Managing diabetes: Hypoglycemia

Updated On Jan 12, 2022

Hypoglycemia occurs when the level of glucose in the blood falls below a certain level (below 4mmol/L (72mg/dL)) – lower than it should be. It is caused by too high dose of medication, delayed meals, too much exercise, alcohol on an empty stomach/drinking too much and declining kidney function. It can be very dangerous, but you can take steps to prevent it.

Symptoms may include:

  • Sweating 
  • Fatigue
  • Feeling dizzy/shakiness
  • Headache
  • Being pale 
  • Feeling weak 
  • Feeling hungry 
  • A higher heart rate than usual 
  • Blurred vision 
  • Confusion 
  • Convulsions 
  • Loss of consciousness 
  • Extreme cases – coma 
  • Lightheadedness 

As blood glucose continues to drop, other signs and symptoms may occur, such as: 

  • Changes in behaviour, such as confusion, irritability or sleepiness
  • Feelings of being anxious or weak 
  • Problems speaking clearly (slurring words)
  • Problems with vision (seeing double or blurred)
  • Seizures/convulsions 


Different types of hypoglycemia:



Level 1 (mild) hypoglycemia 

Blood glucose is less than 70mg/dL but is 54mg/dL or higher 

Level2 (moderate) hypoglycemia

Blood glucose is less than 54mg/dL

Level 3 (severe) hypoglycemia

  • A person is unable to function because of mental or physical changes and need help form another person. Blood glucose is often below 40mg/dL
  • Can be mild, moderate, or severe based on the person’s blood glucose and condition 
  • Treating severe hypoglycemia is through glucagon – treatment that raises the person’s blood glucose quickly. After they gain consciousness it is advised that they consumed something containing sugar 

Reactive hypoglycemia

  • Also known as postprandial hypoglycemia 
  • Low blood sugar that occurs within 4 hours after eating 
  • May be associated with what food was eaten or the variation in the timing of the food eaten 
  • May also be associated with alcohol, surgical procedures (gastric bypass), inherited metabolic disorders and some tumours 
  • May be caused by your body making too much insulin after a large, carb-heavy meal 

Nocturnal hypoglycemia

  • Occurs when a person with diabetes has low blood sugar levels at night
  • Caused by them eating too little food after taking insulin dose or taking more insulin than prescribed in the evening 
  • Signs may include: restlessness, unusual noises, talking or nightmares, waking up feeling tired/having headache, and night sweats 


Preventing hypoglycemia:

  • Raise your sugar levels with carbohydrates 
  • Eating meals and snacks regularly after consuming diabetes medication 
  • Reduce your medication (consult your doctor) 
  • Regularly monitor your blood sugar levels (especially during periods of low value)
  • Taking medication on time and as directed 
  • Recognize the signs and symptoms 
  • Eating a balanced diet