Diagnosis
If you have symptoms of low blood sugar, check your blood sugar level with a blood glucose meter. The meter is a small device that measures and displays your blood sugar level. For many people, hypoglycemia is when blood sugar level drops below 70 mg/dL or 3.9 mmol/L. But your numbers might be different. Ask your healthcare professional about the right range for your blood sugar.
Treatment
Treatment for diabetic hypoglycemia depends on how serious your low blood sugar becomes.
If you think your blood sugar may be too low, check your blood sugar level with a blood glucose meter. Be extra careful if you have symptoms of low blood sugar but can't check your blood sugar level right away. Assume your blood sugar is low and treat for hypoglycemia.
Managing hypoglycemia
- Eat or drink carbohydrates
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Eat or drink something that's mostly sugar or carbohydrates to raise your blood sugar level quickly. Pure glucose is the preferred treatment. It comes in tablets, gels and other forms.
Foods with more fat, such as chocolate, don't raise blood sugar as quickly. And diet soft drinks cannot be used to treat hypoglycemia because they don't have any sugar.
Examples of foods that raise your blood sugar level quickly include:
- Glucose tablets. Read the package label for the right amount to take. Glucose tables are sold at most pharmacies without a prescription.
- Glucose gel. Read the package label for the right amount to take.
- Hard candy or jelly beans. A serving usually is about 5 to 6 pieces, but check the food label for the exact serving size.
- Four ounces, or 1/2 cup, of fruit juice.
- A half a can, or about 4 to 6 ounces, of regular soda. Do not use diet soda.
- One tablespoon, or 15 milliliters, of sugar, corn syrup or honey.
In general, aim to have food or drink with 15 to 20 grams of carbohydrates. Often, that is enough to raise blood sugar levels back into a safe range.
- Recheck your blood sugar level
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Check your blood sugar 15 minutes after eating or drinking something to treat hypoglycemia. If your blood sugar is still low, eat or drink another 15 to 20 grams of carbohydrates. Repeat this pattern until your blood sugar is above 70 mg/dL, or 3.9 mmol/L.
- Have a snack or meal
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Have a snack or a meal to keep your blood sugar from dropping again. If you usually take insulin with food, keep the following advice in mind. In general, you don't need more insulin if you eat a snack after you have a low blood sugar level. But if you're going to eat a meal, you may need a lower dose of insulin. This helps ensure that your blood sugar doesn't rise too quickly.
It's important to try not to overtreat your low blood sugar. If you do, you may cause your blood sugar level to rise too high. That's likely to make you feel thirsty and tired.
If you have a young child who gets diabetic hypoglycemia, talk with your child's healthcare team. Young children often need less than 15 grams of carbohydrates to treat low blood sugar. Ask your child's healthcare professional what amount your child needs.
Emergency treatment
The treatment for severe hypoglycemia, glucagon, is a hormone that raises blood sugar quickly. It can be lifesaving if someone isn't alert enough to eat or drink something to raise low blood sugar. Glucagon is available only by prescription.
Glucagon comes in an emergency syringe kit, an auto-injector pen or a pre-mixed injection that's ready to use. Glucagon also is available as a powdered nasal spray given in one nostril. Store glucagon as directed on the packaging. Be aware of the expiration date. When given to someone who is not conscious, the person should be turned on the side. This helps prevent choking in case of vomiting.
About 15 minutes after getting glucagon, the person should be alert and able to eat. If someone doesn't respond within 15 minutes, call emergency medical care. If someone quickly responds to glucagon, it's still recommended that you contact the person's diabetes care team promptly.
Talk with your healthcare professional if you needed help from others to treat a bout of low blood sugar. Your healthcare professional likely will want to figure out if your insulin or other diabetes medicine needs to be adjusted. An adjustment might be needed to prevent another serious episode.
Hard-to-manage hypoglycemia
Some people have frequent and severe hypoglycemia despite medicine adjustments. If that happens, your healthcare professional may suggest that you keep your blood sugar in a higher than usual range.
Your healthcare professional also might suggest that you use a device that measures your blood sugar every few minutes. It's called a continuous glucose monitor. It uses a sensor placed under the skin to measure blood sugar. Your healthcare professional likely will recommend that you have glucagon with you at all times too. Teach people you trust, such as family, friends and close co-workers, how to use it.
Continuous glucose monitor and insulin pump
A continuous glucose monitor, on the left, is a device that measures blood sugar every few minutes using a sensor inserted under the skin. An insulin pump, attached to the pocket, is a device that's worn outside of the body. The device has a tube connecting the reservoir of insulin to a catheter inserted under the skin of the abdomen. Insulin pumps are programmed to deliver specific amounts of insulin continuously and with food.
Hypoglycemia unawareness
Some people don't have or don't feel early symptoms of hypoglycemia. This is called hypoglycemia unawareness. If you have hypoglycemia unawareness, your healthcare professional may recommend a higher glucose target range.
It's very important to regularly check your blood sugar before you go to bed. Have a snack that contains carbohydrates before going to sleep if your blood sugar is lower than your bedtime target range. Your healthcare professional also may recommend a continuous glucose monitor that can sound an alarm when your blood sugar is dropping.
Self care
The following tips can help you be prepared for diabetic hypoglycemia and its complications.
Teach people how to help
Tell people you trust about your hypoglycemia. For example, you could talk with family, friends and co-workers. If others know what symptoms to look for, they might be able to alert you to early symptoms. It's important that family members and close friends know where you keep glucagon and how to give it. That way, a serious situation can be easier to safely manage.
Plan ahead
Always carry a low blood sugar treatment with you, such as glucose tablets or gel, hard candy or regular soda. Also carry glucagon if it's prescribed for you.
Wear a medical ID
It's a good idea to wear a necklace or bracelet that identifies you as someone who has diabetes. You also can keep in your wallet a medical alert card that says you have diabetes.
Preparing for your appointment
If you have low blood sugar several times a week, make an appointment with your healthcare professional. Together you can determine what's leading to your hypoglycemia and figure out what changes to make to prevent it.
Here's some information to help you get ready for your appointment.
What you can do
- Be aware of restrictions before the appointment. Sometimes you need to stop eating or drinking anything but water for 8 to 12 hours for blood tests. This is called fasting. When you make the appointment, ask if you need to fast. If so, ask what changes you need to make to your diabetes treatment plan because you're not eating or drinking.
- Make a list of your symptoms and how often they happen. It helps to keep a record of your blood sugar readings and low blood sugar reactions. That way, you and your healthcare professional can see patterns that lead to hypoglycemia.
- Make a list of key personal information. Include any major stresses or recent life changes.
- Make a list of medicines, vitamins and supplements you take. Include the amounts you take, also called the doses.
- Keep a record of your blood sugar test results if you track your levels at home. Give your healthcare professional a written or printed record of your blood sugar levels, times and medicines taken.
- Take your blood glucose meter with you. Some meters let your healthcare professional's office download the recorded blood sugar test results.
- Write down questions to ask your healthcare professional. Ask about any parts of your diabetes treatment plan where you need more information.
Questions you may want to ask include:
- How often do I need to check my blood sugar?
- What is my target blood sugar range?
- How do diet, exercise and weight changes affect my blood sugar?
- How can I prevent low blood sugar?
- Do I need to worry about high blood sugar? What are the symptoms I need to watch out for?
- Do I need a prescription for emergency glucagon?
- If I keep having hypoglycemia, when do I need to see you again?
Feel free to ask other questions too.
What to expect from your doctor
Your healthcare professional is likely to ask you questions such as:
- What symptoms do you notice when you have low blood sugar?
- How often do you have these symptoms?
- What do you do to raise your blood sugar levels?
- What's a typical day's diet like?
- Are you exercising? If so, how often?
- Do your family, friends and co-workers know what to do if you have severe hypoglycemia?
