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.
is the amount of glucose in the blood. When these levels (also called
blood sugar levels) drop too low, it's called hypoglycemia
(pronounced: high-poe-gly-SEE-me-uh). Very low blood sugar levels can cause serious
symptoms that need to be treated right away.
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 (or both) to help their bodies use the sugar in their
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
What Can Cause Low Blood Sugar Levels?
Some things that can make low blood sugar levels more likely are:
skipping meals and snacks
not eating enough food during a meal or snack
exercising longer or harder than usual without eating some extra food
getting too much insulin
not timing the insulin doses properly with meals, snacks, and exercise
Also, some things may increase how quickly insulin gets absorbed into the bloodstream
and can make hypoglycemia more likely. These include:
taking a hot shower or bath right after having an insulin injection increases
blood flow through the blood vessels in the skin, which can make the insulin be absorbed
more quickly than usual
injecting the shot into a muscle instead of the fatty layer under the skin
injecting the insulin into a part of the body used a lot in a particular sport
(like injecting the leg right before soccer practice).
All of these situations increase the chances that a person may get hypoglycemia.
What Are the Signs & Symptoms of Low Blood Sugar?
Different people may feel low blood sugar levels differently. People with low blood
feel hungry or have "hunger pains" in their stomach
feel shaky or like they're trembling
have a rapid heart rate
feel sweaty or have cold, clammy skin
have pale, gray skin color
have a headache
feel moody, cranky, or irritable
feel drowsy, weak, or dizzy
be unsteady or stagger when walking
have blurred or double vision
have seizures or convulsions
lose consciousness (pass out)
If you have diabetes, try to remember how your body reacts when your blood sugar
levels are low. It may help you figure out when you're having a low blood sugar level
more quickly the next time.
Checking for Low Blood Sugar Levels
The warning signs of hypoglycemia are the body's natural response to low blood
sugar levels. When blood sugar levels fall too low, the body releases the hormone
adrenaline, which helps get stored glucose into the bloodstream quickly. This can
have an increased heart rate
If the hypoglycemia isn't treated, more serious symptoms may happen, such as drowsiness,
confusion, seizures, and loss of consciousness.
The only way to know for sure if you're having a low blood sugar level
is to test. Blood sugar levels can be tested with a
. This computerized device measures and displays the amount of glucose
in a blood sample. But if you can't quickly check your blood sugar level, it's important
to treat yourself for hypoglycemia immediately to prevent symptoms from getting worse.
Sometimes a person with diabetes may have symptoms of low blood sugar levels, but
blood sugar levels are not actually low. This is a called a false reaction.
The hormone adrenaline (mentioned above) is not just released when blood sugar drops
too low — it's also released when blood sugar levels fall quickly when they're too
high. If you're having a false reaction, you might actually have blood sugar levels
in a healthy range but feel as if you have low blood sugar. Testing blood sugar levels
before treating yourself for hypoglycemia can help you figure out if you're having
a false reaction.
Some people with diabetes don't actually notice the typical signs of low blood
sugar levels. For them it's even more important to check blood glucose levels often
and take extra precautions to prevent low blood sugar (see our prevention tips below).
If you're having trouble feeling the symptoms of low blood sugar, let your diabetes
health care team know.
How Are Low Blood Sugar Levels Treated?
Your diabetes health care team will give you guidelines for treating low blood
sugar levels, depending on your symptoms. If you can, try to test your blood sugar
levels to make sure that your symptoms are because of hypoglycemia. If you can't test
blood sugar immediately, don't delay in treating your symptoms — you can always check
your blood sugar after you've taken steps to get your blood sugar back up into the
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 health care team might suggest that you:
Eat, drink, or take something that contains sugar that can get into the blood
quickly. Your doctor may tell you to have really sugary foods or drinks (like regular
soda, orange juice, or cake frosting) or might give you glucose tablets or gel to
take — all of these can help to raise your blood sugar level fast, which is what you
need to do when it's low.
Wait about 10 minutes to let the sugar work.
Recheck your blood sugar level with a glucose
meter to see if blood sugar levels are back to normal.
Get a glucagon shot (see below), if your symptoms are severe or get worse after
you eat, drink, or take glucose.
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 (pronounced: GLOO-kuh-gon) is a hormone that helps raise
blood sugar levels quickly. Your parents, teachers, and coaches should all know how
shots in case of a low blood sugar emergency or at least know to call
911. Your doctor can prescribe a glucagon kit, which should be kept in a place where
the people who are close to you can easily find it.
Also, you should always wear a medical identification bracelet or necklace and/or
carry an ID that says you have diabetes. That way, if you are not feeling well, whoever's
helping you — even if the person doesn't know you — will know to call for medical
help. This medical identification also can also include your doctor's phone number
or a parent's phone number.
Preventing Low Blood Sugar Levels
By knowing what causes low blood sugar levels and being prepared, you can lessen
the chance that you'll have them. But no matter how well they take care of themselves,
people with diabetes will sometimes have low blood sugar levels.
Here are some other tips to help you avoid low blood sugar levels:
Eat all your meals and snacks on time and try not to skip any.
Take the right amount of insulin.
If you exercise longer or harder than usual, have an extra snack.
Don't take a hot bath or shower right after an insulin shot.
Stick to your diabetes management plan.
Check your blood sugar levels regularly, so you can tell if your blood sugars
are running too low and your treatment plan needs adjustment.
Carry something containing sugar with you at all times and take it right away
if you have symptoms. Don't wait to see if the symptoms will go away — they
may get worse!
Alcohol and drugs can cause major problems with your blood sugar levels, so avoiding
them is another way to prevent diabetes problems. Drinking can be particularly dangerous
— even deadly — for people with diabetes because it messes up the body's ability to
keep blood glucose in a normal range. This can cause a very rapid drop in blood glucose
in people with diabetes. Drug or alcohol use is also dangerous because it may affect
someone's ability to sense low blood sugar levels.
You should also check your blood sugar — and treat hypoglycemia, if needed — before
you drive. Make sure you have some form of sugar handy in the car to use if you get
low at any time while driving. If you do feel low, immediately pull over safely to
the side of the road and treat your hypoglycemia — and don't start to drive again
until your symptoms are gone. You also should test your blood sugar before activities
during which a low blood sugar reaction could be especially dangerous, such as skiing,
swimming, or rock climbing.
Learning how to recognize the signs of low blood sugar levels and get them back
to normal is an important part of caring for diabetes. Keeping track of your blood
sugar levels and recording lows when they occur will help you and your diabetes health
care team keep your blood sugar levels in a healthy range.