When blood glucose levels (called blood sugar levels) drop too low, it's called hypoglycemia. For people with diabetes, hypoglycemia (hi-poe-gly-SEE-me-uh) happens when blood sugar levels fall below the healthy range set by their doctor. Show
A blood sugar level slightly lower than the healthy range might not cause symptoms. But very low blood sugar levels can cause severe symptoms that need medical treatment right away. What Are the Signs & Symptoms of Hypoglycemia?Mild hypoglycemia can cause such symptoms as:
Severe hypoglycemia can also cause these symptoms:
Teach your child about the symptoms of low blood sugar and what to do. Even young kids who can't describe their symptoms can learn to tell an adult when they don't feel well. Help your child understand that they need treatment when they don’t feel well. And explain how to find an adult who can help them. Some people with diabetes can't sense the early warning signs of low blood sugar. They may not recognize they need quick treatment. This can lead to more serious symptoms as blood sugar levels continue to fall. If you think your child can’t sense what low blood sugar feels like, tell the diabetes care team. What Causes Hypoglycemia?Hypoglycemia can happen for different reasons. Anyone with diabetes can get low blood sugar, even people who follow their care plan carefully. Sugar levels can drop if your child:
How Is Hypoglycemia Diagnosed?The only way to know for sure if someone has low blood sugar is to test their blood. If you think your child has hypoglycemia, test it if you can. But if you can’t do this quickly, it's important to treat them right away to prevent symptoms from getting worse. How Is Hypoglycemia Treated?When blood sugar levels are low, the goal is to get them back up into the healthy range quickly. Here are the basic steps to follow if your child is alert and awake:
You can repeat these steps until the blood sugar level is in the healthy range. If your child cannot keep down juice or food, can’t wake up or is having a seizure, give glucagon right away. Then call 911. Do not give anything by mouth until they are awake and alert. After getting glucagon, your child will be more alert and feel better within 15 minutes. When your child is alert enough to eat, give sugary food or drink to help prevent their blood sugar from falling again. If you give your child glucagon, tell the doctor who manages your child’s diabetes that you gave it. An episode of severe low blood sugar could be a sign that the diabetes care plan needs to be changed. Call your diabetes team if your child is having frequent low blood sugars. Their diabetes plan may need to be adjusted to help prevent future episodes. How Can Parents Help?Nearly every child with diabetes will have an episode of mild hypoglycemia at times. Rarely, an episode will be a serious emergency. You can help make this less likely, and be ready if it does happen. Here are some tips:
If you have questions about how to prevent or treat hypoglycemia, or about the diabetes care plan, call your child's diabetes health care team. Hypoglycemia refers to low levels of sugar, or glucose, in the blood. Hypoglycemia is not a disease, but it can indicate a health problem. All cells within the body, including in the brain, need energy to function. Glucose supplies energy, and the hormone insulin enables the cells to absorb and use it. In severe cases, low blood sugar, or glucose, may lead to coma and death. Hypoglycemia can occur with several conditions, but it most commonly happens as a reaction to diabetes medications, such as insulin. People with diabetes use insulin to treat high blood sugar. This article explains hypoglycemia, including its symptoms and treatment options. Share on PinterestFaintness can be an early sign of hypoglycemia. Hypoglycemia happens when there is not enough glucose, or sugar, in the blood. The National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that symptoms usually appear when blood sugar levels are below 70 milligrams per deciliter (mg/dl). However, this number can vary between individuals. People can check with their doctor to find out their personal level of low blood sugar. People with low blood sugar may want to use a blood glucose meter — a small, portable machine that monitors blood sugar levels. Some monitors sound an alarm if levels drop below a certain level. People can purchase blood glucose monitors online or discuss with their healthcare team. Learn about home blood glucose monitors and how to use them here. People with mild hypoglycemia may experience the following common symptoms:
Severe hypoglycemia may involve:
ComplicationsIf a person does not take action, they may have:
Severe hypoglycemia can be life threatening, and in rare cases, may lead to death without treatment. Someone who regularly experiences hypoglycemia may be unaware that it is happening or getting worse. They may not notice the warning signs, which may lead to severe and possibly fatal complications. People may experience hypoglycemia for reasons including:
Blood sugar regulationThe digestive system breaks down carbohydrates from food. One of the molecules this creates is glucose, the body’s main energy source. Glucose enters the bloodstream after we eat. Insulin, a hormone the pancreas produces, then allows cells in the body to absorb glucose. This means that even if plenty of glucose is available in the bloodstream, cells will starve of energy without insulin. After eating, the pancreas automatically releases the right amount of insulin to allow cells to absorb enough glucose from the bloodstream. As glucose enters the cells, blood sugar levels fall. Any extra glucose goes into the liver and muscles in the form of glycogen, or stored glucose. The body can use this glucose later when it needs more energy. Insulin is responsible for bringing high blood sugar levels back to normal. If glucose levels fall because an individual has not eaten for a while, the pancreas secretes glucagon, another hormone, which triggers the breakdown of stored glycogen into glucose. The body then releases the glycogen into the bloodstream, bringing glucose levels back up. If people take insulin and inject too much, it can cause cells to absorb excess glucose from the bloodstream, leading to low blood sugar. Hypoglycemia and diabetesBoth type 1 and type 2 diabetes involve a problem with insulin. The American Diabetes Association (ADA) classes low blood sugar as less than 70 mg/dl. In both types of diabetes, the cells do not get enough energy from glucose. People with type 1 diabetes and some with type 2 diabetes need to take insulin or other medications to reduce their blood sugar levels. If the insulin dose is too high, blood sugar levels can fall too far, leading to hypoglycemia. Hypoglycemia can also occur if the person exercises more than usual or does not eat enough. A person does not need to increase their dose to have too much insulin in their body. It may be that the insulin they took was more than their body needed at that moment. According to the NIDDK, insulin and two other diabetes medications — sulfonylureas and meglitinides — can result in hypoglycemia. Learn about insulin resistance here. Hypoglycemia in children: Pediatric ketotic hypoglycemiaSome children experience pediatric ketotic hypoglycemia, a condition involving low blood sugar levels and high levels of ketones. If people do not have enough glucose to use as energy, the body begins to break down fat in the body instead. The body produces chemicals called ketones as a by-product of breaking down fat. According to a 2019 study, pediatric ketotic hypoglycemia usually occurs due to poor intake of food, a gastrointestinal illness and vomiting, or a period of prolonged fasting. Severe metabolic and hormonal conditions may also cause pediatric ketotic hypoglycemia. Pediatric ketotic hypoglycemia may affect children from 6 months old and often resolves after the age of 6 years. SymptomsSymptoms of hypoglycemia in infants and children may include:
If a child shows any of the above signs or symptoms, a doctor should examine them as soon as possible. Insulin autoimmune syndromeAnother possible cause of hypoglycemia is insulin autoimmune syndrome, a rare disease that happens when the body’s immune system attacks insulin, mistaking it for an unwanted substance. Symptoms tend to appear suddenly, according to the Genetic and Rare Diseases Information Center (GARD). Symptoms often go away after a few months, but they can return if blood sugar levels drop. Symptoms and treatment are similar to those for hypoglycemia due to other causes. Treatment can usually control the symptoms. Anybody with symptoms of hypoglycemia and does not know the underlying cause will need to consult with a doctor. A doctor may:
Whipple’s triadA collection of three criteria, known as Whipple’s criteria, can suggest that symptoms stem from a pancreatic tumor. The three criteria of Whipple’s triad are as follows:
During a doctor’s appointment, a person may not have symptoms. The doctor may ask them to fast for a time, usually overnight. This allows hypoglycemia to occur so that the doctor can make a diagnosis. Some people may have to spend time in the hospital and fast for longer. If symptoms appear after eating, they will need another glucose test after food. Learn more here about pancreatic cancer. A person who notices the signs of hypoglycemia should consume 15–20 grams (g) of carbohydrates or glucose, such as:
They should then check blood sugar levels after 15 minutes, and eat another snack and repeat until their blood sugar levels are within a normal range. After this, people can eat slower-release carbohydrates, such as cereal, bread, rice, or fruit. People will also need to seek treatment for any underlying cause. For diabetesA person with diabetes can follow the 15:15 rule. They will need to check their blood sugar, treat the hypoglycemia with 15g of carbohydrate, and then wait 15 minutes and recheck their levels. If their blood sugar levels are still low, the person should repeat the process. They should eat some glucose, wait about 15 minutes, then recheck their blood sugar. People with diabetes may need to follow regular eating times to help keep blood sugar levels stable. Severe symptomsIf symptoms are severe, and the individual cannot treat themselves, somebody else will need to give them glucagon through an injection or via the nose. People will usually regain consciousness within 5–15 minutes but may then experience nausea or vomiting. Losing consciousnessIf the person loses consciousness, someone will need to place them in the recovery position and administer a glucagon injection. If this is not possible, people will need to call 911 immediately. It is important not to place food or drink into the mouth of an unconscious person, as it could block the airways. Do not drive with low blood sugarPeople will need to avoid driving while they have low blood sugar levels as it could be dangerous. People will need to wait until their levels return to within a normal range before driving. If people start to experience symptoms of hypoglycemia while driving, they will need to safely stop the car and check their blood sugar levels. People may find it helpful to store quick-acting carbohydrates, such as orange juice or glucose tablets, in their car if their levels drop while driving. If people have hypoglycemia or diabetes, they can discuss an eating plan with a healthcare provider. Tips may include the following:
Learn about counting carbs with diabetes here. Preventing hypoglycemia will depend on the underlying cause. Managing the underlying condition can help to avoid hypoglycemia. There are steps people can consider that may help. These include:
Hypoglycemia can lead to symptoms such as dizziness, weakness, and, in severe cases, a loss of consciousness. People with some medical conditions, including diabetes, may have a higher risk of hypoglycemia. It is important for people to know how to recognize the symptoms and be ready to take action if they occur. Consuming carbohydrates or glucose when blood sugar levels drop can help return them to a normal range. Last medically reviewed on December 6, 2021
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