Hypoglycemia

What You Need To Know About


Hypoglycemia (low blood glucose) is a condition where the level of blood glucose drops below acceptable limits. Glucose, an important source of energy for the body comes from food. Carbohydrates such as potato, cereals, milk, other roots and tubers, certain fruit and sweets are the main source of glucose in the diet.

Physiology: After a meal, glucose is absorbed into the blood stream and carried to the various cells. Insulin, a hormone made by the pancreas, helps to transfer the glucose to the cells for energy. Extra glucose is either stored in the liver as glycogen or in the fat cells as fat. Both these are sources of energy in times of need. When the level of glucose in the blood starts to drop, glucagon, another hormone made by the pancreas, brings it back to normal by breaking down glycogen.

In some people with diabetes, glucagon does not provide the normal response. In addition, other hormones such as adrenaline may raise the blood glucose level. In diabetics who are on insulin or pills, glucose levels cannot return easily to the normal range. Hypoglycemia can occur suddenly.

Hypoglycemia can also be a result of other medications or diseases, hormone or enzyme deficiencies or tumors.

Symptoms of Hypoglycemia...


Hypoglycemia causes symptoms such as hunger, shakiness, nervousness, sweating, dizziness or light-headedness, sleepiness, confusion, difficulty in speaking, anxiety or weakness.

It can also happen at night when a person cries out or has nightmares, finds nightclothes or sheets damp from perspiration or feels tired, irritable or confused on waking up.

Causes of Hypoglycemia:

Hypoglycemia can occur as a side effect of some diabetes medicines, insulin or pills that increase insulin production or when meals or snacks are too small , delayed or skipped; increased physical activity, or consumption of alcoholic beverages.

Preventing hypoglycemia

Remember that diabetes management plans are designed to match the dose and timing of medication to the usual routine of meals and activities.


Take your medication in the recommended doses at the recommended times.

Ask your doctor to tell you which medications can cause hypoglycemia.

Learn how to adjust your medication to changes in routine.


Following your meal plan is an important aspect of diabetes management.

Get your meal plan designed by our dietitians to suit your personal preferences and lifestyle.

Follow it carefully.

Have regular meals, eat enough food at each meal, and don’t skip snacks or meals.

Remember to have a snack at bedtime or before you exercise.

Our dietitians will recommend snacks that are more effective in preventing hypoglycemia during the night.


Hypoglycemia can be caused by extra physical activity.

Check your blood glucose level before you exercise and have a snack if the level is below 100 mg/dl.

Adjust your medication before physical activity.

Check your blood glucose level at regular intervals if you are exercising hard or for a long time and have a snack as required.

Check your blood glucose level periodically after physical activity.

Heavy drinking, especially on an empty stomach, can be quite dangerous for people on medicines that increase insulin production. Hypoglycemia can occur even after a day or two.


If you have to, eat a snack or a meal while you are consuming alcoholic beverages.

Our educators will tell you how you can safely include alcohol in a meal plan.

If you keep blood glucose levels as close to normal as possible to prevent long-term complications, it can increase the risk of hypoglycemia.

Learn from our educators about the ways you can prevent hypoglycemia and how to treat it effectively if it does happen.

Hypoglycemia while driving is dangerous because you may have trouble concentrating on the road, or you may not react quickly enough to road hazards or to the actions of other drivers.


Check your blood glucose level before driving.

During longer trips stop to check it frequently.

Eat snacks to prevent it from dropping below 80 mg/dl.

If necessary, stop driving and get treatment.

‘Hypoglycemia unawareness’ is a condition where people with diabetes (mostly Type 1, and in some instances Type 2), do not have early warning signs of hypoglycemia. This develops when frequent episodes of hypoglycemia change the way in which the body reacts to low blood glucose levels. Studies have shown that you can restore awareness by preventing hypoglycemia for several weeks.

Check your blood glucose levels more often to know when hypoglycemia is about to happen.

You may also need to change medications and re-plan diet and physical activity routine.

How is hypoglycemia treated?

Signs and symptoms are not the same for everyone. Learn to recognize your signs and symptoms and inform your friends, colleagues and family so that they can help if required. School staff should know how to recognize the symptoms and what help is needed. If you have hypoglycemia many times in a week, contact your doctor. You may need to change your medication, increase or decrease it, or form a different meal plan or a new physical activity plan.

If you think your blood glucose level is going down, check it with your glucose meter. If the level is below 80 mg/dl, take any one of these options immediately to raise the level.

½ cup of fruit juice, or carry a fruit with you

5-6 pieces of hard candy

1 tablespoon of sugar or honey

(Use less for children. Get advice about the right amount from our educators).

Then, recheck blood glucose levels after 15 minutes to make sure it is 80 mg/dl or above. Repeat this till you reach the optimum level. Have a snack after this if your next meal is an hour away.

In severe cases of hypoglycemia, especially in Type 1 diabetes, you may lose consciousness. People around you should know what to do. Family, friends or co-workers should be aware of the gravity of the situation and get medical help.

Be ready for hypoglycemia.

Learn what can trigger low blood glucose levels.

Keep your blood glucose meter at hand at all times.

Keep several servings of quick-fix foods or drinks handy.

Carry a medical identification card.

Have a plan ready in case of severe hypoglycemia.

Tell family and friends about your signs of hypoglycemia and how they can help in case of emergency.

What to learn from your doctor:

Whether your medication can cause hypoglycemia

When you should take your medication

How much medication you should take

Whether you should continue medication if you fall sick

Whether you should adjust your medication before any physical activity

What you should do if you skip a meal.