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Symptoms of Low Blood Sugar (Hypoglycemia) and What to Do

Low blood sugar, also known as hypoglycemia, occurs when the level of glucose (sugar) in your blood drops too low. Glucose is the primary source of energy for your body, and particularly your brain. When blood sugar levels dip below normal, it can cause a range of symptoms, from mild discomfort to severe complications. This article will delve into the symptoms of hypoglycemia, discuss what causes it, and outline the steps you should take if you experience it.

What is Hypoglycemia?

Hypoglycemia typically occurs in people with diabetes who are taking insulin or certain oral medications that increase insulin production. However, it can also occur in people without diabetes, though this is less common. Blood sugar levels are considered low when they fall below 70 mg/dL (3.9 mmol/L), though individual targets may vary. Understanding the underlying causes and recognizing the symptoms are crucial for effective management.

Symptoms of Low Blood Sugar

The symptoms of hypoglycemia can vary from person to person and can also depend on how quickly the blood sugar level drops. The severity of symptoms also tends to worsen as blood sugar levels continue to fall. The symptoms can be generally categorized as mild to moderate and severe. Why Is My Fasting Blood Sugar Still High 5 Possible Reasons

Mild to Moderate Symptoms

These symptoms typically manifest when blood sugar levels are moderately low and are often the first indicators that something is amiss. They include:

• Shakiness or Trembling: This is one of the most common early signs of hypoglycemia. Your body is signaling that it needs glucose.
• Sweating: Profuse sweating, even in the absence of physical activity or heat, can be a sign of low blood sugar.
• Dizziness or Lightheadedness: A lack of glucose can affect brain function, leading to feelings of dizziness or lightheadedness.
• Hunger: An intense feeling of hunger, often accompanied by stomach grumbling, is a frequent symptom.
• Irritability or Mood Changes: Hypoglycemia can affect mood and behavior, making you feel irritable, anxious, or confused.
• Headache: A dull or throbbing headache can develop as a result of the brain's lack of glucose.
• Rapid Heartbeat: Your heart may beat faster than usual as your body attempts to compensate for the lack of energy.
• Blurred Vision: Low blood sugar can sometimes affect vision, causing blurring or double vision.
• Difficulty Concentrating: Focus and concentration may become difficult due to the brain's limited glucose supply.
• Pale Skin: Paleness, especially in the face, can also indicate hypoglycemia.

Severe Symptoms

If hypoglycemia is not promptly treated, it can progress to more severe symptoms, which require immediate medical attention. These include:

• Confusion or Disorientation: Severe hypoglycemia can impair cognitive function, causing confusion, disorientation, and difficulty thinking clearly.
• Seizures: Uncontrolled electrical activity in the brain can result in seizures or convulsions.
• Loss of Consciousness: In extreme cases, hypoglycemia can lead to loss of consciousness or coma.
• Weakness or Coordination Problems: Significant muscle weakness or difficulty with coordination can occur.
• Slurred Speech: Similar to intoxication, hypoglycemia can affect speech, causing slurring or difficulty articulating words.

Causes of Low Blood Sugar

Understanding the causes of hypoglycemia is crucial for prevention, especially for individuals at risk. Common causes include: What Does Low Blood Sugar Feel Like Signs Of Hypoglycemia To Watch For

• Diabetes Medications: Insulin and certain oral medications used to treat diabetes can sometimes cause blood sugar to drop too low, especially if the dose is too high or if food intake is inadequate.
• Skipping or Delaying Meals: Not eating regularly, skipping meals, or delaying meals can lead to a drop in blood sugar levels.
• Intense Exercise: Strenuous physical activity can deplete glucose stores and cause hypoglycemia, particularly if not properly planned or managed.
• Excess Alcohol Consumption: Alcohol can interfere with the liver's ability to release glucose into the bloodstream, increasing the risk of hypoglycemia, especially when consumed without food.
• Certain Medical Conditions: Conditions like liver disease, kidney disease, and some tumors can also cause hypoglycemia.
• Reactive Hypoglycemia: This condition occurs when blood sugar levels drop a few hours after eating, often triggered by a high-carbohydrate meal.
• Gastric Bypass Surgery: Changes in digestion after gastric bypass can occasionally lead to hypoglycemia.

What to Do When You Experience Low Blood Sugar

If you suspect you have hypoglycemia, immediate action is necessary to raise your blood sugar levels and prevent further complications. The "15-15 rule" is a commonly recommended approach:

1. Check Your Blood Sugar (if possible): If you have a blood glucose meter, check your blood sugar to confirm that it is low (typically below 70 mg/dL).

2. Consume 15 Grams of Fast-Acting Carbohydrates: Choose a source of carbohydrates that is quickly absorbed into the bloodstream. Examples include:

   • 4 ounces (1/2 cup) of juice (not diet juice)
   • 4 ounces (1/2 cup) of regular soda (not diet soda)
   • 1 tablespoon of honey or syrup
   • 3-4 glucose tablets

3. Wait 15 Minutes: After consuming the fast-acting carbohydrates, wait 15 minutes to allow your blood sugar to rise.

   
   

4. Recheck Your Blood Sugar: After 15 minutes, recheck your blood sugar to see if it has risen above 70 mg/dL.

5. Repeat if Necessary: If your blood sugar is still below 70 mg/dL, repeat the process by consuming another 15 grams of fast-acting carbohydrates and waiting 15 minutes before rechecking. Why Your Postprandial After Meal Blood Sugar Matters

6. Eat a Meal or Snack: Once your blood sugar is above 70 mg/dL, eat a meal or snack that contains both carbohydrates and protein to help stabilize your blood sugar levels and prevent another drop. Good options include:

   • Crackers with peanut butter
   • Cheese and fruit
   • A sandwich

7. Seek Medical Attention if Necessary: If you experience severe symptoms such as loss of consciousness or seizures, or if you are unable to raise your blood sugar levels on your own, seek immediate medical attention. Call emergency services or have someone take you to the nearest emergency room.

Prevention of Hypoglycemia

Preventing hypoglycemia involves careful management of diet, medication, and lifestyle. Here are some strategies to reduce your risk:

• Regular Meals and Snacks: Eating regular meals and snacks throughout the day helps to maintain stable blood sugar levels. Avoid skipping meals or waiting too long between meals.
• Consistent Carbohydrate Intake: Be mindful of your carbohydrate intake, especially if you have diabetes. Work with a healthcare professional to determine the appropriate amount of carbohydrates for your individual needs.
• Timing of Medication: If you take insulin or oral diabetes medications, ensure that you are taking them at the correct times and in the correct doses.
• Monitor Blood Sugar: Regularly monitor your blood sugar levels, especially before meals, after meals, and before bedtime. This helps you to identify patterns and make necessary adjustments to your treatment plan.
• Exercise with Caution: Adjust your medication or food intake as needed when exercising to prevent hypoglycemia. Monitor your blood sugar levels before, during, and after exercise.
• Limit Alcohol Consumption: If you choose to drink alcohol, do so in moderation and always consume it with food.
• Communicate with Healthcare Team: Maintain open communication with your healthcare team, including your doctor, diabetes educator, and dietitian. Discuss any concerns or questions you have about hypoglycemia management.

When to See a Doctor

While most episodes of hypoglycemia can be managed at home, it's essential to seek medical attention if you experience:

• Severe Symptoms: Such as loss of consciousness or seizures.
• Frequent Episodes: Of hypoglycemia, despite taking preventative measures.
• Unexplained Hypoglycemia: If you don't have diabetes and experience hypoglycemia.
• Difficulty Managing Diabetes: Especially if you have frequent blood sugar fluctuations.

Hypoglycemia Unawareness

Some people with diabetes may develop hypoglycemia unawareness, which means they no longer experience the early warning signs of low blood sugar. This can be dangerous, as they may not realize their blood sugar is dropping until it reaches dangerously low levels. Regular blood sugar monitoring and working closely with your healthcare team can help to address hypoglycemia unawareness.

Summary

Hypoglycemia is a condition characterized by abnormally low blood sugar levels. Recognizing the symptoms, understanding the causes, and knowing how to treat and prevent hypoglycemia are essential for individuals with diabetes and those at risk. By taking proactive steps, such as maintaining regular meals, monitoring blood sugar levels, and communicating with your healthcare team, you can effectively manage hypoglycemia and maintain your overall health and well-being. ```

By Victor M. Montori, M.D.