Low Blood Sugar (Hypoglycemia)

Understanding, Managing, and Preventing Low Blood Glucose Levels

Endocrinology

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Last updated: Mar 24, 2025

What is Hypoglycemia?

Hypoglycemia occurs when blood glucose levels fall below 70 mg/dL (3.9 mmol/L). It's most common in people with diabetes but can affect others under certain conditions.

Common Symptoms

  • Mild to Moderate:

    • Shakiness or trembling
    • Sweating
    • Hunger
    • Rapid heartbeat
    • Anxiety or nervousness
    • Confusion
  • Severe:

    • Seizures
    • Loss of consciousness
    • Difficulty speaking
    • Blurred vision

Common Causes

  • Skipping or delaying meals
  • Taking too much diabetes medication
  • Intense physical activity
  • Alcohol consumption
  • Certain medications

Treatment

Immediate Actions (15-15 Rule)

  1. Consume 15 grams of fast-acting carbohydrates:
    • 4 glucose tablets
    • 4 oz (120ml) of fruit juice
    • 1 tablespoon of honey
  2. Wait 15 minutes
  3. Recheck blood sugar
  4. Repeat if necessary

Long-term Management

  • Regular blood sugar monitoring
  • Maintaining consistent meal schedules
  • Carrying quick-acting glucose
  • Wearing medical identification

Prevention

  • Follow medication instructions carefully
  • Eat regular, balanced meals
  • Monitor blood sugar before exercise
  • Keep a food/glucose diary
  • Work closely with healthcare providers

When to Seek Medical Help

  • Loss of consciousness
  • Inability to swallow safely
  • Symptoms that don't improve with treatment
  • Recurring episodes without clear cause

Special Considerations

  • Driving: Always check glucose before driving
  • Exercise: Monitor levels before, during, and after activity
  • Alcohol: Never drink on an empty stomach
  • Night-time: Consider checking blood sugar before bed

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