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Hypoglycemia and How to Manage It

Diabetic hypoglycemia occurs when someone with diabetes doesn’t have enough sugar (glucose) in his or her blood. Glucose is the main source of fuel for the body and brain, so you can’t function well if you don’t have enough.1

Low blood sugar (hypoglycemia) is defined as a blood sugar level below 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L).1

In this article we help you identify the early warning signs of hypoglycemia so that you can take steps to prevent a medical emergency, and treat low blood sugar promptly. It is important to tell family and friends what symptoms to look for and what to do if you’re not able to treat the condition yourself.1

So, first things first.

It is very important for you to know what puts you at risk of hypoglycemia so you can avoid it.2

You are at risk of having a low blood sugar reaction if you:2

  • Skip or delay a meal or snack
  • Take too much insulin or eat too few carbohydrates
  • Exercise
  • Drink alcohol, especially without eating carbohydrates

What are the early warning signs of hypoglycemia?1

Make sure you check your blood sugar level if you experience any of the following initial signs and symptoms of diabetic hypoglycemia:

  • Shakiness
  • Dizziness
  • Sweating
  • Hunger
  • Fast heartbeat
  • Inability to concentrate
  • Confusion
  • Irritability or moodiness
  • Anxiety or nervousness
  • Headache

Nighttime signs and symptoms1

If diabetic hypoglycemia occurs when you’re sleeping, signs and symptoms that may awaken you include:

  • Damp sheets or nightclothes due to perspiration
  • Nightmares
  • Tiredness, irritability or confusion upon waking

Severe signs and symptoms1

If diabetic hypoglycemia isn’t treated, signs and symptoms of severe hypoglycemia can occur. These include:

  • Clumsiness or jerky movements
  • Inability to eat or drink
  • Muscle weakness
  • Difficulty speaking or slurred speech
  • Blurry or double vision
  • Drowsiness
  • Confusion
  • Convulsions or seizures
  • Unconsciousness

So, what should you do?2

If your blood sugar is less than 70 milligrams per deciliter (mg/dl):

  • Eat 15 to 30 grams of carbohydrate (sample foods listed below)
  • Wait 15 minutes and then recheck your blood sugar
  • If your blood sugar is still less than 100 mg/dl, take another 15 grams of carbohydrate and retest your blood sugar in another 15 minutes. Repeat if necessary.

Your Quick Carbohydrate Guide for Treating Low Blood Sugar2

If your blood sugar is less than 70 mg/dl, you need 15 to 30 grams of a quickly absorbed carbohydrate, like the ones listed below. Each of the following servings provides 15 grams of carbohydrate.

Candies and Other Sweets

  • 12 gummy bears
  • 1 Tablespoon honey, jam or jelly
  • 1 Tablespoon sugar in water


  • 1/2 cup apple juice
  • 1/2 cup orange or grapefruit juice
  • 1/2 cup pineapple juice
  • 1/2 cup regular soda (not diet)
  • 1/3 cup grape juice
  • 1/3 cup cranberry juice


  • 1/2 banana
  • 1 small apple
  • 1 small orange
  • 2 tablespoons of raisins
  • 15 grapes

Note: The foods listed above are easily absorbed and will raise blood sugar levels quickly. Foods that contain protein or fat – such as chocolate, candy bars, ice cream, cookies, crackers and bread – don’t raise blood sugar quickly enough.

So, what should you do to prevent hypoglycemia?3

Experiencing hypoglycemia can be very scary. There are some things you can do to make sure this doesn’t happen to you or prevent it from happening again.

Most of the time you can prevent hypoglycemia by:

  • Monitoring your blood sugar often
  • Staying alert for the first symptoms mentioned above
  • Keeping some sugar or sweet handy (and eating it as necessary)

When to see a doctor1,2

Severe hypoglycemia can lead to serious problems, including seizures or unconsciousness, that require emergency care. Make sure your family, friends and co-workers know what to do in an emergency.

Important: If you have frequent low blood sugars speak to your doctor. You may need changes in your medication and/or meal plan.

References: 1. Diabetic hypoglycemia – Symptoms and causes [Internet]. Mayo Clinic. 2020 [cited 20 July 2020]. Available from: 2. Treating Low Blood Sugar [Internet]. 2020 [cited 20 July 2020]. Available from: 3. Hypoglycemia: Diabetes Education Online [Internet]. 2020 [cited 20 July 2020]. Available from:

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