Diagnosis

If you use insulin or another diabetes medication to lower your blood sugar, and you have signs and symptoms of hypoglycemia, test your blood sugar levels with a blood glucose meter. If the result shows low blood sugar (under 70 mg/dL), treat accordingly.

If you don't use medications known to cause hypoglycemia, your doctor will want to know the following:

  • What were your signs and symptoms? If you don't have signs and symptoms of hypoglycemia during your initial visit with your doctor, he or she might have you fast overnight or longer. This will allow low blood sugar symptoms to occur so that he or she can make a diagnosis.

    It's also possible that you'll need to undergo an extended fast in a hospital setting. Or if your symptoms occur after a meal, your doctor will want to test your glucose levels after you eat.

  • What is your blood sugar level when you're having symptoms? Your doctor will draw a sample of your blood to be analyzed in the laboratory.
  • Do your symptoms disappear when blood sugar levels increase?

In addition, your doctor will likely conduct a physical examination and review your medical history.

Treatment

Immediate treatment

If you have symptoms of hypoglycemia, do the following:

  • Eat or drink 15 to 20 grams of fast-acting carbohydrates. These are sugary foods without protein or fat that are easily converted to sugar in the body. Try glucose tablets or gel, fruit juice, regular — not diet — soft drinks, honey, and sugary candy.
  • Recheck blood sugar levels 15 minutes after treatment. If blood sugar levels are still under 70 mg/dL (3.9 mmol/L), eat or drink another 15 to 20 grams of fast-acting carbohydrate, and recheck the blood sugar level again in 15 minutes. Repeat these steps until the blood sugar is above 70 mg/dL (3.9 mmol/L).
  • Have a snack or meal. Once your blood sugar is normal, eating a snack or meal can help stabilize it and replenish your body's glycogen stores.

Immediate treatment of severe hypoglycemia

Hypoglycemia is considered severe if you need help from someone to recover. For example, if you can't eat, you might need 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 case of emergency.

If you're helping someone who is unconscious, don't try to give the person food or drink. If there's no glucagon kit available or you don't know how to use it, call for emergency medical help.

Treatment of an underlying condition

Preventing recurrent hypoglycemia requires your doctor to identify the underlying condition and treat it. Depending on the underlying cause, treatment may involve:

  • Medications. If a medication is the cause of your hypoglycemia, your doctor will likely suggest changing or stopping the medication or adjusting the dosage.
  • Tumor treatment. A tumor in your pancreas is treated by surgical removal of the tumor. In some cases, partial removal of the pancreas is necessary.

Clinical trials

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

Preparing for your appointment

If you have type 1 diabetes and you're having repeated hypoglycemic episodes, or if your blood sugar levels are dropping significantly, talk with your doctor to find out how you might need to change your diabetes management.

If you haven't been diagnosed with diabetes, make an appointment with your primary care doctor.

Here's some information to help you get ready for your appointment.

What you can do

  • Write down your symptoms, including when they started and how often they occur.
  • List your key medical information, including other conditions for which you're being treated and the names of medications, vitamins or other supplements you take, including doses.
  • Log details about your recent diabetes management if you have diabetes. Include the timing and results of recent blood sugar tests, as well as the schedule on which you've been taking your medications, if any.
  • List your typical daily habits, including alcohol intake, meals and exercise routines. Also, note recent changes to these habits, such as a new exercise routine, or a new job that's changed the times you eat.
  • Take a family member or friend along, if possible. Someone who accompanies you can help you remember the information you're given.
  • Write down questions to ask your doctor. This can help you make the most of your time with your doctor.

Questions to ask your doctor if you have diabetes include:

  • Are my signs and symptoms due to hypoglycemia?
  • What do you think is triggering my hypoglycemia?
  • Do I need to adjust my treatment plan?
  • Do I need to change my diet or exercise routine?
  • I have other health conditions. How can I manage these conditions together?

Questions to ask if you haven't 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 improve my symptoms?
  • Should I see a specialist?

What to expect from your doctor

Your doctor might ask you questions, including:

  • When do your symptoms typically occur?
  • Does anything seem to provoke your symptoms?
  • Have you been diagnosed with other medical conditions?
March 13, 2020
  1. Jameson JL, et al., eds. Hypoglycemia. In: Harrison's Principles of Internal Medicine. 20th ed. The McGraw-Hill Companies; 2018. https://accessmedicine.mhmedical.com. Accessed Jan. 9, 2020.
  2. Low blood glucose (hypoglycemia). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia. Accessed Jan. 4, 2020.
  3. AskMayoExpert. Unexplained hypoglycemia in a nondiabetic. Mayo Clinic; 2019.
  4. Cryer PE. Hypoglycemia in adults with diabetes mellitus. https://www.uptodate.com/contents/search. Accessed Jan. 4, 2020.
  5. American Diabetes Association. Standards of medical care in diabetes — 2020. Diabetes Care. 2020;43(suppl):s1. https://care.diabetesjournals.org/content/suppl/2019/12/20/43.Supplement_1.DC1. Accessed Jan. 11, 2020.
  6. Service FJ, et al. Hypoglycemia in adults without diabetes mellitus: Clinical manifestations, diagnosis and causes. https://www.uptodate.com/contents/search. Accessed Jan. 4, 2020.
  7. Hypoglycemia (low blood sugar). American Diabetes Association. https://www.diabetes.org/diabetes/medication-management/blood-glucose-testing-and-control/hypoglycemia. Accessed Jan. 4, 2020.

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