For those with type 1 diabetes, here are several tips for preventing low
blood sugar – and what to do if your blood sugar drops.
Type 1 diabetes is a common chronic condition in which a person's pancreas
stops producing insulin, a hormone that enables people to obtain energy
from food. Without insulin, sugar builds up in the blood and can reach
dangerous levels. Since this condition is incurable, people with type
1 diabetes must take insulin for their entire lives to avoid life-threatening
For people with type 1 diabetes, low blood sugar (hypoglycemia) results
from there being too much insulin and not enough sugar (glucose) in the
blood. Hypoglycemia is defined as a blood sugar level that falls below
70 milligrams per deciliter (mg/dL). It's important for diabetics
to monitor their blood sugar levels regularly, and to pay attention to
early warning signs of low blood sugar. And parents of children with type
1 diabetes need to be especially vigilant. To read more about what parents
should know about type 1 diabetes, click
“Symptoms of diabetic hypoglycemia can differ from person to person,“ says
Chesda Eng, MD, a board-certified internal medicine physician at
St. Joseph Heritage Medical Group. “The signs and symptoms can also change depending on time of day
or specific triggers, so there isn’t one standard we can apply across
the board. Some people don’t even have symptoms at all, or fail
to recognize them. This is why it’s important for patients to educate
themselves on the kinds of symptoms that may occur, and to see their doctors
for a full examination and course of treatment.”
A number of factors can cause hypoglycemia in people with diabetes, especially
the ways in which insulin or other diabetes medications are used:
- Taking too much insulin or other diabetes medication
- Taking medications at the wrong time
- Not adjusting one’s dose before exercise
- Exercising more than usual, or at odd hours
- Not eating enough during meals, or skipping meals altogether
- Waiting too long after a dose to have a meal
Early Warning Signs
Diabetics should pay attention to the early warning signs, so they can
treat low blood sugar promptly. Early signs and symptoms of diabetic hypoglycemia
Diabetic hypoglycemia can also happen during sleep. Signs of nighttime
hypoglycemia include damp sheets due to perspiration, disturbed sleep
due to nightmares, tiredness or confusion on waking.
If this condition goes untreated, severe diabetic hypoglycemia can occur.
Signs and symptoms include blurry vision, slurred speech, clumsy or jerky
movements, weakness, drowsiness, confusion – even seizures, unconsciousness
How to prevent low blood sugar
If you are a diabetic, you should carry glucose tablets or gel at all times,
and wear a continuous glucose monitor (CGM). You should also:
Eat on a schedule. The primary reason diabetics seek emergency treatment for hypoglycemia
is taking insulin and then not eating.
Get enough sleep. Studies suggest sleepiness can be linked to hypoglycemia.
Watch physical activity levels. Hard exercise can lower blood glucose, therefore insulin or amount of
food may need to be adjusted.
If you have questions about any of these symptoms and methods, write them
down and talk with your doctor about them.
What to do if Your Blood Sugar Drops
“If you are experiencing symptoms of low blood sugar, you essentially
need to consume some fast-acting carbohydrates,” says Dr. Eng. “When
your blood glucose measures out at 70 mg/dl or less, follow the ‘rule
- Take 15 grams of carbohydrates, such as half a cup of soda or fruit juice.
Alternatively, you can take four glucose tablets (available over-the-counter
in pill or gel form from the pharmacy).
- Wait 15 minutes, then test blood glucose again.
- If the results are still too low, eat or drink another 15 grams of carbohydrates.
- Wait 15 minutes, and retest.
- Repeat as necessary until your blood sugar rises to a safe range.
- Contact your doctor or emergency physician if you cannot stabilize your
When to see a Doctor
Hypoglycemia can leave patients too confused to help themselves -- or
even to fall unconscious, which requires emergency intervention. It is
important for diabetics to keep family, friends and co-workers informed
on what to do should certain situations arise.
If the patient can’t swallow, or loses consciousness:
- They should not be given food or liquids, as they can cause choking
- They will need an injection of glucagon, which allows sugar to be released
into the blood
- When a glucagon injection isn’t available, the patient will need
emergency treatment in a hospital
Experts agree that diabetics should learn all the symptoms, keep alert
to them, and take their symptoms seriously.
“Diabetic hypoglycemia is not something to be taken lightly, as
it can lead to dangerous complications,” says Dr. Eng. “As
a patient, you can help yourself stay healthy by identifying the factors
that are contributing to your hypoglycemia and correcting them. This can
be as simple as things like keeping mealtimes regular and being careful
about when you take your medications, or creating a personal schedule
and writing down your doctor’s instructions."
“But if you are experiencing symptoms of hypoglycemia often -- more
than once a week -- you need to consult with your doctor,” adds
Dr. Eng. “Your medication or dosage may need adjustment, or your
overall treatment program reviewed and revised. Remember, your doctor
is there to help. When it comes to hypoglycemia, diabetics shouldn’t
try to go it alone.”
Learn more about
Dr. Eng. Learn more about
St. Joseph Heritage Medical Group.
Have you ever experienced symptoms of diabetic hypoglycemia? Share your
This information is not intended as a substitute for professional medical
care. Always follow your healthcare professional's instructions.