Warning Signs of Hypoglycemia All Diabetics Should Know

Medically Reviewed By William C. Lloyd III, MD, FACS
Woman with headache, migraine, stress, insomnia, hangover

Ever had the shakes and wondered why?

If you have diabetes and have ever experienced some unexplained shakiness or dizziness, you might have been experiencing the early signs of hypoglycemia. Hypoglycemia is the medical term for an incident when your blood sugar level drops below 70 milligrams per deciliter. It’s one of the most common side effects for people who take insulin or certain medications that stimulate your pancreas to produce more insulin to help treat their diabetes.

But you might have experienced those symptoms and not even realized it. Many people, especially people who have had diabetes for a long time, are prone to episodes of hypoglycemia but don’t recognize the symptoms—called hypoglycemia unawareness. Some people don’t even experience symptoms when their blood glucose levels first hit the threshold for hypoglycemia.

If not treated, hypoglycemia can lead to unconsciousness or even seizures or a coma. So the best way to treat an episode of hypoglycemia is to prevent it from happening in the first place. Be aware of situations that might increase your risk of developing hypoglycemia, like when you’re exercising or moving around more than usual, or if you eat less than normal. Also, learning to recognize all the warning signs is a key to managing your diabetes.

Early Symptoms of Hypoglycemia

The early signs of hypoglycemia can be easy to miss. You might just chalk them up to fatigue or even a mild illness. But taking note of these initial symptoms is critical to taking quick treatment action.

Some people even feel hungry or develop a headache.

Nighttime Symptoms of Hypoglycemia

Unfortunately, hypoglycemia doesn’t take the night off. All of the symptoms mentioned above can appear in the middle of the night, but you may experience them slightly differently. For example, you may wake up to find your pajamas and sheets soaked in sweat. Or you might awaken and find yourself feeling fatigued, irritable or confused. You might also cry out in the night or have nightmares.

When Hypoglycemia Becomes Severe

One of the scariest factors of hypoglycemia is by the time your blood glucose drops to a dangerous level, you’re probably too incapacitated to do anything about it. Someone else will have to administer emergency glucagon to you. If you’re diabetic or prone to hypoglycemia, you can prepare by getting a prescription for a kit from your doctor, and then teaching your family and friends how to use it.

Monitoring Matters

If you are taking any insulin or other diabetes medication that increase insulin production, you’ll need to be especially vigilant about hypoglycemia. Experts usually recommend that people who are prone to hypoglycemia or hypoglycemia unawareness keep their blood glucose meter ready to check their glucose levels frequently, especially if they will need to drive anywhere.

Also, it’s worth being extra careful if you are taking medications for your diabetes and engaging in any activities that might cause low blood sugar—for example, if you’re more physically active than usual or you’re going to be eating later than you usually do.

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  1. Diabetic hypoglycemia. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/basics/symptoms/con-20034680
  2. Hypoglycemia. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.niddk.nih.gov/health-information/health-topics/Diabetes/hypoglycemia/Pages/index.aspx
  3. Hypoglycemia (Low Blood Glucose). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-l...
  4. Hypoglycemia? Low Blood Glucose? Low Blood Sugar? Clinical Diabetes. January 2012; vol. 30, no. 1 38. http://clinical.diabetesjournals.org/content/30/1/38.full
  5. What Can I Do To Prevent Serious Hypoglycemic Episodes When I am Hypoglycemic Unaware? Joslin Diabetes Center. http://www.joslin.org/info/what_can_i_do_to_prevent_serious_hypoglycemic_episodes_when_I_am_hypoglyc...
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Feb 14
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