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Everyday Health
10 Warning Signs of Low Blood Sugar
By By Moira Lawler. Medically Reviewed by Elise M. Brett, MD,
13 hours ago
For most people, a blood sugar level of 70 milligrams per deciliter or below is considered hypoglycemia. iStock
If you're living with diabetes, you know how important it is to reduce blood sugar when it is too high, a phenomenon called hyperglycemia . But blood sugar that is too low, or hypoglycemia , is equally critical to avoid.
While type 2 diabetes doesn't increase a person's hypoglycemia risk on its own, those who take insulin or medications that increase insulin production can experience low blood sugar, according to Harvard Medical School. If people who take medication to boost insulin skip a meal, eat fewer carbs than normal, or engage in more physical activity than usual, they risk low blood sugar. "Hypoglycemia happens when the amount of blood glucose (sugar in the blood) drops to a level that's too low to sustain normal functioning," says Erin Palinski-Wade, RD, CDCES , who is based in Sparta, New Jersey. "In most people, doctors define hypoglycemia as a blood sugar level at or below 70 milligrams per deciliter (mg/dL)."
What Does Low Blood Sugar Mean in People with Diabetes?
According to a review of studies, around 1 in 4 people who took insulin for over five years experienced an episode of severe low blood sugar . This decrease in blood sugar levels can cause both short-term complications , like confusion and dizziness, as well as more serious issues, including seizures, coma, and, rarely, death, according to the American Diabetes Association (ADA). To prevent hypoglycemia and its potentially dangerous side effects, Mayo Clinic recommends monitoring your blood sugar levels and treating low blood sugar as soon as you become aware of it. A continuous glucose monitor (CGM) can warn people who take insulin about oncoming low blood sugar so they can take action and prevent severe episodes. Most people who need to take insulin would benefit from a CGM, as upcoming hypoglycemic events trigger an alarm.
Also, pay attention to these telltale symptoms of dipping blood sugar levels to make sure yours stays under control.
1. Ravenous Hunger
If you suddenly, inexplicably feel as if you're extremely hungry, your body is signaling that it's experiencing a blood sugar drop, according to the Cleveland Clinic. You can manage your blood sugar by counting your carbohydrate intake and understanding the different types and food sources, notes the ADA. The "right" amount of carbs for each person depends on a variety of factors, so you should work with your dietitian or certified diabetes care and education specialist to determine what's right for you.
2. Feelings of Anxiety
When glucose levels fall too low, your body releases the hormones epinephrine (also called adrenaline) and cortisol , which signals the liver to release more sugar into the blood, notes Harvard Medical School. Hypoglycemia can lead to shakiness, sweating, and heart palpitations. Panic attacks share these symptoms, per the Cleveland Clinic. Sudden, severe feelings of anxiety or panic could point to low blood sugar. However, according to the ADA, a fear of low blood sugar may cause severe anxiety for around 1 in 7 people with types 1 and 2 diabetes. In turn, this can affect emotional wellness, quality of life, and diabetes management, contributing to worse diabetes complications.
3. Restless Nights
Doctors use the term "nocturnal hypoglycemia" to refer to blood glucose levels dropping below 70 mg/dl at night. This accounts for about half of all low blood glucose episodes and can cause a number of sleep problems, according to John Hopkins Medicine.
"Symptoms include night sweats , nightmares, episodes of waking suddenly and crying out, and feelings of unrest and confusion upon waking," says Palinski-Wade. "A snack before bed can reduce the frequency and severity of sleep disturbances."
Ideally, your blood sugar reading should be between 90 and 150 mg/dL before rest, according to Joslin Diabetes Center.
4. Shakes and Tremors
According to a study published in 2023, shaking is a common symptom of hypoglycemia, especially in people with diabetes. The study authors reported research that found 71 percent of a small sample of older adults with diabetes experienced tremors during hypoglycemic events. In response to hypoglycemia, the body releases hormones like adrenaline and noradrenaline. These increase blood sugar levels, but they also trigger some of early symptoms of hypoglycemia such as sweating, palpitations, and tremors.
5. Sweating
Sweating is usually one of the first signs of hypoglycemia . Just like tremors, sweating links to a spike in adrenaline and noradrenaline, which increases as glucose levels drop . Up to 84 percent of people with diabetes experience sweating when they're hypoglycemic , according to research. And according to Kaiser Permanente, sweating is almost always present during low blood sugar episodes but should go away shortly after a person consumes sugar.
6. Lightheadedness
When your blood sugar is low, your brain tries to preserve as much energy as possible. You may feel lightheaded as a result. If you experience this common symptom of hypoglycemia, Mayo Clinic recommends treating the hypoglycemia quickly with 15 to 20 grams (g) of fast-acting carbs, such as juice. Try to lie down, too. If the lightheadedness keeps up for more than 15 minutes, it's time to seek medical help.
7. Difficulty Concentrating
The brain relies on blood sugar for energy, so if there's a drop in glucose, your brain may not function at full capacity. That can make it difficult to concentrate on one thing at a time. Repeated instances of severe hypoglycemia risks long-term brain damage, especially around spatial learning and memory, according to a study published in 2018.
If you suddenly start experiencing vision problems, a drop in blood sugar may be the culprit. The reduced brain function that contributes to concentration problems may also lead to blurred vision and can even contribute to seizures and loss of consciousness. According to the Optometrists Network, blurred vision is one of the earliest hypoglycemia symptoms. It might affect a single eye or both. However, correcting blood sugar levels will often restore normal vision.
9. Slurred Speech and Poor Coordination
Your sugar-starved brain may change the way you sound. Slurred speech is a common symptom associated with blood sugar levels that drop below 40 mg/dL, notes Mayo Clinic. Combined with clumsy movements - another sign of low blood sugar - you may seem as though you've had a few too many cocktails, even if you haven't touched a drop, according to the U.K.'s National Health Service.
What to Do During a Hypoglycemic Episode
If you have diabetes and experience symptoms of low blood sugar, or blood glucose shows below 70 mg/dL, quickly eat or drink 15 g of carbohydrates to increase blood glucose. Wait 15 minutes, and test your level again - doctors refer to this as the 15-15 rule. Repeat this until blood glucose reaches a minimum of 70 mg/dL. Once your blood sugar is above 70 mg/dL and symptoms improve, eat something to sustain normal blood sugar levels, such as cookies, a sandwich, or your next scheduled meal. Doctors should also prescribe a glucagon emergency rescue kit for people who are using insulin in case they are unable to take sugar by mouth. A caregiver can administer glucagon and arouse them and potentially save their lives. Glucagon is available by injection and by nasal spray and is a hormone that the pancreas produces to trigger blood glucose release from the liver. Supplementing glucagon can help when blood sugar is dangerously low.
The Takeaway
Hypoglycemia affects the body by causing shaking, sweating, blurred vision, and mood changes. People with low blood sugar may feel suddenly anxious, lightheaded, or hungry.
Recognizing the signs of hypoglycemia can support the return of blood sugar levels to normal as well as a person's overall diabetes treatment plan. Speak to a physician about the best way to manage your blood sugar levels long-term.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Edridge CL, Dunkley AJ, Bodicoat DH, et al. Prevalence and Incidence of Hypoglycaemia in 532,542 People With Type 2 Diabetes on Oral Therapies and Insulin: A Systematic Review and Meta-Analysis of Population Based Studies. PLoS One . June 10, 2015.
Aucoin M, Bhardwaj S. Generalized Anxiety Disorder and Hypoglycemia Symptoms Improved With Diet Modification. Case Reports in Psychiatry . July 14, 2016.
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