Hypoglycemia or low blood sugar can be a common occurrence for people with diabetes, even when carefully managing the disease.  Hypoglycemia happens when the amount of blood glucose or our blood sugar, drops too low to sustain normal functioning.   For most people, this is defined as a blood sugar level below 70 mg/dl.

A 2015 study review in Plos One found that among those with type 2 diabetes, on average individuals were having up to 19 mild episodes of hypoglycemia each year and nearly one severe episode per year.  Individuals taking insulin were particularly at risk for low blood sugar as it was found to be more common in them. 

When a person is experiencing hypoglycemia, it can cause both short-term complications such as dizziness and confusion as well as more serious, long-term complications.  If it is not recognized and is left untreated, it can lead to a coma and even death. 

This is why it is crucial to recognize and prevent hypoglycemia and the dangerous side effects that go along with it.  Monitoring blood glucose levels closely can catch when blood glucose levels drop and to take action to treat it.  Also paying attention to telltale signs signaling low blood sugar is critical to avoid potentially serious consequences:

1. Sweating – This is a common symptom and is usually one of the first signs of hypoglycemia.  The excessive perspiration comes on without warning, regardless of how warm or cold the external temperature may be. 

2. Shakiness or tremors – As glucose levels begin to drop, the central nervous system start to malfunction.  As a result, it releases catecholamines which are chemicals that encourage glucose production and also produce these symptoms. 

3. Feeling anxious – Low blood glucose results in the adrenal glands releasing the hormone epinephrine also called adrenaline signaling the liver to make more sugar.  This excess epinephrine creates an “adrenaline rush” causing a feeling of anxiety.

4. Difficulty in concentrating – When glucose levels dip, the brain is especially sensitive to this resulting in a sense of confusion and an inability to concentrate.

5. Mood swings – If a person who is normally level-headed becomes emotionally unstable or showing mood swings such as irrational outbursts, random or hysterical crying, or uncontrollable anger, could be indicating a reduction in blood sugar.  Emotional instability is one of the first neurological symptoms of hypoglycemia and can be a clue to what is going on.

6. Excessive hunger – A ravenous hunger even just after you’ve eaten can be a sign of low blood sugar.  The treatment for this is to take 15 grams of a carbohydrate rich food such as two tablespoons of raisins, 4 ounces of fruit juice or 5-6 pieces of hard candy such as peppermints.

7. Slurred speech – You may not notice but if someone else comments wondering if you’ve had too much to drink, this can be a sign of a sugar-starved brain making it difficult to form proper speech.

8. Sleep disturbances – Trouble with sleeping or nocturnal hypoglycemia can be a common symptom if blood sugar levels crash during the night.  Symptoms include night sweats, nightmares, episodes of waking suddenly and crying out or feelings of unrest and confusion when waking.  To help prevent low blood glucose during the night eat a high protein snack with a carbohydrate such as Greek yogurt or cheese and crackers to reduce this occurrence.

9. Dizziness and light-headedness – These are two common symptoms of hypoglycemia that should get one’s attention.  Dropping blood sugar levels can lead to fainting so once these signs are noticed, sit or lie down immediately to prevent injury.

10. Trouble with vision – Sudden blurriness or seeing double can indicate a drop in blood sugar.