Articles / Type 2 Diabetes / Hypoglycemia: How to Avoid the Sugar Plunge

Written by Nan Kuhlman

Medically Reviewed by Susan Kerrigan, MD | Feb 19, 2019

Most everyone has felt jittery, shaky, or dizzy when they haven’t eaten for a while. These are mild symptoms of low blood sugar (or hypoglycemia), and they usually go away once you’ve had something to eat. For people with diabetes, though, symptoms of hypoglycemia can become much more serious quickly.

Don’t people with diabetes have high blood sugar, not low blood sugar?

It’s true that people with diabetes have higher levels of blood glucose, and because of that, they must take insulin to regulate their blood sugar or medications to help them produce more insulin. It’s these very medications that can create the side effect of low blood sugar.

How do insulin and other medications create low blood sugar?

The blood sugar balance can easily be thrown off if you change your food consumption or your activity levels. Skipping a meal or eating later than normal can create low blood sugar, as well as not eating enough carbohydrates or simply being sick. Consuming too much alcohol and not enough food is also a problem because you could become hypoglycemic and not realize it due to the alcohol buzz. Women sometimes face hormonal issues, such as menopause, which can change how their bodies process glucose, so they must work closely with their healthcare team to properly manage their medications.

 

Blood Sugar Goals

How can I prevent hypoglycemia?

Eating regularly and checking your blood glucose levels is a good start. If you struggle with not recognizing the symptoms of hypoglycemia or if it happens a lot, a continuous glucose monitor (CGM) might be good for you. Using good sense when exercising or engaging in more than your normal activity is also important. Since exercise reduces blood sugar levels up to 24 hours, you could have a snack before your activity or consider reducing your insulin dose if your doctor advises it.

What do I do if I become hypoglycemic anyway?

The first step if you start to feel symptoms is to check your blood glucose level. It should be at least 70 mg/dL. But if you can’t check it and you have the symptoms of hypoglycemia, you should assume it is hypoglycemia and treat it using the “15-15 Rule.” Here’s how the American Diabetes Association explains it:

“Have 15 grams of carbohydrate to raise your blood glucose and check it after 15 minutes. If it’s still below 70 mg/dL, have another serving. Repeat these steps until your blood glucose is at least 70 mg/dL. Once your blood glucose is back to normal, eat a meal or snack to make sure it doesn’t lower again.” ~American Diabetes Association

This carbohydrate could be hard candy or jelly beans, but you’ll need to read the label to figure out how many to eat to meet the 15-gram requirement. Another option usually available is 4 ounces of regular soda (not diet) or juice. If you choose to use glucose tablets or gel, you’ll need to follow the instructions to consume the right amount. Because you need to digest the carbohydrate quickly, it’s best not to eat a complex carbohydrate (one that contains fat, like chocolate) because it’s slower to digest.

Facing a blood sugar plunge like hypoglycemia can be a little scary if you don’t know what it is or what to do. Educating yourself, paying close attention to your body, developing healthy habits, and working with your doctor can make handling any possible hypoglycemia a lot easier.

References

Continuous glucose monitoring. (2017). National Institute of Diabetes and Digestive and Kidney Disorders. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/continuous-glucose-monitoring

Hypoglycemia (Low Blood Glucose). (2019). American Diabetes Association. Retrieved from http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html

Low Blood Glucose (Hypoglycemia). (2016). National Institute of Diabetes and Digestive and Kidney Disorders. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia

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