Ana Maria Kausel, MD, is a double board-certified endocrinologist affiliated with Mount Sinai St. Luke's/Mount Sinai West in New York City.
Hypoglycemia (low blood sugar) is a condition that occurs when the glucose level in your blood drops too low. It is usually related to having diabetes, but it can be caused by other factors and conditions, such as medications, drinking too much alcohol, critical illnesses, or hormone deficiencies. Although rare, certain tumors can cause hypoglycemia.
Blood glucose below 70 milligrams per deciliter (mg/dL) is considered hypoglycemia for those with diabetes, according to the American Diabetes Association. Blood glucose of 70 mg/DL is considered falling glucose for those without diabetes, and the tipping point for hypoglycemia can also vary from person to person.
For people without diabetes, hypoglycemia can not be diagnosed solely based on blood sugar level, and not by a home test. These individuals should undergo a lab test to determine their blood glucose level. A hypoglycemia diagnosis can be made if their blood glucose level is less than 55 mg/DL and they have symptoms of hypoglycemia.
Common symptoms of hypoglycemia include shakiness, fast heartbeat, sweating, headache, and fatigue.
There can be a variety of causes. In people with diabetes, it can happen from not eating enough or frequently enough, during or after exercise, or by taking too much insulin or medication. In those without diabetes, it can be caused by drinking too much alcohol, taking certain medications that lower blood sugar, critical illnesses, hormone deficiencies, or an overproduction of insulin.
In mild cases, it can be treated with glucose tablets or high-sugar foods or drinks every 15 minutes as needed to stabilize blood sugar. In severe cases (including loss of consciousness) in those with diabetes, prescription drugs that contain the hormone glucagon, which triggers a release of stored glucose, can be used. If blood sugar levels do not go up, urgent medical attention is needed.
Common symptoms include shakiness, a fast heartbeat, sweating, fatigue, anxiety, and hunger. If blood glucose drops dangerously low, symptoms such as confusion, vision problems, behavioral changes, slurred speech, seizures, or loss of consciousness can occur.
Those with diabetes can use their blood glucose meter to check if their blood sugar has dropped below 70 mg/dL. Those without diabetes who have symptoms of hypoglycemia, especially recurring symptoms, should see a physician who can run blood tests, ask about your medical history, and do a physical exam to try to determine the underlying cause of the hypoglycemia.
Carbohydrates are nutrients that break down into glucose in the body. They can include sugar, starches, and fiber. Those with diabetes need to monitor their carbohydrate intake. Simple carbohydrates (table sugar, fruit, milk) are digested rapidly into glucose and complex carbohydrates (whole grains, vegetables) are digested more slowly for a more steady rise in blood sugar.
These are glucose monitors that offer continuous feedback and blood sugar readings 24-hours a day. Most monitors have a small sensor inserted under the skin to give readings about every 5 minutes. CGMs can be used by people with diabetes to closely track blood sugar levels to check patterns and fluctuations in real-time.
Glucose is the main sugar in the blood that’s a major source of fuel for the body’s cells. Those with diabetes can help manage blood glucose levels by adjusting their diet and food choices. The hormone insulin helps control levels in the blood. If blood sugar is too high or too low it can lead to serious medical problems.
Hypoglycemia unawareness is when your brain becomes less able to recognize hypoglycemia and it does not produce symptoms. This can occur over time with diabetes and may happen at night. It is more common in type 1 diabetes than in type 2. Regular daily glucose monitoring is important in order to detect hypoglycemia unawareness.
American Diabetes Association. Hypoglycemia (Low Blood sugar).
American Heart Association. Carbohydrates. Updated April 16, 2018.
U.S. Centers for Disease Control and Prevention. Insulin resistance and diabetes. Updated August 12, 2019.
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
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