2/11/2017 HypoglycemiaLowBloodGlucose(BloodSugar):AmericanDiabetesAssociation

American Diabetes Association

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Arlington, VA 22202
1-800-DIABETES (800-342-2383)

Hypoglycemia (Low Blood Glucose)

Hypoglycemia is a condition characterized by abnormally low blood glucose (blood sugar) levels,
usually less than 70 mg/dl. However, it is important to talk to your health care provider about your
individual blood glucose targets, and what level is too low for you.

Hypoglycemia may also be referred to as an insulin reaction, or insulin shock.

Hypoglycemic symptoms are important clues that you have low blood glucose. Each person's
reaction to hypoglycemia is different, so it's important that you learn your own signs and
symptoms when your blood glucose is low.

The only sure way to know whether you are experiencing hypoglycemia is to check your blood
glucose, if possible. If you are experiencing symptoms and you are unable to check your blood
glucose for any reason, treat the hypoglycemia. Severe hypoglycemia has the potential to cause
accidents, injuries, coma, and death.

Signs and Symptoms of Hypoglycemia (happen

quickly)
Shakiness
Nervousness or anxiety
Sweating, chills and clamminess
Irritability or impatience
Confusion, including delirium
Rapid/fast heartbeat
Lightheadedness or dizziness
Hunger and nausea
Sleepiness
Blurred/impaired vision
Tingling or numbness in the lips or tongue
Headaches
Weakness or fatigue
Anger, stubbornness, or sadness
Lack of coordination
Nightmares or crying out during sleep
Seizures
Unconsciousness

Treatment
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Treatment
1. Consume 15-20 grams of glucose or simple carbohydrates
2. Recheck your blood glucose after 15 minutes
3. If hypoglycemia continues, repeat.
4. Once blood glucose returns to normal, eat a small snack if your next planned meal or
snack is more than an hour or two away.

15 grams of simple carbohydrates commonly used:

glucose tablets (follow package instructions)
gel tube (follow package instructions)
2 tablespoons of raisins
4 ounces (1/2 cup) of juice or regular soda (not diet)
1 tablespoon sugar, honey, or corn syrup
8 ounces of nonfat or 1% milk
hard candies, jellybeans, or gumdrops (see package to determine how many to consume)

Glucagon
If left untreated, hypoglycemia may lead to a seizure or unconsciousness (passing out, a coma).
In this case, someone else must take over.

Glucagon is a hormone that stimulates your liver to release stored glucose into your bloodstream
when your blood glucose levels are too low. Injectable glucagon kits are used as a medication to
treat someone with diabetes that has become unconscious from a severe insulin reaction.
Glucagon kits are available by prescription. Speak with your health care provider about whether
you should buy one, and how and when to use it.

The people you are in frequent contact with (for example, family members, signicant others, and
coworkers) should also be instructed on how to administer glucagon to treat severe hypoglycemic
events. Have them call 911 if they feel they can't handle the situation (for example, if the
hypoglycemic person passes out, does not regain consciousness, or has a seizure, if the care
taker does not know how to inject glucagon, or if glucagon is not available).

If glucagon is needed:

1. Inject glucagon into the individual's buttock, arm or thigh, following the manufacturer's
instructions.
2. When the individual regains consciousness (usually in 5-15 minutes), they may
experience nausea and vomiting.
3. If you have needed glucagon, let your health care provider know, so they can discuss
ways to prevent severe hypoglycemia in the future.

Do not:

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Inject insulin (will lower blood glucose even more)

Provide food or uids (individual can choke)
Put hands in mouth (individual can choke)

Hypoglycemia Unawareness
Very often, hypoglycemia symptoms occur when blood glucose levels fall below 70 mg/dl. But,
many people have blood glucose readings below this level and feel no symptoms. This is called
hypoglycemia unawareness. People with hypoglycemia unawareness are also less likely to be
awakened from sleep when hypoglycemia occurs at night.

Hypoglycemia unawareness occurs more frequently in those who:

frequently have low blood glucose episodes (which can cause you to stop sensing the early
warning signs of hypoglycemia)
have had diabetes for a long time
tightly control their diabetes (which increases your chances of having low blood glucose
reactions)

If you think you have hypoglycemia unawareness, speak with your health care provider. Your
health care provider may adjust/raise your blood glucose targets to avoid further hypoglycemia
and risk of future episodes.

Other Causes of Symptoms

Other people may start to have symptoms of hypoglycemia when their blood glucose levels are
higher than 70 mg/dl. This can happen when your blood glucose levels are very high and start to
go down quickly. If this is happening, discuss treatment with your health care provider.

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Diabetes Basics: Hypoglycemia and Hyperglycemia

Medical IDs
Many people with diabetes, particularly those who use insulin, should have a medical ID with them
at all times.

In the event of a severe hypoglycemic episode, a car accident, or other emergency, the medical ID
can provide critical information about the person's health status, such as the fact that they have
diabetes, whether or not they use insulin, whether they have any allergies, etc. Emergency medical
personnel are trained to look for a medical ID when they are caring for someone who can't speak
for themselves.

Medical IDs are usually worn as a bracelet or a necklace. Traditional IDs are etched with basic, key
health information about the person, and some IDs now include compact USB drives that can
carry a person's full medical record for use in an emergency.

How Can I Prevent Low Blood Glucose?

Your best bet is to practice good diabetes management and learn to detect hypoglycemia so you
can treat it earlybefore it gets worse.

If you're new to type 2 diabetes, join our free Living With Type 2 Diabetes program to get help and
support during your rst year.

Featured Book Set

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Managing Your Diabetes Glucose (http://www.shopdiabetes.org/534-SET-

Managing-Your-Diabetes-Glucose.aspx?loc=hypog&source=dorghypog)
(http://www.shopdiabetes.org/534-SET-Managing-Your-Diabetes-
Glucose.aspx?loc=hypog&source=dorghypog) A money-saving
four-book set with tips and techniques to help you manage
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ADA Blood Glucose Log Book

Stay organized and on track with this handy logbook.

Guide to Insulin and Type 2 Diabetes

Advice, support, and practical tips to help you t insulin into
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Complete Guide to Carb Counting, 2nd ed

Fully updated and with nearly 8,000 menu and food items.

Diabetes Carbohydrate & Fat Gram Guide, 4th ed.

Includes a whole week of meal plans, and much more.

Last Reviewed: June1,2015

Last Edited: July1,2015

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