Preventing Low Blood Sugar
Judy Seybold, MS, RDN, LD, CLC
Chief Nutrition Officer
Feeling jittery, irritable, or hungry with blurred vision can be a sign of low blood sugar. Hypoglycemia, often called low blood sugar, is usually related to the treatment of diabetes but can occur in people without diabetes. Blood sugar (glucose) is your body's energy source. In the absence of diabetes, hypoglycemia can be a result of other underlying health conditions. Know that hypoglycemia is a condition, not a disease.
For people with diabetes, blood sugar levels vary throughout the day depending on a variety of factors such as activity, food intake, and medications. When blood sugar falls too low (generally under 70mg/dl), immediate action is needed to bring it back to normal levels.
Causes without Diabetes
Hypoglycemia in people without diabetes is not very common, but it can happen for many reasons such as excessive alcohol intake, underlying critical illness, hormone deficiencies, insulin overproduction, and medications.
Causes with Diabetes
Hypoglycemia is common in type 1 diabetes but can still occur in people with type 2 diabetes taking insulin or certain medications. A person with 1ype 1 diabetes may experience up to two episodes of mild low blood sugar with symptoms each week. Here are some causes of hypoglycemia:
Food:
- Not enough carbohydrates
- Eating less carbohydrates while not adjusting insulin
- Not adjusting insulin timing based on the source of carbs (liquid vs. food) – liquids are absorbed faster than solids
- Skipping or delaying a meal
- Drinking too much alcohol without food
Insulin:
- Too much insulin
- Injecting the wrong insulin type
- Injecting directly into the muscle instead of just under the skin
Physical activity:
- Increased intensity
- Increased duration
Signs and Symptoms
Awareness of signs and symptoms of hypoglycemia is the best way to prevent it from being a severe hypoglycemic event. These symptoms should alert you to check your blood sugar:
- Blurred vision
- Coordination issues
- Confusion
- Crying
- Headaches
- Hunger
- Irritability
- Nausea
- Rapid heartbeat
- Seizures
- Sleepiness
- Sweating
Treatment – “15-15 Rule”
Checking blood sugar levels is the only way to tell if they are too low. If blood sugar falls under 70 mg/dL, you want to treat it. If you have symptoms but are unable to check your blood sugar, go ahead and treat it.
Treat yourself with 15 grams of carbohydrate to raise your blood sugar. Re-check it 15 minutes. Be sure to have a fast-acting carbohydrate with you to treat low blood sugar before it drops to dangerous levels:
- Hard candies – read the label to get 15g of carbohydrate
- ½ cup of fruit juice
- 2 Tbsp. raisins
- 1 Tbsp. honey, sugar or corn syrup
- Gel tube – dose according to package instructions
- Glucose tabs – dose according to package directions
If it’s still below 70 mg/dL, then treat it again. Repeat this until blood sugar is at least 70 mg/dl. Once it is back to normal, then eat a meal or a snack.
If hypoglycemia isn’t treated, then glucagon injections are needed. Your doctor should advise on the use of glucagon as a treatment for severe hypoglycemia.
Prevention
Good self-management and awareness of symptoms of hypoglycemia is the best prevention. It’s important to detect and treat it as soon as possible so it doesn’t lead to a severe hypoglycemia. Studies show that the more a person tests their blood sugar, the lower the risk for hypoglycemia. Frequent checking enables you to catch lower levels before they get too low. Continuous glucose monitors can also alert you to hypoglycemia.
Suggested times to check:
- Before and after meals
- Before and after exercise
- During exercise, if it is intense, long duration, or frequency has increased
- Before bed
- During the night if you have exercised intensely as it can drop too low when you are sleeping and unable to recognize symptoms
- When your insulin or work routine has changed
- When your work schedule has changed
Work with your health care provider or registered dietitian to help determine the cause of hypoglycemia. Keep records of food intake, blood sugar, insulin, and exercise so you can see patterns in low blood sugar. Your registered dietitian nutritionist can also help you develop a healthy eating pattern based on the information you provided that promotes stable blood sugar levels.
Shop Sifter for products that help promote stable blood sugar levels
Additional Resources
American Diabetes Association
Mayo Clinic
National Institute of Diabetes and Digestive and Kidney Disease