of consciousness or seizures, seek immediate medical attention.
• Frequent Episodes: If you experience frequent episodes of hypoglycemia, even if they are mild, talk to your healthcare provider. They may need to adjust your medication or investigate the underlying cause.
• Hypoglycemia Unawareness: If you have hypoglycemia unawareness, where you don't experience noticeable symptoms of low blood sugar, it's crucial to work with your healthcare provider to develop strategies to improve your awareness and prevent severe episodes.
• Non-Diabetic Hypoglycemia: If you experience hypoglycemia without having diabetes, it's essential to see a doctor to determine the underlying cause and receive appropriate treatment.

Monitoring Technology and Hypoglycemia

Advancements in diabetes technology have significantly improved the management of hypoglycemia.

• Continuous Glucose Monitors (CGMs): CGMs are devices that continuously track your blood sugar levels and provide real-time readings. They can also alert you when your blood sugar is dropping too low, allowing you to take action before symptoms develop. Many CGMs can be integrated with insulin pumps to automatically adjust insulin delivery based on blood sugar levels.
• Insulin Pumps: Insulin pumps deliver a steady stream of insulin throughout the day, which can be adjusted based on your needs. They can also be programmed to suspend insulin delivery if your blood sugar is dropping too low, helping to prevent hypoglycemia.

Here's an HTML table showing key differences in hypoglycemia treatment options.

Treatment Method	Description	Pros	Cons
15-15 Rule	Consuming 15g of fast-acting carbs, waiting 15 minutes, then rechecking blood sugar.	Quick, effective for mild cases, readily available.	May require multiple repetitions, not suitable for severe cases.
Glucagon Injection	Injection that rapidly raises blood sugar.	Effective for severe hypoglycemia when patient is unconscious.	Requires training for administration, potential for nausea/vomiting.
CGM Systems	Continuous blood sugar monitoring with alerts.	Provides real-time data, early warning system, improves glycemic control.	Requires initial setup/calibration, potential for skin irritation, cost.

Conclusion

Hypoglycemia is a common and potentially serious condition, particularly for individuals with diabetes. Understanding the symptoms, causes, and treatment options is essential for managing your health effectively. By following the tips outlined in this article, you can prevent hypoglycemia and respond quickly and appropriately if your blood sugar drops too low. Always work closely with your healthcare provider to develop a personalized management plan that meets your individual needs. Staying informed and proactive can help you stay healthy and thrive, even with diabetes.

By Craig R. Jenkins, D.O.