What is hypoglycemia?

Hypoglycemia is when a person has low blood sugar.  Blood sugar is thought to be low when it falls below 70 mg/dl.  Some people may experience symptoms of hypoglycemia at blood sugar levels greater than 70 mg/dl.

How would I know if my blood sugar is low?

Symptoms of low blood sugar (hypoglycemia) include:

• Sweating,
• Becoming Shaky,
• Feeling Hungry,
• Headache or Light-headed, and
• Irritable or Crabby.

If a person does not treat the symptoms above the blood sugar will fall lower and they may become:

• Confused,
• Very tired, or
• Unconscious (pass out).

How can my blood sugar go too low?

Hypoglycemia can happen when a person is taking oral medications or insulin to lower the blood sugar and treat their diabetes. Specifically, blood sugars can go too low when a person:

• Takes too much insulin,
• Exercises too long or too hard,
• Drinks alcohol,
• Does not eat enough food,
• Eats a meal later than usual, or
• Skips a meal.
 
How do I treat low blood sugar?

Do not delay in treating low blood sugar.  If you feel your blood sugar is low you need to treat it as soon as possible.  If your meter is nearby and you are able to check your blood sugar, please do so.  If you feel low and are not able to check your blood sugar quickly, please treat yourself.  It is better to have your blood sugar go a little high than to have it go too low. 

You will want to treat your low blood sugar by eating or drinking something that contains quick-acting sugar with 15 grams of total carbohydrate per serving.  Fifteen grams of carbohydrate will raise your blood sugar 50-60 mg/dl in 10-15 minutes.

Good choices with 15 grams of carbohydrates are:

• ½ cup apple juice
• ½ cup orange juice
• 5 Lifesavers®
• 2 pieces of hard candy
• 1 cup low-fat milk
• 1 Tablespoon honey
• 2 Tablespoons raisins
• ½ cup regular gelatin
• 6 sugar cubes
• 1 Tablespoon syrup
• 3- 4 glucose tablets
• ½ (80 gram) glucose bottle
• ½ (31 gram) instant glucose tube
   

Glucose tablets, instant glucose bottles and tubes can be purchased at your local drug store.

After eating or drinking the quick-acting carbohydrate, wait 10 to 15 minutes and re-check your blood sugar.

If you still feel your blood sugar is low, or if your blood sugar is below 70mg/dL, repeat the steps above by eating another 15 grams of carbohydrate until your blood sugar is higher than 70mg/dl.

Try to eat a well-balanced meal with a source of  slow-acting carbohydrate (whole grains) and lean protein (chicken, fish, eggs, or low-fat dairy) within the next hour.

If your next meal is more than an hour away, choose a healthy snack with a source of slow-acting carbohydrate (whole grains) and lean protein.

Healthy snack options include:

• 1 cup low-fat milk
• Light yogurt
• ½ sandwich on wheat bread
• 6 Wheat crackers with 1oz cheese
• Apple and 1 Tablespoon peanut butter
   

Avoid over-treatment

Foods used in treating low blood sugar are extra foods that are not part of your meal plan. Foods used to treat low blood sugars should not be viewed as “treats”. Chocolate candy is not a good choice because it will not produce a rapid rise in your blood sugar.
 
How do I prevent low blood sugars?

Prevent your blood sugar from going too low by:

• Eating meals at about the same time each day.
• Do not skip meals.
• Take the correct amount of insulin or diabetes oral medications.
• Plan for a snack before exercise and before driving long distances (if you have not had a meal for 2-3 hours).
• Know when your insulin will peak.
• Always carry a form of quick-acting sugar to treat a low blood sugar reaction.

If a person with diabetes becomes unconscious or is not able to swallow, give him or her glucagon rather than trying to make him or her eat or drink.  Glucagon is a shot given into a large muscle.  It will increase the blood sugar levels in the body.

Teach Back:

What is the most important thing you learned from this handout?

What changes will you make in your diet/lifestyle, based on what you learned today?

If you are a UW Health patient and have more questions, please contact UW Health at one of the sites listed below: