Managing Low Blood Sugar

by:  Susan Klick, MSN, RN, CNL

Do You Know How to Manage a Low Blood Sugar?

A recent online survey of both Type I and Type 2 diabetes revealed that many are uncertain of how to prevent and manage hypoglycemia (low blood sugar). Avoiding alcohol as a way to prevent hypoglycemia was reported by 30% of the participants and 49% were unaware that glucose tablets could be used to treat an episode. Forty-two percent of participants who had never experienced hypoglycemia were unable to correctly define what it is. Let’s take a look at the What – When – Why – and How of low blood sugar.

WHAT IT IS: Hypoglycemia or low blood sugar occurs when the blood glucose drops below the normal level. For most people, a blood glucose reading below 70 mg/dl is considered below normal.

WHEN IT OCCURS: Hypoglycemia happens when there is not enough glucose in your blood to provide the energy your body needs. You may experience symptoms when the level of blood sugar in your body falls below its normal range. This may happen if you do not eat enough food at a meal or a snack, or if you skip a meal. It may happen if you take more insulin or diabetes medicine than needed for the food that you eat. It may also occur if you exercise or are more active than usual. Drink alcohol without eating food can also cause hypoglycemia.

WHY IT IS DANGEROUS: This condition is dangerous because your brain is not getting enough glucose (sugar) to work properly. If there is not enough glucose for your brain to function, you may pass out or even have convulsions.

HOW TO RECOGNIZE HYPOGLYCEMIA: A low blood glucose reaction brings on uncomfortable feelings.  Mild symptoms occur in the early stage and include sudden hunger, headache, shaking, fast heartbeat, sweating, feeling tired or drowsy, feeling dizzy, having blurry vision, nervousness, and/or numbness or tingling around the mouth and lips. If not treated, you may experience symptoms of moderate hypoglycemia which can include personality change, irritability, confusion, poor coordination, difficulty concentration, and slurred or slow speech. If the reaction is still not treated, and your blood glucose continues to fall, you may pass out or develop convulsions. This is severe hypoglycemia and will require emergency treatment.

Some people have what is called “Hypoglycemia Unawareness,” a condition in which you lose the ability to feel the symptoms of low blood glucose until the blood glucose is very low. The first symptom may be confusion or passing out. This can occurs in diabetics who keep their blood glucose very close to normal or who have had diabetes for many years. It may be the result of having many episodes of low blood glucose.

HOW TO TREAT HYPOGLYCEMIA:   Check your blood sugar if you think it may be low or if you are experiencing symptoms. If your symptoms make you very uncomfortable and you feel that you do not have the time to check your blood glucose, eat first and then immediately check your blood sugar. If your blood glucose is less than 70 mg/dl:

  1. Treat with 15 grams of carbohydrates (4 oz. juice, 3 glucose tablets, ½ can soda, 8 Lifesavers)
  2. Wait 15 minutes and retest. It takes about 15 minutes for the sugar to raise your blood glucose level.
  3. If your blood glucose is less than 60 mg/dl, treat with another 15 grams of carbohydrates.
  4. If your next meal is more than an hour away, eat a snack of 15 more grams of carbohydrate and one ounce of protein (i.e. five crackers and one ounce of low fat cheese, half of a ham or turkey sandwich)

There may be times when your blood sugar is not low, but has dropped rapidly from a very high level to a lower level. Your body is reacting to the quick drop, not the actual level. You do not want to treat a normal blood glucose and cause it to rise above normal. However, continue to pay attention to your symptoms and your blood sugar. If the symptoms become worse or your blood sugar continues to drop, eat a snack with carbohydrates and protein such as crackers and peanut butter, crackers with cheese, half of a ham or turkey sandwich, or a cup of milk with cereal.

Note: Candy bars, ice cream and chocolate are not good choices for treating hypoglycemia.   Foods with fat or protein will not raise your blood glucose fast enough.

HOW TO PREVENT HYPOGLYCEMIA: The best ways to prevent hypoglycemia are to:

  1. Eat on time
  2. Make sure you eat enough food for the medication you are taking
  3. Do not drink alcohol without eating food
  4. Take your medication on time
  5. Be prepared. Always carry some form of carbohydrate (glucose tablets, juice, hard candy) in the event that a meal is delayed or you are more active than usual.


Healio Endocrine Today:   Survey: People with diabetes uncertain about management of hypoglycemia January 20, 2015.

BD Getting Started: Hypoglycemia and Diabetes


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