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Hypoglycemia
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Metabolic Problems

Hypoglycemia

Hypoglycemia, or low blood glucose, occurs when blood sugar levels drop below a healthy range, requiring prompt identification and management.

What is Blood Glucose?

Blood glucose, or blood sugar, is the main sugar found in your blood and serves as your body's primary source of energy. It is derived from the food you eat. When blood glucose levels rise, the pancreas releases insulin, a hormone that helps glucose enter your cells for energy use.

In people with diabetes, the body either does not produce enough insulin, cannot use it effectively, or both, causing excess glucose to remain in the bloodstream rather than reaching the cells.

Understanding Hypoglycemia

Hypoglycemia occurs when blood glucose levels drop below a healthy range:

  • For people with diabetes: This is typically defined as a level lower than 70 mg/dL, though individual targets may vary.
  • For people without diabetes: This is typically defined as a level lower than 55 mg/dL.

Causes and Risk Factors

Hypoglycemia is common in individuals with type 1 or type 2 diabetes who use insulin or other diabetes medications. Potential causes include:

  • Side effects of insulin or medications that stimulate insulin release.
  • Insufficient intake of carbohydrates.
  • Increased physical activity.
  • Consuming alcohol without adequate food.
  • Illness that prevents eating or keeping food down.

While rare, hypoglycemia can occur in people without diabetes due to liver disease, kidney disease, hormone deficiencies, certain medications, or following specific types of weight loss surgery.

Symptoms

Symptoms of low blood glucose often appear quickly and can vary by individual, but may include:

  • Shaking
  • Sweating
  • Nervousness or anxiety
  • Irritability or confusion
  • Dizziness
  • Hunger

Diagnosis and Treatment

People with diabetes typically monitor their levels using a blood glucose meter or a continuous glucose monitoring (CGM) system. If you do not have diabetes, a provider may order blood tests to determine the underlying cause of low blood glucose.

Treatment for mild or moderate hypoglycemia involves consuming carbohydrates. Severe hypoglycemia, which can lead to passing out, coma, or death, is treated with glucagon—a hormone that raises blood glucose levels—administered via nasal spray or injection.

Prevention

To help prevent hypoglycemia, individuals with diabetes should:

  • Follow their prescribed diabetes meal plan and carry fast-acting carbohydrates, such as glucose tablets or juice.
  • Monitor blood glucose levels before and after physical activity.
  • Take all diabetes medications exactly as prescribed.

Frequently Asked Questions

You must call emergency services or have someone take you to the hospital if you are experiencing severe hypoglycemia symptoms that impair consciousness, such as seizures, confusion, or unconsciousness. In these cases, you cannot safely swallow food or drink, and oral glucose is ineffective. Additionally, if you have treated an episode twice and your blood sugar remains below 70 mg/dL, or if you are unable to keep food down due to vomiting, immediate medical attention is required.
Hypoglycemia unawareness occurs when the body fails to trigger the usual warning symptoms, such as shaking or sweating, before blood sugar drops to dangerous levels. This is often caused by frequent episodes of low blood sugar or long-standing diabetes. Management involves working with your healthcare provider to adjust medication dosages to reduce the frequency of lows, using continuous glucose monitors (CGMs) that provide real-time alerts, and setting higher glycemic targets to create a safety buffer.
The 15/15 rule is the standard first-aid protocol for mild to moderate hypoglycemia. You should consume 15 grams of fast-acting carbohydrates, such as four glucose tablets, half a cup of fruit juice, or regular soda. Wait 15 minutes and recheck your blood glucose. If it is still below 70 mg/dL, repeat the process. Once levels normalize, eat a small snack or meal containing protein and complex carbohydrates to prevent a recurrence.
lcohol can cause delayed hypoglycemia because the liver prioritizes metabolizing alcohol over maintaining blood glucose levels. This risk is significantly higher if you drink on an empty stomach or if you are taking insulin or sulfonylureas. Symptoms of alcohol-induced hypoglycemia can be mistaken for intoxication, such as slurred speech and unsteady gait. To mitigate this risk, always consume alcohol with food and monitor your blood glucose levels before bed and during the night if you have consumed alcohol.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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