The symptoms of both high and low blood sugars can be very confusing. After many years of diabetes your body may become so accustomed to high blood sugar levels that even normal blood sugar may be experienced as a low. Sensations such as sweating for no reason, blurry vision, headache, heart palpitations, fatigue, shakiness, and dizziness may not mean your sugar is low. You may simply be experiencing excess stress. When stress hormones are released and your blood sugar is normal, your body goes into fight-or-flight mode, which you will experience as a low (low blood sugar). The body may react by releasing stored glucose into the bloodstream, which will cause your blood sugar to rise. Unfortunately, this may not make you feel any better and you may, in fact, feel worse. Some diabetics experience a sense of dread when this happens, which may cause extreme anxiety.
Eventually your body will reset its blood glucose thermostat, but this may take some time. In the meantime, if you have tested your blood sugar level, you will know nothing horrible is happening and you should just wait for normalcy to return. If your blood sugar is between 70 and 120, you’re OK. If it’s below 70 you may be suffering a hypoglycemic episode (low blood sugar).
Diabetics who are on insulin or sulfonylurea drugs may suffer from a dangerous condition called hypoglycemia unawareness. When your sugars frequently go low, the body may suffer from what’s called a “maladaption,” which means you adapt to the situation in a non-beneficial way. Your body stops responding like it normally would to low blood sugar, so you don’t get the typical symptoms. You feel fine, and then go right to severe symptoms, including confusion and passing out, which is extremely dangerous.
If you’re suffering from hypoglycemia unawareness, your doctor should back off somewhat on blood sugar control, recommends Torrance, California, endocrinologist Cathy Doria-Medina, M.D. “The advantage of relaxing control is not only to avoid low blood sugar episodes. If you can avoid hypoglycemia for a while, some people will regain that warning system.”
Some diabetics may not experience any of the typical symptoms of hyperglycemia (high blood sugar) or hypoglycemia, especially when their diabetes is of long-term duration and they have had repeated low sugars or persistent high sugars. Because they feel “OK,” they do not think it is necessary to act upon a low sugar that they see with their meter even though it then might drop further and become dangerously low. On the other hand, they might not think it is important to bring down their high sugars, because they are not experiencing any symptoms.
Pre-diabetics or diabetics who don’t test regularly may misinterpret symptoms of high blood sugars because they’re excessively thirsty, hungry, or urinating a lot. But these symptoms may be caused by dehydration, a bladder infection, or even low blood sugar. The only way to know is to test.
Diabetics also suffer from other medical conditions that can cause the sensation of a low blood sugar, such as high blood pressure and heart disease. Dizziness can result from blood pressure pills causing blood pressure to drop. The dizziness feels like low blood sugar, so if you drink some juice, this may make your blood sugar levels spike.
A low blood sugar is not a green light to consume high-calorie/high-fat foods that contribute to unnecessary weight gain. “For example,” Dr. Doria-Medina explains, “a first-time patient of mine was sitting in the waiting room with an orange juice. She told me she was really hungry and thought she was experiencing a low blood sugar episode. But the reason probably was that she was just hungry. Her sugar was 300. She wasn’t checking her blood sugars regularly and her family physician had told her one of the symptoms of hypoglycemia was hunger, so she was drinking juice.”
It’s best to correct a low blood sugar with just what you need—sugar. Glucose tablets have what you need in the simplest form and will turn around a low sugar quickly. They are easy to carry around and available at your drugstore. Regular sweets or juice take longer to digest and may not elevate your sugar quickly enough.
It is important to retest your blood sugar to see that it is coming up. The symptoms of a low sugar can persist a long time even after the blood sugar is no longer low. This is because the hormones your body produces to combat the low sugar take a while to clear out. If you rely just on the symptoms, you may continue to consume sugar when it is not needed, which results in over treatment and a high blood sugar later.