Diagnosis

You can determine if you have low blood sugar by using a blood glucose meter — a small computerized device that measures and displays your blood sugar level. You have hypoglycemia when your blood sugar level drops below 70 mg/dL (3.9 mmol/L).

It's important to record the date, time, test results, medication and dosage, and diet and exercise information each time you test your blood. Also, note any low blood sugar reactions. Your doctor diagnoses hypoglycemia using your records and looks for patterns to see how your medications and lifestyle affect your blood sugar.

Treatment

Hypoglycemic management

If you think your blood sugar may be dipping too low, check your blood sugar level with a blood glucose meter. Then eat or drink something that's mostly sugar or carbohydrates to raise your blood sugar level quickly. Foods with a lot of fat, such as chocolate, don't work as well. Examples of foods that will raise your blood sugar level quickly include:

  • Five to six pieces of hard candy
  • Four ounces (120 milliliters) of fruit juice or regular — not diet — soda
  • One tablespoon (15 milliliters) of sugar, jelly or honey
  • Three glucose tablets (available without a prescription at most pharmacies)
  • A serving of glucose gel (read the label for amount)

If you have symptoms of low blood sugar but can't check your blood sugar level right away, then act as though you have hypoglycemia. You might want to carry at least one sugary item with you at all times. It's also a good idea to wear a bracelet that identifies you as someone who has diabetes.

Check your blood sugar level again 15 to 20 minutes later. If it's still too low, eat or drink something sugary. When you feel better, eat meals and snacks as usual.

Difficult-to-manage hypoglycemia

Some people have frequent and severe hypoglycemia despite medication adjustments. In these circumstances, your doctor may recommend a higher glucose goal range and prescribe glucagon, a hormone that causes blood glucose to rise.

Glucagon, available only by prescription, comes in an emergency syringe kit. It contains one dose that has to be mixed before injecting. Store the glucagon at room temperature and be aware of the expiration date. If you're unconscious, someone who gives you the injection should turn you on your side to prevent choking in case you vomit.

In 15 minutes, you should be alert and able to swallow. You then need to eat. If you don't respond within 15 minutes, you need emergency medical care.

Preparing for your appointment

If you have symptoms of hypoglycemia several times a week, make an appointment with your doctor. Together you can determine what's contributing to the hypoglycemia and decide 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 pre-appointment restrictions. For blood sugar testing, you'll need to refrain from eating or drinking anything but water for eight hours for a fasting glucose test or four hours for a pre-meal test. When you make the appointment, ask if fasting is necessary.
  • Write down your symptoms and how often they occur. It may help to keep a record of low blood sugar reactions so that you and your doctor can see patterns leading to hypoglycemia.
  • Write down key personal information, including major stresses or recent life changes. If you're monitoring your glucose values at home, bring a record of the glucose results, detailing the dates and times of testing.
  • List medications, vitamins and supplements you take.
  • Create a record of metered glucose values. Give your doctor a written or printed record of your blood glucose values, times and medication.
  • Take your glucose meter with you. Some meters download recorded glucose values, which often can be done at your doctor's office.
  • Write down questions to ask your doctor. Be clear about aspects of your diabetes management that you need clarified.

For diabetic hypoglycemia, questions you may want to ask include:

  • How often do I need to monitor my blood sugar?
  • What is my goal 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 signs and symptoms I need to watch out for?
  • Do I need a prescription for the emergency injection of glucagon?
  • I have other medical problems. How can I manage them together?
  • What kind of follow-up, if any, should I expect?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of 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?
Feb. 20, 2015
References
  1. Kronenberg HM, et al. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.clinicalkey.com. Accessed Jan. 14, 2015.
  2. Cryer PE. Management of hypoglycemia during treatment of diabetes mellitus. http://www.uptodate.com/home. Accessed Jan. 14, 2015.
  3. Hypoglycemia (low blood glucose). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html. Accessed Jan. 14, 2015.
  4. Hypoglycemia. National Diabetes Information Clearinghouse. http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/. Accessed Jan. 14, 2015.