Low Blood Glucose: What It Means and How to Manage It

What is low blood glucose?

Low blood glucose, also called hypoglycemia, is when your blood glucose, or blood sugar, drops lower than normal. It most commonly occurs in people with diabetes, when they take insulin or other medications that help control blood sugar levels. If it happens a lot, you can develop hypoglycemia unawareness, a condition where you might overlook low blood sugar signs like shakiness or irregular heartbeats. In very severe cases, untreated hypoglycemia might cause seizures, coma, or even death.

Early warning signs of low blood glucose

As your blood sugar falls, you may feel a number of symptoms.

• Weakness
• Shakiness
• Lightheaded and dizzy
• Sweating
• Sensation of hunger
• Nausea
• Irregular or rapid heartbeat

You may feel like it’s harder to focus or concentrate, and feel fatigue and low energy. Additionally, irritability or anxiety can creep in. It can also cause a headache. Lastly, you might experience tingling or numbness of your lips, tongue, or cheek.

Nighttime Signs and Symptoms

Low blood sugar in your sleep, also known as nighttime hypoglycemia, can disrupt your sleep without you realizing it. Some of the telltale signs of nighttime hypoglycemia include damp sheets or nightclothes due to perspiration.

You might experience nightmares that are more vivid than usual. Upon waking, you might feel groggy, irritable, or confused. If you notice these signs consistently, reach out to your healthcare professional. They can help diagnose the problem, and determine if you should use a continuous glucose monitor to monitor your blood glucose level better.

How is hypoglycemia diagnosed?

Yoru doctor will discuss symptoms with you. They also use a specific formula known as Whipple's triad to make a hypoglycemia diagnosis.

According to the American Diabetes Association, the Whipple's triad is pivotal in hypoglycemia diagnosis. This triad means that you must meet three conditions to be diagnosed with hypoglycemia.

1. Exhibiting Symptoms: You are experiencing symptoms typical of low blood sugar such as weakness, shakiness, or sweating.
2. Verification Through Tests: These symptoms occur during episodes of low blood glucose as verified by a laboratory test, not just a handheld glucose meter or continuous glucose monitor.
3. Symptom Resolution: The symptoms disappear when your blood sugar goes back to a normal range.

Certain diseases can mimic hypoglycemia symptoms, including postprandial syndrome and certain heart issues, so it’s important to get an accurate diagnosis.

Know Your Numbers

If you have any symptoms of low blood sugar, you’ll need to check your blood glucose levels. If you have diabetes, you’ll have the tools to do that. If you are having symptoms but you can’t check your blood glucose for any reason, treat the hypoglycemia anyway.

Your doctor may recommend continuous monitoring of blood glucose levels using tools like a glucose meter or a continuous glucose monitor. These devices provide real-time information about your blood glucose level, helping you track fluctuations and patterns.

What causes hypoglycemia?

Hypoglycemia can occur for various reasons, in people with and without diabetes. Understanding the causes can help you avoid low blood sugar in the future.

Possible causes of hypoglycemia without diabetes

Hypoglycemia in people without diabetes is less common, yet it does occur. It can be caused by a number of factors.

1. Medications: Specific medications, such as quinine, used for treating malaria, can trigger hypoglycemia. Other medications, if not taken correctly, especially by children or people with kidney disease, could cause low blood glucose levels.
2. Alcohol Consumption: Excessive drinking, particularly without sufficient food intake, can prevent the liver from discharging stored glucose into the bloodstream, leading to low blood sugar.
3. Critical Illnesses: Conditions like severe hepatitis, kidney disorders, and advanced heart disease can contribute to hypoglycemia. Kidney disorders can prevent proper medication processing, leading to a buildup of glucose-lowering drugs, and low blood sugar.
4. Long-term Starvation: Hypoglycemia could manifest in cases of long-term malnutrition and starvation, where your body struggles to create glucose from limited glycogen stores.

Possible causes of hypoglycemia with diabetes

For people with diabetes, especially those on glucose-lowering medications or insulin therapy, hypoglycemia is a common risk. Causes could include:

1. Inappropriate Insulin Doses: An excess insulin dose can drastically lower your blood sugar, causing hypoglycemia.
2. Insufficient Calories: If you're not consuming enough food, particularly carbohydrates, relative to your insulin dose, blood glucose could drop.
3. Over-exercise: Physical exertion utilizes energy and, without adequate food intake, can swiftly cause hypoglycemia.
4. Alcohol: Drinking alcohol, especially on an empty stomach, can block glucose production, leading to low blood sugar.

What should I do if my blood sugar is low?

Low blood sugar or hypoglycemia can pose a significant health risk, and it's essential to know how to respond appropriately. It's helpful to control your insulin dose, monitor your blood glucose level using a glucose meter or continuous glucose monitor, and follow the advice of healthcare professionals to manage this condition effectively. Here, we'll address two important treatment approaches: hypoglycemia occurring after meals, and the "15-15 Rule".

Hypoglycemia after meals

Hypoglycemia may strike after certain meals. This type of hypoglycemia, also known as reactive or postprandial hypoglycemia, could mean you're at an elevated risk of developing diabetes, especially type 2 diabetes, which is often linked with insulin resistance.

This after-meal plunge in blood sugar is usually linked with surgeries that interfere with the ordinary function of the stomach. Stomach bypass surgery is commonly associated with this, but it can also happen to people who have undergone other surgeries. See a healthcare professional if you are experiencing low-blood sugar symptoms after eating.

The "15-15 Rule"

If you're experiencing symptoms of low blood sugar, the American Diabetes Association recommends the "15-15 Rule." Here's how it's done:

1. Check your blood glucose level with a glucose meter. If it's below 70 mg/dL, proceed with the following steps.
2. Consume 15 grams of glucose or simple carbohydrates. Examples: glucose tablets/candies, fruit juice, or regular soda (not diet).
3. Review your blood glucose after 15 minutes. If it's still below 70 mg/dL, have another 15 grams of glucose or simple carbohydrates.
4. Repeat step 3 until your blood sugar registers at or above 70 mg/dL.

Remember, insulin therapy must always be customized to your needs. If you have frequent instances of hypoglycemia, consult with your healthcare professional. They might need to adjust your insulin dose or your meal planning.

When to see a doctor

If you have diabetes, you should be having regular appointments with your healthcare provider to make sure you’re managing your blood sugar levels effectively. If you’re having frequent low blood glucose, make an appointment as you may need to make adjustments to your medication or treatment plan. If you don’t have diabetes, but experience low blood sugar symptoms, see a healthcare provider to better understand what is causing your symptoms.

Summary

Low blood glucose, or hypoglycemia, is a serious condition that requires immediate attention. It's helpful to recognize the symptoms and understand the importance of regular monitoring with glucose meters or continuous glucose monitors. Remember, swift action is vital when your blood glucose levels dip below 70 mg/dL.

Frequently Asked Questions

What is the difference between hypoglycemia and hyperglycemia?

Hypoglycemia and hyperglycemia are both related to diabetes but represent different extremes of blood glucose levels. Hypoglycemia refers to low blood glucose, while hyperglycemia is high blood glucose. Both conditions demand immediate attention to prevent serious health complications.

What are the typical signs of hypoglycemia?

Common symptoms of hypoglycemia include confusion, dizziness, feeling shaky, hunger, headaches, irritability, pounding heart or irregular heartbeat, pale skin, sweating, trembling, and weakness. Hypoglycemia unawareness can also occur, where you don't feel symptoms of low blood sugar.

How are continuous glucose monitors useful in managing hypoglycemia?

Continuous glucose monitors can detect low blood glucose levels in real-time, helping to avoid the risk of hypoglycemia. They help in maintaining an optimal glucose level by providing insights on glucose trends that can notify individuals to take necessary preventive actions.

What could be the long-term complications of poor glucose management?

Improper management of diabetes can lead to serious complications like kidney disease and damage to blood vessels. It's important to adhere to recommended guidelines and regularly monitor blood glucose levels to prevent such complications.