• Hypoglycemia is a common occurrence with type 1 diabetes.
  • You can usually treat mild to moderate hypoglycemia on your own.
  • Certain devices can monitor and alert you to hypoglycemia or stop insulin delivery when blood sugar is low.

For people with type 1 diabetes, testing blood sugar levels is part of the everyday routine. It’s a crucial step in calibrating insulin to keep blood sugar in the ideal zone.

Yet sometimes you might get more insulin than you need. When this happens, you end up with low blood sugar, also known as hypoglycemia.

Read on to find out more about hypoglycemia, including why it happens, how to recognize it, and when to call 911.

The cells in your body need sugar in the form of glucose to make energy. And you need the right amount of insulin to balance your level of blood sugar.

When you have more insulin than you need, you end up with low blood sugar, or hypoglycemia.

Most people with type 1 diabetes have one or two episodes of mild hypoglycemia each week, according to research from 2010.

A 2018 study from Canada and another 2018 study from Brazil found that hypoglycemia is a common adverse event in people with type 1 diabetes. And 2017 research from a hospital in India suggested that it’s one of the leading causes of emergency room visits.

The goal for most people with type 1 diabetes is to keep glucose levels between 70 and 180 milligrams per deciliter (mg/dL). In this range, complications are less likely.

A level between 55 and 70 mg/dL is mild to moderate hypoglycemia. If levels drop below 55 mg/dL, a person with type 1 diabetes may experience severe hypoglycemia.

Because everyone is a little different, it’s best to discuss your target zone with a healthcare professional.

The most common causes of hypoglycemia are:

  • getting too much insulin
  • improperly timing insulin
  • not eating enough carbs to match the insulin
  • skipping a meal
  • not monitoring enough while exercising or drinking alcohol

You might be more prone to hypoglycemia if you have kidney or liver disease or an infection.

Hypoglycemia may also be more likely to occur if you’re:

  • in a hot and humid climate
  • on your menstrual period
  • traveling
  • at a high altitude

The condition may also be more likely in people with type 1 diabetes who are going through puberty.

It’s important to know the symptoms so you can take steps to treat hypoglycemia. Early symptoms may include:

  • sweating
  • shakiness
  • hunger

These symptoms can be so subtle you may not notice them. As it worsens, you might develop:

  • weakness or tiredness
  • trouble walking
  • blurry vision

Symptoms of severe hypoglycemia can include:

  • fatigue
  • fainting
  • confusion
  • seizures
  • loss of consciousness

Severe hypoglycemia can lead to accidents if you pass out while driving or in some other dangerous situation.

It can also happen while you’re sleeping. Using a continuous glucose monitor can alert you to nighttime episodes. Your family members should know how to identify key signs of hypoglycemia at night, including:

  • hot, clammy skin
  • damp bedsheets
  • changes in breathing
  • trembling or shaking

Family members should know where you keep your emergency kit in case of severe hypoglycemia at night. If a family member suspects their partner is experiencing hypoglycemia and cannot wake them, they should be prepared to administer glucagon and call a doctor.

The longer you have diabetes, the more difficult it can be to recognize signs of hypoglycemia. If you experience hypoglycemia frequently, you can develop what’s called hypoglycemia unawareness.

Hypoglycemia unawareness can be very dangerous. You can improve your awareness by strictly avoiding low blood sugar for several weeks.

Certain medications, such as high blood pressure drugs, can also mask symptoms.

Because you may not always recognize hypoglycemia signs, it’s important to educate people close to you. This way, they can take action if they notice any symptoms.

Hypoglycemia is low blood sugar. Hyperglycemia, on the other hand, occurs when blood sugar levels are too high.

Hyperglycemia happens when you don’t have enough insulin to handle the sugar. This can be because you:

  • took too little insulin
  • ate more than you planned
  • exercised less than you thought you would
  • are already feeling sick or stressed

Symptoms of hyperglycemia include thirst and frequent urination.

When you first feel symptoms, check your blood sugar right away. When it’s between 51 and 70 mg/dL:

  1. Eat 10 to 15 grams of fast-acting carbs like fruit juice or hard candy, or consume 3 to 4 glucose tablets.
  2. After 15 minutes, test your blood again. If it’s still low, repeat.

For the next few days, you may be less likely to notice symptoms of low blood sugar, so test your levels regularly.

Tell your doctor if this happens often. Your treatment plan may need some adjusting.

If hypoglycemia goes on too long, it can cause permanent damage to your health or become life threatening.

So, if you notice symptoms, you need to act quickly. If you’re weak or disoriented, ask for help.

When blood sugar is under 50 mg/dL:

  1. Eat 20 to 30 grams of fast-acting carbs or 6 to 8 glucose tablets.
  2. After 15 minutes, test again. If it’s still low, repeat.

If needed, someone can give you an emergency dose of glucagon. This can be administered by injection or nasal spray. Your blood should be tested again in 15 minutes.

Someone should call 911 if:

  • You’ve lost consciousness.
  • You had glucagon but you needed a second dose or still feel disoriented.
  • Your blood sugar remains too low after 20 minutes.

When in doubt, call for help. First responders can give you intravenous glucose to quickly raise your blood sugar.

Several tools can help prevent and treat hypoglycemia or provide information if you can’t speak for yourself.

Emergency kit

Keep an emergency kit on hand and include items such as:

  • glucagon
  • glucose tablets
  • fast-acting carb-filled snacks
  • a medical ID card or bracelet specifying that you have type 1 diabetes
  • written instructions for how someone can help you in an emergency

Medical ID bracelet

A medical ID bracelet or necklace alerts others, including emergency medical personnel, that you have type 1 diabetes. This can save precious time — and your life.


Glucagon is a hormone that raises blood sugar. It’s a prescription medication available as a:

  • nasal spray
  • prefilled syringe
  • auto-injector pen

Close family, friends, and co-workers can be taught how to use it if you can’t administer it yourself.

Continuous glucose monitor

A continuous glucose monitor can alert you when glucose is getting low. Parents and caregivers can also keep track and get smartphone alerts when blood sugar is too low or too high.

If your pump and monitor are on a closed-loop system, the insulin will be automatically adjusted in response to low glucose. These devices are especially helpful during the night in case you don’t wake up when your blood sugar drops.

Hypoglycemia in type 1 diabetes is when your blood sugar drops below the target range. When you catch it early, you can take steps to raise your blood sugar.

A severe drop in blood sugar can quickly become a life threatening event. But there are helpful ways to monitor glucose, help keep it in the target zone, and administer quick treatment.

When in doubt, seek emergency care.