People with diabetes sometimes experience drops in their blood sugar levels. Although blood sugar spikes and drops are usual throughout the day, it becomes a concern when levels fall too low.
Doctors refer to this condition as diabetic hypoglycemia, or hypoglycemia in diabetes.
Hypoglycemia means blood sugar, or glucose, levels fall below the normal range. If left untreated, hypoglycemia can be dangerous and may require emergency medical treatment.
This article takes a closer look at hypoglycemia in diabetes, along with symptoms, causes, and prevention.
Hypoglycemia can happen to anyone, but people with diabetes are more likely to experience it.
This may range from mild hypoglycemia with minimal or no symptoms to severe hypoglycemia where blood sugar levels fall below 40 milligrams per deciliter (mg/dl).
Symptoms of hypoglycemia may begin at different blood sugar levels, depending on the person and circumstances.
Since hypoglycemia in diabetes can occur without warning, it is important for people to be aware of the signs and symptoms. It is vital to act quickly.
Some early signs of hypoglycemia may include:
- feeling nervous, anxious, or irritable
- sudden sweating or chills
- lightheadedness or feeling dizzy
- drop in energy levels
- rapid heartbeat
- blurred or impaired vision
The American Diabetes Association (ADA) also lists other less common signs of hypoglycemia. These include:
- color draining from the skin
- tingling or numbness in the lips, tongue, or cheeks
- coordination problems or clumsiness
- feeling sleepy
If two or more of the above symptoms are present, people should immediately check their blood sugar levels.
Symptoms at night
Hypoglycemia in diabetes can happen at anytime. People are at a higher risk of developing low blood sugar at night if they:
- are physically active close to bedtime
- drink alcohol at night
- take too much insulin
Symptoms to look out for at night include:
- crying out during sleep
- intense sweating
- feeling tired or irritable on waking up
The biggest concern with hypoglycemia at night is that blood sugar levels can stay low for several hours, increasing the risk of complications.
When blood sugar levels drop to a dangerously low level, this may affect organ function. Severe hypoglycemia in diabetes is also commonly called diabetic shock.
Severe symptoms include:
- slurred speech
- difficulty walking or seeing clearly
- loss of consciousness
When there are no symptoms
People are more likely to experience hypoglycemia unawareness if they:
- have had diabetes for over 5–10 years
- have frequent bouts of low blood sugar
- take certain medicines, such as beta-blockers for hypertension
According to the CDC, a blood sugar level
Seeking medical attention as soon as possible is crucial.
The American Diabetes Association (ADA) recommends treating low blood sugar levels that are less than 70 mg/dl.
Anyone experiencing frequent hypoglycemia should contact their doctor for medication regimen adjustment.
If a person is experiencing severe symptoms, it is best for someone to call emergency services immediately. A person with diabetes should also explain to family and friends how to respond to a case of severe hypoglycemia.
According to the
- have type 1 diabetes
- are 65 years or older
- take insulin or other diabetes medications that can cause low blood sugar
Hypoglycemia in diabetes can occur due to:
- diabetes medicines such as insulin, sulfonylureas, or meglitinides
- medication overdose
- insufficient carbohydrates at mealtime
- fasting or skipping meals
- increased physical activity
- drinking too much alcohol
The CDC also lists some
- hot and humid weather
- unexpected changes in daily schedule
- spending time at a high altitude
Mild and moderate hypoglycemia in diabetes is often treatable. But severe hypoglycemia increases the risk of serious complications, such as:
- loss of consciousness
- hypoglycemia unawareness
- heart disease
- neurological impairment
The most effective way to prevent hypoglycemia in diabetes is to regularly monitor blood sugar levels. The ADA calls this the “tried and true method”.
Regular monitoring can alert a person to unusual drops in blood sugar levels before the situation becomes serious.
There are several ways to help prevent hypoglycemia in diabetes. These include a person:
- checking their levels before and after meals
- checking their levels before and after exercise or intense physical activity
- checking levels immediately if mild symptoms appear
- performing quick checks if woken up during the night
- checking levels more frequently if habits or lifestyles change, such as during travel
- eating meals on time
- ensuring a healthy balance of nutrients in every meal
- avoiding exercising late in the day or close to bedtime
- eating a snack or meal if drinking alcohol
- taking medicines on time in the correct dosage
While it is rarer, hypoglycemia can also occur in people without diabetes. This can be due to medicines or food habits that affect the body’s ability to regulate glucose, or sugar.
Some conditions or situations that raise a person’s risk are:
- taking certain medicines, such as antibiotics or antimalarial treatment
- kidney or liver conditions
- disorders of the adrenal or pituitary gland
- stomach surgery
- enzyme deficiencies
- drinking too much alcohol
- congenital hypoglycemia in infants
Hypoglycemia in diabetes is a common condition in people with diabetes, where blood sugar levels drop below the healthy or normal range.
This leads to symptoms such as shakiness, sweats, disorientation, and in serious cases, seizures, coma, and even death. Most cases of hypoglycemia in diabetes are treatable at home.
However, severe hypoglycemia needs emergency care at a hospital to prevent long-term complications.
People with diabetes should be alert to the signs and symptoms of hypoglycemia. They should aim to monitor their blood sugar levels regularly so they can treat hypoglycemia quickly.