Signs and symptoms of low blood sugar in adults

Symptoms

Most people feel symptoms of hypoglycemia when their blood sugar is 70 milligrams per deciliter (mg/dL) or lower.

Each person with diabetes may have different symptoms of hypoglycemia. You'll learn to spot yours.

Early symptoms include:

• Confusion
• Dizziness
• Feeling shaky
• Hunger
• Headaches
• Irritability
• Pounding heart; racing pulse
• Pale skin
• Sweating
• Trembling
• Weakness
• Anxiety

Without treatment, you might get more severe symptoms, including:

• Poor coordination
• Poor concentration
• Numbness in mouth and tongue
• Passing out
• Seizures
• Nightmares or bad dreams
• Coma

Diabetes Drugs Linked to Hypoglycemia

Ask your doctor if any of your medicines can cause low blood sugar.

Insulin treatment can cause low blood sugar, and so can a type of diabetes medications called "sulfonylureas."

Commonly used sulfonylureas include:

• Glimepiride (Amaryl)
• Glipizide (Glucotrol)
• Glibenclamide (Glyburide, Micronase)

Older, less common sulfonylureas tend to cause low blood sugar more often than some of the newer ones. Examples of older drugs include:

• chlorpropamide (Diabinese)
• tolazamide (Tolinase)
• tolbutamide (Orinase)

You can also get low blood sugar if you drink alcohol or take allopurinol (Zyloprim), aspirin, probenecid (Benemid, Probalan), or warfarin (Coumadin) with diabetes medications.

You shouldn't get hypoglycemia if you take alpha-glucosidase inhibitors, biguanides (such as metformin), and thiazolidinediones alone, but it can happen when you take them with sulfonylureas or insulin.

Diet and Hypoglycemia

You can get low blood sugar if you take too much insulin for the amount of carbohydrates you eat or drink.

For instance, it can happen:

• After you eat a meal that has a lot of simple sugars
• If you miss a snack or don't eat a full meal
• If you eat later than usual
• If you drink alcohol without eating any food

Don't skip meals if you have diabetes, particularly if you're taking diabetes medications.

Treatment

If you have diabetes and think you have hypoglycemia, check your blood sugar level.

Do your levels often drop after meals that include a lot of sugars? Change your diet. Avoid sugary foods, and eat frequent small meals during the day.

If you get low blood sugar when you haven't eaten, have a snack before bedtime, such as a protein or a more complex carbohydrate.

In cases of severe hypoglycemia, you may require an injection of baqsimi, dasiglucagon (Zegalogue), or glucagon injection (Gvoke).

Your doctor may find that you take too much insulin that peaks toward the evening-to-morning hours. In that case, they may lower your insulin dose or change the time when you get your last dose of it.

When You Have Low Blood Sugar

First, eat or drink 15 grams of a fast-acting carbohydrate, such as:

• Three to four glucose tablets
• One tube of glucose gel
• Four to six pieces of hard candy (not sugar-free)
• 1/2 cup fruit juice
• 1 cup skim milk
• 1/2 cup soft drink (not sugar-free)
• 1 tablespoon honey (put it under your tongue so it gets absorbed into your bloodstream faster)

Fifteen minutes after you've eaten a food with sugar in it, check your blood sugar again. If your blood sugar is still less than 70 mg/dL, eat another serving of one of the foods listed above. Repeat these steps until your sugar becomes normal.

If You Pass Out

Hypoglycemia may make you pass out. If so, you'll need someone to give you a glucagon injection.

Glucagon is a prescription medicine that raises blood sugar, and you may need it if you have severe hypoglycemia. It's important that your family members and friends know how to give the injection in case you have a low blood sugar reaction.

If you see someone having a severe hypoglycemic reaction, call 911 or take them to the nearest hospital for treatment. Do not try to give an unconscious person food, fluids, or insulin, as they may choke.

Do Not Drive When You Have Low Blood Sugar

It's very dangerous. If you're driving and you have hypoglycemia symptoms, pull off the road, check your blood sugar, and eat a sugary food. Wait at least 15 minutes, check your blood sugar, and repeat these steps if necessary. Eat a protein and carbohydrate source (such as peanut butter crackers or cheese and crackers) before you drive on.

What does it feel like when your blood sugar is too low?

What is the most common cause of low blood sugar?

How do you know if your blood sugar is low without diabetes?