Hypoglycemia is when your body's blood sugar levels suddenly drop, causing various complications. Hypoglycemia is prevalent among patients with diabetes. However, some medications or factors may also result in low sugar level symptoms.
Did you know:
- 4 in 5 people with type 1 diabetes and nearly half of all people with type 2 diabetes who take insulin experience episodes or symptoms of hypoglycemia. 1
- According to a global study across 24 countries, Latin America had the highest rates of hypoglycemia events among individuals with type 1 diabetes, while Russia had the highest rates for those with type 2 diabetes. 2
- Low blood sugar symptoms and episodes are more common in women than in men, which could be due to differences in the distribution of fat, hormones, and slower glucose absorption.3
What is Hypoglycemia (Low Blood Sugar)?
Fasting blood sugar levels below 70 mg/dL can be considered hypoglycemic. While blood sugar levels can drop for several reasons, the incidence of this condition is higher in diabetic patients undergoing insulin treatment. Hypoglycemia is not a constant condition. It stems from sugar level fluctuations. However, it can cause several other complications and be fatal.
Hence, knowing low blood sugar symptoms and immediately treating them is crucial to avoiding similar, repeated episodes. If you're suffering from one or more symptoms of low blood sugar, here's what you need to know:
What is Dangerously Low Blood Sugar?
As mentioned earlier, blood sugar levels below 70 mg/dL are lower than the clinically accepted normal blood sugar range. However, blood sugar levels that fall to 54 mg/dL or even lower can be concerning and demand immediate medical attention. 4
Low Blood Sugar Symptoms
Low blood sugar can cause several complications, which include the following:
- Shakiness or Trembling: Trembling is one of the most common low blood sugar symptoms people experience. When blood sugar levels drop too low, it can cause the body to release stress hormones like adrenaline, leading to trembling or shakiness. If you're facing shakiness, often with a rapid heartbeat, it could be your body's way of showing you symptoms of low blood sugar.
- Sweating: Excessive sweating, particularly cold sweats, can be a sign of low blood sugar. It is another response triggered by the release of stress hormones in an attempt to raise blood sugar levels. In other words, your body produces more adrenaline by reducing blood sugar levels. This fight-or-flight hormone then narrows down blood vessels, leading to excessive sweating. 5
Sweating issues are, however, not just a low blood sugar symptom. People with diabetes experience various kinds of sweating, including hyperhidrosis, gustatory sweating, and night sweats.
- Dizziness or Light-headedness: Dizziness or light-headedness is a symptom of low sugar levels. You may experience it with a sensation of spinning or instability. When your blood sugar levels are low, every part of your body does not receive the glucose percentage required for functioning, and the same happens to your brain. 6 Thus, the lack of glucose and energy makes you feel dizzy.
- Confusion or Difficulty Concentrating: Low sugar symptoms can lead to various cognitive difficulties. The brain heavily relies on glucose for energy to function, and insufficient energy supply can result in neuronal death. This condition is called hypoglycemic brain damage. Though hypoglycemic brain damage occurs at a very advanced stage, initial low sugar level symptoms can include confusion and difficulties in speaking. 7
- Weakness or Fatigue: If you experience a sudden loss of energy, leaving you feeling fatigued, then there's a chance you're experiencing one of the low blood sugar symptoms. It occurs because glucose is the primary energy source for the body's cells, and low blood sugar levels can affect overall energy levels.
Weakness is one of the most common symptoms of low blood sugar levels and can serve as an initial indication of declining glucose levels. In extreme cases or during a sudden, rapid decline, low blood sugar can lead to temporary unconsciousness.
- Headaches: Low blood sugar levels can trigger headaches or migraines in some individuals. This occurs due to the brain's increased sensitivity to changes in glucose levels, leading to vascular changes and subsequent headache symptoms. If you're experiencing frequent headaches that go away after you eat, it might be because of low blood sugar, which is prevalent in diabetic patients. Low blood sugar could potentially do more harm to your brain than any other organ and, hence, must be taken care of immediately.
- Blurred Vision: One of the well-known signs of low blood sugar is vision changes, such as blurred vision or double vision, which keep happening throughout the episodes of hypoglycemia. It is often temporary and resolves once blood sugar levels return to normal. 8
However, if your blood sugar levels constantly fluctuate from low to normal, it can lead to prolonged periods of blurred vision due to the changes in your lens.
- Irritability or Mood Changes: Low sugar levels can affect mood and behaviour, leading to irritability, mood swings, or heightened emotional responses. These symptoms occur due to alterations in brain chemistry resulting from glucose deprivation.
- Hunger: Hunger might often seem straightforward, but excessive hunger could be one of the symptoms of low sugar levels. The triggering hunger could be the body's way of signalling the need for more glucose to raise blood sugar levels. Individuals experiencing low blood sugar may feel intense hunger or cravings for sugary foods.
- Nausea or Vomiting: Nausea or vomiting are also low blood sugar symptoms that are commonly known. It can occur due to the release of stress hormones or as a response to the body's attempt to regulate blood sugar levels.
- Palpitations or Rapid Heartbeat: Low blood sugar can lead to palpitations or a rapid heartbeat. It occurs due to the body's release of adrenaline, which can increase heart rate and blood pressure and raise blood sugar levels.
- Anxiety or Panic Attacks: In severe cases of hypoglycemia, individuals may experience feelings of anxiety or even panic attacks. It can occur due to the body's stress response to low blood sugar levels, triggering intense emotional reactions.
Complications of Low Blood Sugar
While low sugar symptoms might not be as threatening initially, even short-term episodes can damage vital organs and potentially lead to serious consequences. Here are some complications one might face with low blood sugar:
- Multi-organ failure: Multi-organ failure is a condition in which two or more organs of your body fail to perform their functions, which can be fatal. It is one of the most severe symptoms of hypoglycemia. It occurs when the organs fail to receive the glucose or energy required to function.
Remember, the longer the period of low sugar levels, the higher the chances of multi-organ failure. One can also suffer from multi-organ failure after several repeated episodes of hypoglycemia.
- Cardiac arrhythmias: A cardiac arrhythmia is a situation in which the heart's normal rhythm is affected. Low blood sugar has a very close relationship with cardiac arrhythmias, as the fluctuation of sugar levels disrupts the heart's rhythm. It is also one of the most common symptoms of hypoglycemia.
- Cardiac Arrest: Hypoglycemia can lead to cardiac arrest through various mechanisms. When blood sugar levels drop too low, the body's stress response is activated, releasing hormones like adrenaline. 9
While adrenaline helps raise blood sugar levels, in severe hypoglycemia, it can cause the heart to beat faster and more irregularly, leading to arrhythmias. These abnormal heart rhythms can disrupt the heart's ability to pump blood effectively, potentially leading to cardiac arrest, where the heart stops beating.
- Coma: When blood sugar levels fall too low, the brain, which relies heavily on glucose for energy, becomes deprived of its primary fuel source. As a result, brain function becomes impaired, leading to confusion, disorientation, and loss of consciousness.
In severe cases of hypoglycemia, the brain may enter a state of coma, where it is unable to function. Consequently, the individual is unresponsive to external stimuli. Coma can occur when the brain is severely deprived of glucose for an extended period, leading to a shutdown of normal brain activity. Hence, coma is also one of the well-known advanced-level symptoms of hypoglycemia.
- Brain Damage: Prolonged or severe hypoglycemia can lead to brain damage due to the brain's dependence on glucose for energy. Neurons, the cells that make up the brain, require a constant supply of glucose to function properly. 10
When blood sugar levels drop too low, neurons may not receive an adequate supply of glucose, leading to dysfunction or cell death. Depending on the severity and duration of the hypoglycemic episode, this can result in various forms of brain damage, ranging from mild cognitive impairment to permanent neurological deficits.
- Death: Untreated severe hypoglycemia, with blood sugar levels remaining critically low, can be life-threatening. Without an adequate supply of glucose, vital organs such as the brain and heart cannot function properly.
Prolonged hypoglycemia can result in organ failure as cells throughout the body lack the energy necessary to sustain essential processes. If untreated, severe hypoglycemia can lead to irreversible damage to vital organs and, ultimately, systemic collapse, resulting in death.
What Causes Hypoglycemia (Low Blood Sugar) in People with Diabetes?
Though there might be other reasons for low sugar symptoms, it is prevalent in people with diabetes. Here are some of the possible causes indicating why hypoglycemia is common among diabetic patients: 11
- Insulin intake: Diabetic patients often take insulin shots to maintain their blood sugar levels. However, if the insulin levels in their bodies increase, blood sugar levels drop suddenly. Hence, it is vital to monitor their blood sugar levels to ensure they don't fluctuate often, and you must take necessary precautions if they do.
- Consumption of less carbs: Diabetic patients generally avoid or reduce the intake of carbs to keep their glucose levels under control. However, if you're taking diabetes medications and do not take enough carbs, your body's glucose level might fall further, leading to hypoglycemia.
What Causes Hypoglycemia in People Without Diabetes?
While most commonly associated with diabetes, hypoglycemia, or low blood sugar symptoms, can also occur in people without the condition. This non-diabetic hypoglycemia arises from several factors:
- Underlying Medical Conditions: Certain medical issues can disrupt blood sugar regulation, leading to hypoglycemia.
- Inconsistent Eating: Frequent skipping of meals can significantly impact blood sugar levels and cause hypoglycemia.
- Excessive Alcohol Consumption: Alcohol can interfere with the liver's ability to release glucose, leading to a drop in blood sugar.
Diagnosis and Tests of Hypoglycemia
The best method to prevent hypoglycemia is by checking for diabetes. If diagnosed, closely monitor blood glucose levels. A sugar profile test can help determine if you have diabetes and assess your overall glucose levels. However, you can also go for the diabetes mellitus type 2 test or the diabetes type 1 test to check the kind of diabetes you have, followed by consulting a healthcare professional.
We have often heard questions like "Is diabetes genetic?" and whether you can develop it if someone in your family is already a diabetes patient. While there are several studies and research conducted on the same, there is significant proof indicating a higher prevalence of type 2 diabetes amongst patients who have a family history of the same.
Moreover, you must also check for gestational diabetes mellitus, which can occur during your pregnancy and is often hereditary. Remember, even if you do not have any symptoms of diabetes or a family history of the condition, you might be prone to prediabetes. Hence, it is always advisable to keep your blood sugar levels under check and closely monitor the changes, if any.
Treatment and Management of Hypoglycemia
Hypoglycemia, or low blood sugar, can be a frightening experience. However, with prompt intervention and effective management strategies, you can regain control and prevent future episodes. Prompt treatment and management are crucial to avert complications such as seizures, loss of consciousness, and even coma. The best approach to preventing hypoglycemia is by following a list of lab tests for diabetes patients provided by your healthcare professional, or by consulting with your doctor if you experience symptoms of low blood sugar.
The primary treatment for hypoglycemia is the consumption of fast-acting carbohydrates to raise blood sugar levels quickly. Examples include glucose tablets, fruit juice, regular soda, or candies like glucose tablets or hard candies. Follow up with a snack or meal containing protein and complex carbohydrates to sustain blood sugar levels.
For individuals at risk of severe hypoglycemia or those unable to treat themselves, glucagon injections may be necessary. Glucagon is a hormone that raises blood sugar levels rapidly. A caregiver or a family member can easily administer it. 12 But without the recommendation of the doctor, it should not be taken.
Prevention is vital to managing hypoglycemia. It involves balancing medication doses with meals and physical activity, monitoring blood sugar levels regularly, and recognising early signs of low blood sugar, such as sweating, trembling, or dizziness. Moreover, taking superfoods for diabetes prevention can also help you reduce episodes of hypoglycemia.
Education is crucial for individuals experiencing symptoms of low blood sugar or diabetes, as well as for their caregivers, to comprehend the risk factors, symptoms, and proper management strategies for hypoglycemia.
On top of education, keeping a good check on your sugar levels is pivotal, whether you are going for something as specific as an HbA1c blood test or a complete blood test package. Healthcare providers may adjust medication regimens, provide personalised meal plans, and offer guidance on lifestyle modifications to minimise the occurrence of low blood sugar episodes.
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