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.
Hypoglycemia is different from hyperglycemia, which occurs when you have too much sugar in your bloodstream.
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 when your level drops below 70 milligrams per deciliter (mg/dL).
Low blood sugar means your body doesn’t have enough energy to properly function or carry out its activities.
The underlying cause of nondiabetic hypoglycemia varies. Sometimes it’s due to an imbalanced or unhealthy diet.
You receive glucose (which is your body’s main energy source) from food. Therefore, you might experience 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:
- hormone levels
- organs (kidneys, liver, or pancreas).
Hypoglycemia in people who don’t have diabetes is less common than hypoglycemia that occurs in people who have diabetes or related conditions.
Everyone reacts differently to fluctuations in their blood sugar levels. Symptoms of hypoglycemia may include:
- pale skin
- tingling or numbness in the lips, cheeks, or tongue
- extreme hunger
- inability to concentrate
- blurred vision
- personality changes
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 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 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
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.
If you’ve had surgery on your stomach to alleviate symptoms of gastroesophageal reflux disease, you may be at risk for a condition known as dumping syndrome. Dumping syndrome also occurs in patients 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 alongside diabetes
If you have diabetes, there are several reasons you may experience hypoglycemia. Causes of hypoglycemia include:
- not eating enough
- skipping meals
- drinking alcohol
- taking too much insulin
- increasing physical activity without making changes to your diet or diabetes medications
Possible causes 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 some antibiotics and medications for malaria or pneumonia
- 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 receptor, after weight loss surgery
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
Your doctor will need to identify the cause of your hypoglycemia to determine the right long-term therapy 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 is an easy way to 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 that are high in complex carbohydrates, such as pasta and whole grains, will 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 glucose (glucagon).
Hypoglycemia can occur in a fasting state, meaning you’ve gone for an extended period without eating. Your doctor may ask you to take a fasting test. This test can last as long as 72 hours. During the test, you’ll have your blood drawn at different times to measure your blood glucose level.
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 two. If your blood sugar level is lower than 55 mg/dl, you may have hypoglycemia.
Keep track of your symptoms with a symptom diary. Your diary should include any symptoms, what you’ve eaten, and how long before or after a meal your symptoms occurred. This information will help your doctor make a diagnosis.
It’s important to manage your hypoglycemia because it can cause long-term health problems. Your body needs glucose to function. Without the right level of glucose, your body will struggle to perform its normal functions. As a result, you may have difficulty thinking clearly and performing even simple tasks.
In severe cases, hypoglycemia can lead to seizures, neurological problems that may mimic a stroke, or even loss of consciousness. If you’re experiencing any of these complications, you or someone near you should seek emergency medical care.
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, including confusion, loss of consciousness, or seizures.
If you think that you may have hypoglycemia unawareness, talk with your 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.
Having low blood sugar levels can increase your risk of many conditions, including heart disease.
Serious side effects
If left untreated, hypoglycemia can have several serious side effects. Severe complications of hypoglycemia include:
- behavior changes
- loss of consciousness
- blurred vision
- slurred speech
Simple changes to your diet and eating schedule can resolve hypoglycemia and prevent future episodes. Follow these tips to prevent hypoglycemia:
If you have diabetes
If you have diabetes, it’s important to monitor your blood sugar levels regularly.
Eating consistently and following a healthy, well-rounded diet are also crucial. Your doctor or dietitian can help you determine how many carbohydrates you should eat at each meal to maintain healthy blood sugar levels.
Take any medications for diabetes as directed by your doctor. Discuss any changes to your diet or exercise routine with your doctor, as they may need to adjust the dosage or timing of your medications.
It’s also a good idea to keep fruit juice or glucose tablets on hand in case your blood sugar levels drop. Wearing a medical ID bracelet with basic information about your medical history can also be beneficial in case of an emergency.
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. Fresh fruit, trail mix, and crackers with peanut butter are a few quick and easy snack ideas for low blood sugar levels.
If you regularly experience low blood sugar levels, talk with your doctor to see whether underlying factors could play a role.
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 be caused by 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.