Type 2 Diabetes Hypoglycemia Hypoglycemia Guide Hypoglycemia Guide Symptoms Causes Diagnosis Treatment How Hypoglycemia Is Diagnosed By by Cynthia Perkins, M.Ed. Medically reviewed by Medically reviewed by Ana Maria Kausel, MD on September 02, 2020 facebook twitter Ana Maria Kausel, MD, is double board-certified in internal medicine and endocrinology/diabetes and metabolism. She works in private practice and is affiliated with Mount Sinai St. Luke's/Mount Sinai West. Learn about our Medical Review Board Ana Maria Kausel, MD Updated on October 14, 2020 Print Table of Contents View All Table of Contents Self-Checks/At-Home Testing Labs and Tests Differential Diagnoses Next in Hypoglycemia Guide Discover How Hypoglycemia Is Properly Treated Diagnosing hypoglycemia when you have diabetes is simple: if your blood sugar is <70 milligrams per deciliter (mg/dL) or below as determined by your blood glucose meter, you need to treat it immediately with fast-acting carbohydrates. The American Diabetes Association defines severe hypoglycemia as blood sugar less than 54 mg/dL. If you don't have diabetes, hypoglycemia is 55mg/dL. If you have symptoms of hypoglycemia, your doctor will need to figure out the cause, starting with a blood test. Similar to when you have a fever, having low blood sugar is not a disease, it's a condition that indicates that something else is going on in your body. Verywell / Laura Porter Self-Checks/At-Home Testing If you're a person with diabetes, especially when you're newly diagnosed and beginning treatment, you will likely encounter episodes of hypoglycemia on occasion. Check your blood sugar with a blood glucose meter if you begin to experience any of the following symptoms of hypoglycemia: ShakinessIrritabilityConfusionTachycardia (elevated heart rate)Hunger If your blood sugar reading is 70 mg/dL or below, you will need to treat it right away with fast-acting carbohydrates such as three to four glucose tablets, half a banana, or a granola bar. Labs and Tests If you do not have diabetes, schedule a visit with your doctor if you keep having symptoms of hypoglycemia. Your doctor will do a physical exam, medical history, and ask you questions about your symptoms. Blood Tests Your doctor will need to see if your blood glucose level is low when you're having symptoms. If you have symptoms of hypoglycemia after you eat, your doctor may have you come back after a meal to check your blood glucose. Your doctor may have your blood drawn and sent to the lab to analyze your insulin levels and/or other substances in your blood. Glucose enters cells with help from insulin and glucose transporters. If you do have hypoglycemia, the cause can be as simple as a medication you're taking that can lead to low blood sugar, like the antibiotic Bactrim (sulfamethoxazole and trimethoprim), beta blockers, monoamine oxidase inhibitors (MAOIs), or Haldol (haloperidol), or the result of an alcohol binge. If it's not due to medications or alcohol, your doctor may do additional testing to find out what the underlying cause is, such as a hormonal deficiency or an illness like kidney disease or hepatitis. Differential Diagnoses If you don't have diabetes and you have symptoms of hypoglycemia yet your blood sugar levels are normal, there's something else going on. In fact, there's a long list of conditions that your symptoms could be attributed to. The most common non-diabetes causes include: Cardiac diseaseMedication side effectsA mental health disorder like generalized anxiety disorderA metabolic disorder like hyperthyroidism Your doctor may do additional testing to look for the cause of your symptoms depending on what they are and your family and medical history. If you have diabetes and your blood glucose levels are too low, but you have few or no symptoms, it is probably due to hypoglycemia unawareness. When you have repeated episodes of hypoglycemia, you can stop showing symptoms. In this case, the hypoglycemia commonly happens at night when you're unaware that your glucose levels have dropped. A continuous glucose monitor can be helpful to detect hypoglycemia, especially at night, because it alerts you when your levels get too high or too low. Your doctor will also work with you to get your levels under control so this stops happening. Even two to three weeks of avoiding hypoglycemia can restore your body's awareness. Discover How Hypoglycemia Is Properly Treated Was this page helpful? Thanks for your feedback! We know healthy eating is key to help manage diabetes, but that doesn't make it easy. Our free nutrition guide is here to help. Sign up and receive your free copy! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S66-S76. doi:10.2337/dc20-S006 Kishnani PS, Austin SL, Abdenur JE, et al. Diagnosis and management of glycogen storage disease type I: a practice guideline of the American College of Medical Genetics and Genomics. Genet Med. 2014;16(11):e1. doi:10.1038/gim.2014.128 Desimone ME, Weinstock RS. Non-Diabetic hypoglycemia. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext. Updated September 23, 2017. Kalra S, Mukherjee JJ, Venkataraman S, et al. Hypoglycemia: The neglected complication. Indian J Endocrinol Metab. 2013;17(5):819-34. doi:10.4103/2230-8210.117219 Additional Reading Martín-Timón I, del Cañizo-Gómez FJ. Mechanisms of hypoglycemia Unawareness and implications in diabetic patients. World Journal of Diabetes. 2015;6(7):912-926. doi:10.4239/wjd.v6.i7.912. Mayo Clinic. Hypoglycemia. Mayo Clinic Staff. Updated February 16, 2018. Service FJ, Cryer PE, Vella A. Hypoglycemia in adults: Clinical manifestations, definition, and causes. UpToDate. Updated March 14, 2017. Hormone Health Network. Nondiabetic Hypoglycemia. Endocrine Society. Updated October 2017.