How Low Can Blood Sugar Go

What To Do If You Have Low Blood Sugar Symptoms

If you have diabetes and are experiencing mild to moderate hypoglycemia symptoms, you need to immediately eat or drink 15 grams of easily digestible carbohydrates.

Very low blood sugar is a medical emergency. If you or someone else with diabetes is experiencing severe symptoms, such as unconsciousness, its important to administer a medication called glucagon and contact emergency services immediately.

If youre at risk for low blood sugar, its important to talk with your doctor about getting a prescription for glucagon.

You should never give an unconscious person anything by mouth, as it could cause them to choke. If you have diabetes, make sure your family and friends know not to do this if you lose consciousness.

Low blood sugar can occur for a number of reasons. Its usually a side effect of diabetes treatment.

Manage Low Blood Glucose Early

Learn to recognise your early warning signs of having a hypo. Be alert to what these are and test your blood glucose levels if any of these symptoms develop. Also make sure to always carry your emergency treatment with you. Keep it in your bag, at work and at home so you can treat low blood glucose early before it becomes more serious.

What To Do When Your Blood Sugar Levels Drop Too Low

People who use insulin and other diabetes medications are at risk for hypoglycemia. Keep this action plan handy so you’re prepared.

If you take insulin or diabetes medication, you may be at risk of developing hypoglycemia, or low blood sugar. Without quick attention, hypoglycemia can lead to serious complications, so its important to know what to do if it happens to you or someone close to you.

In very severe cases, hypoglycemia can lead to seizures or loss of consciousness, says a clinical assistant professor of medicine, endocrinology, gerontology, and metabolism at Stanford Health Care, and chief of the Stanford Endocrine Clinic.

It’s possible to have hypoglycemia but have no symptoms, according to the National Institute of Diabetes and Digestive and Kidney Diseases . On the other hand, symptoms can also come on rapidly. While symptoms vary from person to person, if you develop mild to moderate low blood sugar you may:

• Feel shaky or jittery
• Have a headache or be lightheaded
• Turn pale
• Be irritable or combative
• Have blurred vision or see double

Some people feel tingling or numbness in their extremities too, says Rodolfo Galindo, MD, an assistant professor of medicine in the division of endocrinology, metabolism, and lipids at the Emory University School of Medicine in Atlanta, and chair of the inpatient diabetes taskforce.

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What Are The Causes Of Hypoglycaemia

The usual causes of low blood glucose level are:

• not eating enough carbohydrate with your meal, eg, steak and salad with no carbohydrate such as bread/potato/kumara/rice/pasta
• missing or delaying a meal
• missing snacks
• doing physical activity without either reducing your insulin or taking more carbohydrate before, during or after physical activity
• taking too much insulin
• drinking alcohol in excess or without taking carbohydrate food and/or reducing your insulin.

What Are The Symptoms Of Hypoglycemia

Symptoms of hypoglycemia can start quickly, with people experiencing them in different ways. The signs of hypoglycemia are unpleasant. But they provide good warnings that you should take action before blood sugar drops more. The signs include:

• Shaking or trembling.

• Tingling or numbness in the face or mouth.

During a severe hypoglycemic event, a person may:

• Be unable to eat or drink.
• Have a seizure or convulsions .
• Lose consciousness.
• Slip into a coma or die .

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When To Call 911

Your friend, relative, or coworker should call 911 for help if:

• You pass out and no glucagon is available
• You need a second dose of glucagon
• You had glucagon, but are still confused
• Your blood sugar stays too low 20 minutes after treatment or doesnt respond to your usual treatments

The emergency medical technicians can give you IV sugar . This raises your blood sugar level right away. You might need to stay in the hospital for a few hours.

NEVER be afraid to call 911 or ask someone to call 911 for you if you are concerned .

Other things to know about hypoglycemia:

It takes time for blood sugar to rise after eating, and its important to give your first treatment time to work. Use the table above to guide your treatment and timing instead of eating until you feel better, which will almost always lead to eating too much.

Hypoglycemia can be common with certain types of exercise. Managing blood sugar during and after physical activity is important and is something that a lot of people with T1D have questions about. JDRF has a number of resources available for people with T1D and their families, many of which can be found here.

At What Blood Sugar Level Should I Go To The Hospital

According to the University of Michigan, blood sugar levels of 300 mg/dL or more can be dangerous. They recommend calling a doctor if you have two readings in a row of 300 or more. Call your doctor if youre worried about any symptoms of high blood sugar.

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Take A Pass On The Bread Bowl

Its obvious that sugary stuff leads to an increase in blood sugar, but starchy foods can do the same thing. Your body processes simple carbs quickly and turns them into sugar, and it needs a lot of insulin to absorb them. That means a bag of Doritos is as likely as a candy bar to cause a spike.

If youre in the middle of a blood sugar spike, its best to curtail your carb intake. Check the glycemic index if youre not sure about a food.

Surprisingly, popcorn and white potatoes are worse than ice cream, according to the index. If you stick to low-carb/low-glycemic-index foods, your blood sugar will return to normal much more quickly.

Ultimately, its best to limit your carb intake. A 2004 study found that a diet of 20 percent carbs, 30 percent protein, and 50 percent fat lowered fasting blood sugar and kept blood sugar from spiking after meals.

This was a very small study, but the results suggest that lower carb intake can lead to generally lower blood glucose. In general, most people with diabetes eat 40 to 45 percent of their calories in the form of carbohydrates. Choosing nutrient-rich sources of carbs is best.

Another promising study found that after two years on a low-carb diet, many participants with type 2 diabetes were able to manage their condition without medication or resolve it entirely.

The occasional baked potato isnt a problem, but frequent trips to the drive-through are not a good idea. Find a few veggie-and-protein-heavy meals and make them your go-tos.

Your Hypoglycemia Action Plan

If you experience symptoms of hypoglycemia, its important to take action. Start with these steps:

Test your blood sugar. If you recognize any of these symptoms and believe your blood sugar may be too low, the first step you should take is to test your blood sugar with your glucose meter, Tan says. Anything less than 70 milligrams per deciliter is considered low blood sugar, according to the National Library of Medicine . However, target levels are often individualized, so talk with your healthcare provider about your optimal numbers, Tan adds.

Eat or drink fast-acting carbs. If you have low blood sugar, you need to take action right away. Your best bet is to consume about 15 grams of carbohydrates, the NLM says. Some options include:

• ½ cup or 4 ounces of orange juice
• ½ cup or 4 ounces of regular soda
• 1 tablespoon of sugar dissolved in water
• 1 tablespoon of honey or maple syrup
• 5 or 6 hard candies, jelly beans, or gumdrops
• 1 tablespoon of cake frosting
• 2 tablespoons of raisins
• ½ cup of applesauce

You can also take three to four glucose tablets or a tube of glucose gel. Everyone who takes medications for diabetes should always have glucose tablets with them, Galindo urges.

Wait, then retest. The next step is to wait 15 minutes, then test your blood sugar again. If blood sugar has reached 100 mg/dl or greater, youre fine. If not…

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Your Diabetes Devices And Hypoglycemia

Several insulin pumps are now available that make managing blood sugar levels easier, particularly when connected to a glucose meter or a CGM.

Some of the most important advantages of CGM devices are the improved insulin control and the ability to detect trends and lows early. With improved technology, it is now possible for parents to track blood sugar trends in their kids even when they are hundreds of miles apart .

In addition, automated insulin delivery systems, also known an artificial pancreas or a hybrid closed-loop system, will automatically adjust insulin to match your bodys need to help you spend more time in your target range.

Resources that provide people with T1D and their families with more detailed information about pumps and CGM devices are available through JDRF here. For people looking for a deeper understanding of technology that helps people with T1D better manage their blood sugar, JDRF resources are available here.

How To Recognize Hypoglycemia

The first signs of hypoglycemia include feeling sweaty, shaky, and hungry. However, not everyone has these symptoms or notices them in time to prevent low blood sugar from getting worse. Its also important to know that your symptoms of hypoglycemia will change the longer you have T1D.

As hypoglycemia gets worse, symptoms can include:

• Feeling weak
• Having difficulty walking or seeing clearly
• Acting strange or getting disoriented
• Having seizures

Severe hypoglycemia may make you faint or pass out. This is dangerous if you are driving, climbing stairs, or doing other activities where you need to stay aware of things around you.

Hypoglycemia can happen at night. If it does, you are likely to wake up, but its important not to rely on your body to wake you up. A continuous glucose monitor, or CGM, can alert you and those around you with an alarm to let you know if your blood sugar starts getting low while you are sleeping.

Its a good idea to check your blood sugar often when lows are likely, such as in hot weather or when you travel. Your CGM can also let you know when your blood sugar is getting lower.

Watch out for hypoglycemia unawareness.

You might not have early warning signs of low blood sugar. This is called hypoglycemia unawareness, and it raises the risk of having severe lows. It is more likely if:

• You have had diabetes longer than 5 or 10 years
• You have frequent episodes of hypoglycemia
• You take certain medicines, such as beta blockers for high blood pressure

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Preventing A Low Blood Sugar Level

If you have diabetes, you can reduce your chance of getting a low blood sugar level if you:

• Check your blood sugar level regularly and be aware of the symptoms of a low blood sugar level so you can treat it quickly.
• Always carry a sugary snack or drink with you, such as glucose tablets, a carton of fruit juice or some sweets. If you have a glucagon injection kit, always keep it with you.
• Do not skip meals.
• Be careful when drinking alcohol. Do not drink large amounts, check your blood sugar level regularly, and eat a carbohydrate snack afterwards.
• Be careful when exercising eating a carbohydrate snack before exercise can help to reduce the risk of a hypo. If you take some types of diabetes medicine, your doctor may recommend you take a lower dose before or after doing intense exercise.
• Have a carbohydrate snack, such as toast, if your blood sugar level drops too low while you’re asleep

If you keep getting a low blood sugar level, talk to your diabetes care team about things you can do to help prevent it.

Always Remember ‘if In Doubt Treat’

1. Eat or drink 1 serving of a quick-acting carbohydrate. Each of the following is 1 serving:

• 3 teaspoons of glucose powder in water
• of glucose tablets
• 3 teaspoons of jam or sugar
• a small glass of sugar-sweetened lemonade or cordial
• 6 large jelly beans/5 Mentos.

2. After 10 minutes test your blood glucose again. If it is still less than 4mmol/L, have another serving of quick-acting carbohydrate from the list above.

3. Once your blood glucose is above 4mmol/L, eat some carbohydrate food or if it’s your mealtime, eat your meal.

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Stick To Your Medication And Insulin Regimen

Skipping a dose of medication or insulin can be harmful to your body and increase your blood sugar levels.

Its important to stick to your treatment plan and follow your doctors instructions for taking your medication.

Summary

Healthful lifestyle habits can help people manage their blood sugar levels over the long term, such as eating a balanced diet, getting regular exercise, staying hydrated, and getting good sleep.

S For Treating A Person With Symptoms Keeping Them From Being Able To Treat Themselves

Dont hesitate to call 911. If someone is unconscious and glucagon is not available or someone does not know how to use it, call 911 immediately.

Do NOT:

• Inject insulin
• Provide food or fluids

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What Are Considered Normal Blood Sugar Levels

If you ever suspect that your blood sugar might be low, you can monitor your levels with a test kit from your local pharmacy or doctor. Frequent sugar monitoring is important, as severe hypoglycemia that goes untreated can lead to dangerous outcomes such as coma or even death. Low blood sugar is generally defined as 60 mg/dL or less, but it can vary due to time of day, meals, and other factors. The table below provides blood sugar level goal ranges for people with and without diabetes.

Treating Low Blood Glucose If You Take Medicines That Slow Down Digestion

Some diabetes medicines slow down the digestion of carbohydrates to keep blood glucose levels from rising too high after you eat. If you develop low blood glucose while taking these medicines, you will need to take glucose tablets or glucose gel right away. Eating or drinking other sources of carbohydrates wont raise your blood glucose level quickly enough.

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Preventing Low Blood Sugar

Preventing low blood sugar is better than having to treat it. Always have a source of fast-acting sugar with you.

• When you exercise, check your blood sugar levels. Make sure you have snacks with you.
• Talk to your provider about reducing insulin doses on days that you exercise.
• Ask your provider if you need a bedtime snack to prevent low blood sugar overnight. Protein snacks may be best.

DO NOT drink alcohol without eating food. Women should limit alcohol to 1 drink a day and men should limit alcohol to 2 drinks a day. Family and friends should know how to help. They should know:

• The symptoms of low blood sugar and how to tell if you have them.
• How much and what kind of food they should give you.
• When to call for emergency help.
• How to inject glucagon, a hormone that increases your blood sugar. Your provider will tell you when to use this medicine.

If you have diabetes, always wear a medical alert bracelet or necklace. This helps emergency medical workers know you have diabetes.

When To See A Doctor

According to the University of Michigan, blood sugar levels of 300 mg/dL or more can be dangerous. They recommend calling a doctor if you have two readings in a row of 300 or more.

See your doctor if you have consistently high blood sugar levels. Symptoms of this include:

• increased thirst
• high levels of sugar in urine

Ask your doctor how often to check your blood sugar and about your ideal blood sugar levels.

If you dont currently see a doctor who specializes in diabetes, known as an endocrinologist, you can find one by searching the American Association of Clinical Endocrinologists website.

You can find a certified diabetes educator by visiting the American Diabetes Associations website and searching by zip code.

Summary

Talk to your doctor if you have consistently high blood sugar readings or symptoms of chronic hyperglycemia.

Checking your blood sugar and then treating hyperglycemia early will help prevent any complications.

Health problems can arise when someone has high blood sugar regularly and without treatment.

Examples of complications include:

• nerve damage, called diabetic neuropathy, that may affect sensations in the feet and hands
• diabetic retinopathy, or damage to the blood vessels in the eyes that affects vision
• increased risks for kidney problems
• increased risks for heart problems

Taking steps to keep your blood sugar at target levels can help to minimize the likelihood that these complications will occur.

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