Low blood sugar: Recognising and Managing Hypoglycemia

Hypoglycemia, or low blood sugar, may occur in anyone and is a particular concern for people with diabetes. When blood glucose levels drop below the normal range, the body may experience a variety of symptoms that could escalate quickly if not recognised and managed properly in time.¹

While treatment and prevention of high blood sugar often take centre stage in diabetes management, hypoglycemia is an equally important concern. Knowing what may cause low blood sugar, identifying the symptoms, and understanding how to respond effectively could help improve safety and well-being.

Why is recognising low blood sugar important?

Hypoglycemia is a condition in which blood glucose levels reportedly fall below 70 mg/dL². This drop may occur for a number of reasons, including skipping or delaying meals, over-exercising, excessive alcohol consumption, or high intake of insulin or diabetes medication.

Though anyone may experience a hypoglycemic episode, it may be more frequently seen in individuals with diabetes who are taking insulin or other specific oral medications. Hypoglycemia may result in unconsciousness, seizures, or—in rare cases—even death if left unmanaged. Early detection may be important, as symptoms can progress quickly.¹

What are the signs of low blood sugar?

Awareness may be the first step in recognising hypoglycemia. The body typically provides warning signals when blood sugar levels are falling. Signs and symptoms can vary between individuals but may include the following:

• Shivering
• Crankiness or sudden changes in mood
• Feeling tired or weak
• Sweating
• Hunger
• Feeling lightheaded
• Blurred vision
• Pounding/irregular heartbeat
• Feeling jittery or anxious
• Headaches

In extreme cases, individuals may have confusion, trouble speaking, lack of muscle coordination, or even lose consciousness.¹

Not all patients may present the same symptoms and over time, due to repeated episodes, some may not feel any symptoms at all. This phenomenon is called ‘hypoglycemia unawareness’ (HU), which may make regular blood glucose monitoring an important consideration. Please consult your healthcare provider for personalised monitoring guidance.²

How to confirm and manage hypoglycemia

Management may begin with measurement. The first step to addressing low blood sugar is often to confirm it using a blood glucose test. Self‐Monitoring of Blood Glucose (SMBG) using a good quality glucometer may provide timely and reasonably accurate results. Devices that meet ISO standards are generally designed to offer a higher degree of precision, so users can respond accordingly, in consultation with their healthcare provider.

Once low blood sugar is confirmed (i.e., below 70 mg/dL), a commonly recommended approach is the“15-15 rule”:

1. Consume 15 grams of fast-acting carbohydrates, such as:

• Glucose tablets
• 1/2 cup (120 ml) of juice or regular soft drink
• 1 tablespoon of sugar or honey
• Hard candies (check carb count)

2. Wait 15 minutes and recheck your blood sugar. If it is still below 70 mg/dL, you may repeat the steps.³

Once your blood sugar appears to stabilise, it may help to have a snack or meal to reduce the chances of it dropping again, especially if your next meal is likely to be delayed. Please consult your healthcare provider for guidance tailored to your individual needs.

Preventing future episodes

Hypoglycemia may sometimes be prevented by understanding and recognising patterns. Here are some considerations:

• Test frequently: Regular monitoring of your blood glucose may help identify trends and reduce the likelihood of unexpected lows.
• Avoid skipping meals: Timely consumption of meals may be important, particularly after taking insulin or medication.
• Be cautious with activity: Exercise and other strenuous activities might lower blood sugar levels. It may help to monitor your glucose levels before and after such activity.
• Limit alcohol: Alcohol could interfere with your body’s ability to maintain stable glucose levels and may mask the early symptoms of hypoglycemia.
• Reassess your medication: If you’re experiencing frequent low blood glucose episodes, consider discussing your treatment plan with your healthcare provider to explore possible adjustments.⁴

Understanding how your body responds to different triggers, and making appropriate lifestyle changes in collaboration with your healthcare provider, may help reduce the risk of future hypoglycemic episodes.

Educating family, friends and care-givers

For individuals at risk of hypoglycemia, there may be times when they cannot assist themselves if blood sugar drops significantly. It is also common to experience confusion or mental fog, which could interfere with judgment and response to a given situation.

During such times, it may be helpful for people in their life, such as family members, friends, coworkers, caregivers, or teachers, to understand how to respond to low blood sugar episodes. They could be encouraged to learn how to recognise symptoms, check blood sugar, and follow appropriate steps in case of an emergency.

You may also wish to help them understand how to use a glucometer, for example: inserting the test strip, using a lancet to prick the finger, and placing a drop of blood on the strip for a reading. Please consult your healthcare provider for guidance on how to train others safely.

Keeping a glucometer, test strips, and a spare set of batteries in an easily accessible spot (like a bag, desk drawer, or first-aid kit) may help enable timely checks when needed.

When to seek medical help

Severe hypoglycemia may be life-threatening and may require urgent professional intervention. If the person is unconscious, having a seizure, or unable to swallow, avoid giving them food or drink, and consider calling for emergency medical assistance without delay.

People who experience frequent or severe hypoglycemia may benefit from glucagon emergency kits or from the use of continuous glucose monitors (CGM). These options are best discussed with a healthcare provider to determine what may be appropriate for their individual needs.

Final word: Test timely, choose wisely

Managing hypoglycemia may be more than just reacting to physical symptoms, it could involve building a more proactive relationship with your health. This includes being mindful of all the factors that might influence your glucose levels: the foods you consume, medications, stress levels, and sleep quality. Even a small change in routine, like a delay in breakfast or an unusually intense workout, may contribute to an unexpected dip in blood glucose levels.

Recognising these subtle patterns may help individuals take timely, informed action in consultation with their healthcare provider, potentially reducing the risk of hypoglycemia and supporting overall diabetes management.

Remember: Management begins with measurement. Test timely, choose wisely.

References:

1. https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar
2. https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes
3. https://www.cdc.gov/diabetes/treatment/treatment-low-blood-sugar-hypoglycemia
4. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia

(Disclaimer: The above article is created by our branded content team in partnership with Roche Diabetes Care India Pvt. Ltd. The article is intended for informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Health Shots does not endorse or assume responsibility for the product, service, or information presented. Readers are encouraged to consult their healthcare professional for medical advice.)