People without diabetes can get hypoglycemia, or low blood sugar. This can happen if you take certain medications, have a severe infection, or have other serious issues affecting your organs.

Hypoglycemia is a condition that occurs when the sugar levels (glucose) in your blood are too low. Many people think of hypoglycemia as something that occurs only in people with diabetes. However, it can also occur in people who don’t have diabetes.

It can happen in people who don’t have diabetes but have other underlying conditions or from drinking too much alcohol.

Hypoglycemia can happen in people with diabetes if the body produces too much insulin, which is a hormone that breaks down sugar so that you can use it for energy. You can also get hypoglycemia if you have diabetes and you take too much insulin.

If you don’t have diabetes, hypoglycemia can happen when you don’t have enough sugar in your blood or if your body can’t stabilize your blood sugar level. This occurs in people without diabetes when your level drops below 55 milligrams per deciliter (mg/dL).

Low blood sugar means your body doesn’t have enough energy to properly function or carry out its activities.

Nondiabetic hypoglycemia can result from using certain medications, consuming alcohol in excess, skipping meals, or an underlying health condition.

You receive glucose (your body’s main energy source) from food. Because of that, you might have a drop in blood sugar after going several hours without food or if you don’t eat before a workout. In both cases, eating can help stabilize your blood sugar.

On the other hand, ongoing problems with nondiabetic hypoglycemia (not related to food intake) might indicate a decrease in insulin production. This may be related to issues with your:

  • metabolism
  • hormone levels
  • organs (kidneys, liver, or pancreas)

Hypoglycemia in people without diabetes is less common than hypoglycemia which occurs in people who have diabetes or related conditions.

Everyone reacts differently to fluctuations in their blood sugar levels. Symptoms of hypoglycemia may include:

You may have hypoglycemia without symptoms. This is known as hypoglycemia unawareness.

Hypoglycemia is either reactive or nonreactive. The two types have different causes.

Reactive hypoglycemia

Reactive hypoglycemia occurs within a few hours after a meal. An overproduction of insulin causes reactive hypoglycemia. Having reactive hypoglycemia may mean you’re at risk of developing diabetes.

Nonreactive hypoglycemia

Nonreactive hypoglycemia isn’t necessarily related to meals and may be due to an underlying condition. Causes of nonreactive, or fasting, hypoglycemia include:

  • some medications
  • excess amounts of alcohol, which can stop your liver from producing glucose
  • any disorder that affects the liver, heart, or kidneys
  • eating disorders, such as anorexia
  • pregnancy

Although rare, a tumor of the pancreas can cause the body to make too much insulin or an insulin-like substance, resulting in hypoglycemia. Hormone deficiencies can also cause hypoglycemia because hormones control blood sugar levels.

Dumping syndrome

If you’ve had surgery on your stomach to relieve symptoms of gastroesophageal reflux disease, you may be at risk for a condition known as dumping syndrome. Dumping syndrome also occurs in people who have had gastric bypass surgery.

In late dumping syndrome, the body releases excess insulin in response to carbohydrate-rich meals. That can result in hypoglycemia and related symptoms.

Possible causes of hypoglycemia without diabetes

Several factors can cause hypoglycemia, even if you don’t have diabetes. Causes of hypoglycemia without diabetes include:

  • drinking alcohol
  • taking certain medications, including certain antibiotics and medications for malaria or pneumonia, lithium, and some heart medications like ACE inhibitors, ARBs, and nonselective beta-blockers
  • kidney problems
  • problems with your adrenal or pituitary gland
  • pancreatic tumors
  • severe infections
  • liver disease
  • tumor of the pancreas
  • immune system producing antibodies, either to insulin or to insulin receptors, after weight loss surgery
  • anorexia nervosa

Possible causes of hypoglycemia with diabetes

Causes of hypoglycemia in people with diabetes include:

  • not eating enough
  • skipping meals
  • drinking alcohol
  • taking too much insulin
  • increasing physical activity without making changes to your diet or diabetes medications

Hypoglycemia without diabetes can occur in both children and adults. You’re at an increased risk of developing hypoglycemia if you:

  • have other health problems
  • have family members with diabetes
  • have had certain types of surgery on your stomach

A doctor needs to identify the cause of your hypoglycemia to determine the right treatment for you.

Glucose will help boost your blood sugar levels in the short term. One way to get additional glucose is to consume 15 grams of carbohydrates.

Drinking fruit juice can help get extra glucose into your bloodstream. These sources of glucose often briefly correct hypoglycemia, but then another drop in blood sugar often follows.

Eating foods high in complex carbohydrates, such as pasta and whole grains, can sustain blood sugar levels after a period of hypoglycemia.

Symptoms of hypoglycemia can become so severe that they interfere with daily routines and activities. If you have severe hypoglycemia, you might need to carry glucose tablets or injectable glucagon.

Hypoglycemia can occur in a fasting state, meaning you’ve gone for an extended period without eating. A doctor may request a fasting test that requires someone to fast for 8 hours prior.

Another test is a mixed-meal tolerance test. This test is for people who experience hypoglycemia after eating.

The results are usually available within a day or 2. If your blood sugar level is lower than 55 mg/dl, you may have hypoglycemia.

Keep track of your symptoms with a symptom diary. This information can help with diagnosis. The diary should include:

  • any symptoms
  • what you’ve eaten
  • how long before or after a meal your symptoms occurred

Unmanaged hypoglycemia can cause long-term health problems. Your body needs glucose to function. Without the right level of glucose, your body will have difficulty performing its normal functions. As a result, you may have difficulty thinking clearly and performing daily tasks.

Serious side effects

If left untreated, hypoglycemia can have several serious side effects that may include:

If you’re experiencing any of these complications, you or someone near you should seek emergency medical care.

Hypoglycemia unawareness

Hypoglycemia unawareness occurs when you don’t experience early warning symptoms of hypoglycemia, such as hunger, sweating, and shakiness.

For this reason, you may not realize that your blood sugar levels have dropped, which can make you more susceptible to severe symptoms of hypoglycemia.

If you think that you may have hypoglycemia unawareness, you can talk with a doctor to determine the best course of treatment.

This may include checking your blood sugar levels more frequently, adjusting your medications, or working with a certified diabetes educator to learn to recognize the warning signs of hypoglycemia.

Long-term complications

Having low blood sugar levels can increase your risk of many conditions, including heart disease.

In fact, research shows that severe hypoglycemia could be linked to a higher risk of heart disease and death in people with type 2 diabetes.

In some cases, changes to your diet and eating schedule can resolve hypoglycemia and prevent future episodes. Follow these tips to prevent hypoglycemia:

If you don’t have diabetes

Even if you don’t have diabetes, it’s important to eat regularly to prevent hypoglycemia. Ideally, meals and snacks should contain a balance of carbs, protein, and heart-healthy fats to help support healthy blood sugar levels.

You may also want to keep a few healthy snacks on hand in case you start feeling side effects such as hunger, sweating, or shakiness. Easy snack ideas for low blood sugar levels can include:

  • fresh fruit
  • trail mix
  • crackers with peanut butter or another nut or seed butter

If you regularly experience low blood sugar levels, a doctor can determine underlying factors could play a role.

If you have diabetes

If you have diabetes, you can prevent hypoglycemia by:

  • regularly monitoring your blood sugar levels
  • eating consistently and following a well-rounded diet
  • taking any medications for diabetes as directed by your doctor
  • discussing any changes to your diet or exercise routine with your doctor, as they may need to adjust the dosage or timing of your medications
  • keeping fruit juice or glucose tablets on hand in case your blood sugar levels drop

A doctor or dietitian can help you determine how many carbohydrates you should eat at each meal to maintain healthy blood sugar levels.

Wearing a medical ID bracelet with basic information about your medical history can also be beneficial in case of an emergency.

What can mimic low blood sugar?

Symptoms of low blood sugar, such as dizziness, sweating, and headache, can occur with other health conditions, such as heart problems, hyperthyroidism, certain medications, dehydration, and some mental health or psychiatric disorders.

Why would my blood sugar drop if I don’t have diabetes?

People who do not have diabetes can have low blood sugar due to certain medications, some underlying health conditions, drinking too much alcohol, or skipping meals.

What should I do if my blood sugar is low?

If your blood sugar is low, you can try drinking fruit juice or eating a snack, such as trail mix, to help raise your levels.

Hypoglycemia is a serious condition that can occur when your blood sugar levels drop too low. Although it’s more common in people with diabetes, it can also occur due to other health conditions.

If left untreated, hypoglycemia can cause serious side effects and long-term health consequences.

However, there are plenty of ways to prevent hypoglycemia, including eating regularly, following a healthy diet, monitoring your blood sugar levels carefully, taking medications as directed by your doctor, and, in some cases, surgery.

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