Hypoglycemia

Diagnosis

If you have hypoglycemia symptoms, your healthcare professional does a physical exam and reviews your medical history. You'll likely have a blood test to check your blood glucose level. Your healthcare professional also may order other blood tests to look for causes of hypoglycemia.

If you use insulin or another diabetes medicine to lower your blood sugar and you have symptoms of hypoglycemia, test your blood sugar level with a blood glucose meter. If the result shows low blood sugar, under 70 mg/dL (3.9 mmol/L), treat it based on your diabetes treatment plan. If you can't check your blood sugar, it may be OK to treat symptoms of hypoglycemia anyway.

Keep a record of your blood sugar testing results and how you have treated low blood sugar levels. Your healthcare professional can review the information to help change your diabetes treatment plan if needed.

In a person not taking medicines for diabetes, hypoglycemia is diagnosed using a guideline called the Whipple triad. To diagnose hypoglycemia, this guideline requires that a person has:

• Symptoms of hypoglycemia.
• A laboratory blood test result showing low plasma glucose.
• Relief of hypoglycemia symptoms when low plasma glucose is corrected.

If you don't use medicines known to cause hypoglycemia, your healthcare professional will likely ask:

• What were your symptoms? If you don't have symptoms of hypoglycemia during your visit, your healthcare professional might have you not eat, called fasting, overnight or longer. This allows low blood sugar symptoms to happen and can help your healthcare professional make a diagnosis. Another option is an extended fast that's up to 72 hours. This is usually done in a hospital.
• What is your blood sugar level when you're having symptoms? A healthcare professional takes a blood sample and sends it to a lab. If your symptoms happen after a meal, the blood sugar test may be done after you eat. Another option is to have a monitored mixed meal test to see how your blood sugar reacts to certain foods.
• Do your symptoms go away when you eat fast-acting carbohydrates to raise your blood sugar levels? This helps your health professional know whether your symptoms are caused by low blood sugar.
• Did your symptoms happen after an overnight fast or after eating something? If your symptoms happen after eating, what did you eat?

Treatment

How to treat hypoglycemia right away

If you have hypoglycemia symptoms, do the following:

• Eat or drink about 15 grams of fast-acting carbohydrates. These are sugary foods or drinks without protein or fat that are easily made into sugar in the body. Try glucose tablets or gel; fruit juice; regular, not diet, soda; honey; or sugary candy. Always carry with you fast-acting carbohydrates to treat low blood sugar.
• Recheck your blood sugar level 15 minutes after treatment. If the blood sugar level is still under 70 mg/dL (3.9 mmol/L), eat or drink another 15 grams of fast-acting carbohydrate. Recheck your blood sugar level again in 15 minutes. Repeat these steps until your blood sugar is at a safe level. It should be above at least 70 mg/dL (3.9 mmol/L) but usually above 90 mg/dL (5 mmol/L).
• Have a snack or meal. Once your blood sugar is back in a safe range, eat a healthy snack or meal that includes protein and carbohydrates. This can help prevent another drop in blood sugar. It also replaces your body's stored glycogen.

How to treat severe hypoglycemia right away

Severe hypoglycemia is when you need help from someone to recover. For example, if you can't eat, you might need a glucagon injection or intravenous glucose.

In general, people with diabetes who are treated with insulin should have a glucagon kit for emergencies. Family and friends need to know where to find the kit and how to use it in an emergency.

If you're helping someone who has fainted or cannot safely swallow, don't try to give the person food or drink. If there's no glucagon kit available or if you don't know how to use one, call 911 or your local emergency services number for medical help.

Treatment of a condition causing hypoglycemia

If you have hypoglycemia that happens often, your healthcare professional looks for the condition causing hypoglycemia and treats it. Depending on the cause, treatment may include:

• Nutrition counseling. A review of eating habits and food planning with a registered dietitian may help prevent hypoglycemia.
• Medicines. If a medicine is the cause of your hypoglycemia, your healthcare professional may suggest adding, changing or stopping a medicine or changing the dose.
• Tumor treatment. A tumor in your pancreas is typically treated with surgery to take it out. Another option is to destroy tumor tissue with heat or with a chemical placed in the tumor. Rarely, medicines are used to control hypoglycemia.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Preparing for your appointment

If you have diabetes and you're often having periods of hypoglycemia, or if your blood sugar levels often drop, talk with your healthcare professional to find out how you might need to change your diabetes treatment plan.

If you haven't been diagnosed with diabetes, make an appointment with your healthcare professional to find the cause of your symptoms of hypoglycemia and get treatment.

Here's some information to help you get ready for your appointment. Take a family member or friend along, if possible. Someone who goes with you can help you remember information you're given.

What you can do

Before your appointment:

• Make a list of your hypoglycemia symptoms, including when they started and how often they happen. Also include when they happen, such as when fasting, after eating or both. Note what treatment helps your hypoglycemia symptoms and what you tried that didn't help.
• List your key medical information, including other conditions for which you're being treated. Also list the names of all medicines, vitamins and other supplements you take, including doses.
• Provide your diabetes treatment information if you have diabetes. Include the timing and results of recent blood sugar tests and when you take any medicines you use.
• List your typical daily habits, including how often you drink alcohol and how much. Also include your usual meals and exercise routines. Note recent changes to these habits, such as a new exercise routine or a new job that's changed the times you eat.
• Make a list of questions to ask your healthcare professional.

Questions to ask if you have diabetes include:

• Are my symptoms due to hypoglycemia?
• What do you think is causing my hypoglycemia?
• What things can I do to alert me that I have hypoglycemia?
• What things can I do to prevent hypoglycemia?
• Do I need to adjust my diabetes treatment plan?
• Do I need to change my eating or exercise routine?
• I have other health conditions. How can I manage these conditions together?

Questions to ask if you have not been diagnosed with diabetes include:

• Is hypoglycemia the most likely cause of my symptoms?
• What else might be the cause?
• What tests do I need?
• What self-care steps, including lifestyle changes, can I take to help my symptoms get better?
• Should I see a specialist?

What to expect from your doctor

Your healthcare professional might ask you questions, such as:

• What symptoms have you been having?
• When do your symptoms typically happen?
• Does anything seem to make your symptoms worse? Does anything make them better?
• Have you been diagnosed with other medical conditions?
• What medicines are you currently taking?

Be ready to answer questions so that you have time to talk about what's most important to you.