Hypoglycemia what to do


What Is It?

Published: June, 2019

Hypoglycemia is an abnormally low level of blood sugar (blood glucose). Because the brain depends on blood sugar as its primary source of energy, hypoglycemia interferes with the brain’s ability to function properly. This can cause dizziness, headache, blurred vision, difficulty concentrating and other neurological symptoms.

Hypoglycemia also triggers the release of body hormones, such as epinephrine and norepinephrine. Your brain relies on these hormones to raise blood sugar levels. The release of these hormones causes additional symptoms of tremor, sweating, rapid heartbeat, anxiety and hunger.

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What is non-diabetic hypoglycemia?

Hypoglycemia is the condition when your blood glucose (sugar) levels are too low. It happens to people with diabetes when they have a mismatch of medicine, food, and/or exercise. Non-diabetic hypoglycemia, a rare condition, is low blood glucose in people who do not have diabetes.

There are two kinds of non-diabetic hypoglycemia:

  • Reactive hypoglycemia, which happens within a few hours of eating a meal
  • Fasting hypoglycemia, which may be related to a disease

Glucose is the main source of energy for your body and brain. It comes from what we eat and drink. Insulin, a hormone, helps keep blood glucose at normal levels so your body can work properly. Insulin’s job is to help glucose enter your cells where it’s used for energy. If your glucose level is too low, you might not feel well.

What causes non-diabetic hypoglycemia?

The two kinds of non-diabetic hypoglycemia have different causes. Researchers are still studying the causes of reactive hypoglycemia. They know, however, that it comes from having too much insulin in the blood, leading to low blood glucose levels.

Types of nondiabetic hypoglycemia

Reactive hypoglycemia

  • Having pre-diabetes or being at risk for diabetes, which can lead to trouble making the right amount of insulin
  • Stomach surgery, which can make food pass too quickly into your small intestine
  • Rare enzyme deficiencies that make it hard for your body to break down food

Fasting hypoglycemia

  • Medicines, such as salicylates (such as aspirin), sulfa drugs (an antibiotic), pentamidine (to treat a serious kind of pneumonia), quinine (to treat malaria)
  • Alcohol, especially with binge drinking
  • Serious illnesses, such as those affecting the liver, heart, or kidneys
  • Low levels of certain hormones, such as cortisol, growth hormone, glucagon, or epinephrine
  • Tumors, such as a tumor in the pancreas that makes insulin or a tumor that makes a similar hormone called IGF-II

What are the symptoms of non-diabetic hypoglycemia?

The symptoms include being:

  • Hungry
  • Shaky
  • Sleepy
  • Anxious
  • Dizzy
  • Confused or nervous
  • Sweaty
  • Irritable
  • Syncope (Passing out, losing consciousness)

Some people have trouble speaking and also feel weak.

Talk with your doctor if you have symptoms of hypoglycemia, even if you only have one episode.

How is non-diabetic hypoglycemia diagnosed?

Your doctor can diagnose non-diabetic hypoglycemia by reviewing your symptoms, doing a physical exam, looking at your risk for diabetes, and checking your blood glucose level. Your doctor will also see whether you feel better after you eat or drink to raise your glucose to a normal level.

Checking your blood glucose to see if it is actually low (about 55 mg/dL or less) when you’re having symptoms is an important part of diagnosis. Your doctor will check your blood glucose level and may order other tests. A personal blood glucose meter is not accurate enough for diagnosis.

For fasting hypoglycemia, you may have your blood glucose checked every few hours during a fast lasting several days. For reactive hypoglycemia, you might have a test called a mixed-meal tolerance test (MMTT).

For the MMTT, you first have a special drink containing protein, fats, and sugar. The drink raises your blood glucose, causing your body to make more insulin. Then your blood glucose level is checked a number of times over the next five hours.

Both tests check to see if your blood glucose levels drop too low. Your doctor might also check your blood for insulin levels or other substances.

What is the treatment for non-diabetic hypoglycemia?

Treatment depends on the cause of your hypoglycemia. For example, if you have a tumor, you may need surgery. If medicine is causing your hypoglycemia, you need to change medicines.

For immediate treatment of low blood glucose, make sure you eat or drink 15 grams carbohydrate (in form of juice, glucose tablets, or hard candy).

Ask your doctor or dietitian whether you need to change your diet. The following type of diet may help you:

  • Eating small meals and snacks throughout the day, eating about every three hours
  • Having a variety of foods, including protein (meat and non-meat), fatty foods, and high-fiber foods such as whole-grain bread, fruit, and vegetables
  • Limiting high-sugar foods

Some doctors recommend a high-protein, low-carbohydrate diet but this type of diet has not proven to help hypoglycemia.

Questions to ask your doctor

  • What is causing my hypoglycemia?
  • What are my options for treatment?
  • How long will I need treatment?
  • How often will I need check-ups and blood tests?
  • How long will I have hypoglycemia?
  • Should I see an endocrinologist?
  • Should I see a registered dietitian?

10 Ways to Treat Low Blood Sugar with Real Food

Health and wellness touch each of us differently. This is one person’s story.

Shaky. Fuzzy. Sleepy. Tired. Low. Crashing.

These are all words I used growing up as a type 1 diabetic, to describe how I was feeling when my blood sugar was low.

I was diagnosed when I was 5. So I came up with some interesting ways to describe how I was feeling to my parents and other adults in my life. I remember one time when I was in kindergarten, I was describing how I felt to a PE teacher, and she thought I was just trying to get out of having to do the activity. I nearly had a hypoglycemic seizure because I didn’t have access to proper attention or treatment. (In her defense, she was a substitute and hadn’t been told I had diabetes.)

So, what is the proper treatment for low blood sugar? To answer that question, we first need to know what’s considered low blood sugar, or hypoglycemia. The American Diabetes Association (ADA) defines hypoglycemia as anytime your blood sugar is lower than normal. This can be different for each person with diabetes, but it usually means blood sugar less than 70 mg/dL. Symptoms to look out for include:

  • tiredness
  • increased appetite
  • cloudy thinking
  • blurry vision
  • an inability to concentrate
  • pale facial complexion
  • sweating

I’ve sometimes described it to my nondiabetic friends as an almost “out of body” experience.

Once you start to feel these symptoms, it’s important to immediately test your blood sugar to confirm if you are, in fact, experiencing hypoglycemia.

Some of these symptoms are also characteristic of high blood sugar levels, or hyperglycemia. You may also feel these symptoms anytime you experience a rapid drop in your blood sugar. For example: If your blood sugar is high, and you take insulin to bring it down, you may feel the symptoms commonly associated with hypoglycemia as your blood sugar dips, even if it isn’t actually low by definition.

Once you’ve confirmed your blood sugar is low — or lower than normal — how should you treat it? Essentially, you want fast-acting carbohydrates: simple sugars with little to no fiber. You also want to avoid high-fat foods. The fat that will often stabilize blood sugars after meals can actually delay how quickly your body absorbs those needed simple carbohydrates. In the case of low blood sugar, that’s the opposite of what you want.

The most commonly recommended treatment for low blood sugar is glucose tablets or glucose gel. And let me tell you, those glucose tablets aren’t the tastiest things in the world. Think chalky, super sweet, and fake fruit flavor all rolled into one… sounds appetizing, I know.

So, while these treatments are highly effective, they’re not exactly what this dietitian would call “nutritious.” Don’t get me wrong, nutrition isn’t our main goal when treating low blood sugar — raising your blood sugar quickly is the main goal. But what if you could properly treat low blood sugar and not have to resort to chalky tablets filled with processed sugar, food coloring, and artificial flavors?

Speaking from both professional and personal experience, here are 10 ways to treat low blood sugar with real food:

If your blood sugar is greater than 80 mg/dL, but you’re feeling symptoms of hypoglycemia:

1. all-natural peanut butter with no added sugar (I prefer this one)

If your blood sugar is greater than 80 mg/dL, it’s likely you’re experiencing these symptoms due to rapidly changing blood sugar levels, and aren’t in need of quick-acting carbohydrates. Peanut butter (or any nut butter) without added sugar is filled with protein and fat and can help alleviate these symptoms without raising your blood sugar more.

If your blood sugar is 70-80 mg/dL:

2. peanut butter and crackers

At this point, your blood sugar is still not technically low, by definition. However, this may be lower than you’re comfortable with. Any form of starch — in this case crackers — will help gradually raise your blood sugar just slightly, and the fat and protein in the peanut butter will sustain those levels.

If your blood sugar is 55-70 mg/dL:

3. raisins

4. medjool dates

5. applesauce

6. bananas

7. grapes

8. pineapple

All the foods listed above are fresh or dried fruit that have higher amounts of naturally occurring sugars than other fruits. While there’s some fiber present in these, the amount is minimal and will raise blood sugar quickly and effectively.

If your blood sugar is less than 55 mg/dL:

9. 100% grape juice

10. honey or maple syrup

If your blood sugar has dropped below 55 mg/dL, you need quick, rapid-acting liquid carbohydrates. There should be no fiber, fat, or protein present. Grape juice is one of the highest carbohydrate-filled juices and is my choice for myself and clients experiencing this severity of hypoglycemia.

Some people have trouble chewing and swallowing when blood sugar reaches this level, so we want to focus on concentrated sources of carbohydrates, like higher-carbohydrate juices, or sweeteners like maple syrup and honey.

Before implementing any of these suggestions into your hypoglycemia plan, make sure to check with your doctor or healthcare provider first.

Mary Ellen Phipps is the registered dietitian nutritionist behindMilk & Honey Nutrition. She’s also a wife, mom, type 1 diabetic, and recipe developer. Browse her website for yummy diabetes-friendly recipes and helpful nutrition tips. She strives to make healthy eating easy, realistic, and most importantly… fun! She has expertise in family meal planning, corporate wellness, adult weight management, adult diabetes management, and metabolic syndrome. Reach out to her onInstagram.

6 Steps To Break The Cycle Of Hypoglycemia

When you go a few hours without eating, do you experience shakiness, feeling light-headed or dizziness? Do you go from fine to I’m-going-to-kill-someone-if-I-don’t-eat-right-now in a matter of minutes?

Crave sugar and carbs only to feel tired, shaky, or cranky later? Are headaches a regular thing for you? Do you experience brain fog, anxiety, irritability, or sudden mood swings that seem to correlate with what or when you eat? Does the word “hangry” describe you?

Then, you may be dealing with a blood sugar issue called hypoglycemia.

What Is Hypoglycemia?

Hypoglycemia is a condition caused by low blood sugar (low glucose) levels. It occurs when blood glucose levels fall below the level required to maintain adequate energy for normal bodily functions.

Symptoms of a hypoglycemic episode range from extreme hunger to irritability and dizziness to hallucinations and loss of consciousness in extreme cases.


  • limiting calorie intake through dieting, fasting, or skipping meals
  • too much exercise without proper refueling
  • not eating enough protein

Finally, taking unhealthy doses of insulin medication for diabetes can also cause hypoglycemia. Diabetes drugs, which can often drive blood sugar too low, tend to bring on the worst hypoglycemic symptoms, like hallucinations, loss of consciousness, and even coma.

The Cycle Of Hypoglycemia

Hypoglycemia is cyclical.

The blood sugar drops, causing a host of symptoms. These symptoms trigger you to crave foods that will provide a glucose boost as quickly as possible — sugar, bread, pasta, pastries, bananas, sodas, etc.

You consume the food you crave and feel temporary relief. All of your symptoms may even immediately disappear, causing you to believe that you’re doing the right thing.

Yet, these foods are causing such a sharp spike in blood sugar that your pancreas must secrete more insulin to bring the blood sugar back down. Sometimes, the pancreas overshoots and brings the blood sugar down too low.

Then, the hunger, irritability, anxiety, dizziness, shakiness, paleness, etc. begin again.

Every time these symptoms arise, you reach for the sugar/carbs, your pancreas overshoots to compensate for the blood sugar spike, and the blood sugar dips into the danger zone again. On and on and on it goes. (Does this sound all too familiar? Here’s how you can know for sure if your blood sugar is imbalanced.)

Over time, your body becomes less sensitive to insulin, so the pancreas must secrete more and more to pick up the slack. This is known as insulin resistance.

And after insulin resistance? Diabetes.

Hypoglycemia and insulin resistance are totally and completely reversible. It is possible to maintain a lifestyle without the roller coaster of hypoglycemia! (I talk about balancing blood sugar through diet in a video in Traditional Cooking School’s Women’s Health eCourse. Click here to learn more!)

Who’s At Risk For Hypoglycemia?

Just because diabetes doesn’t run in your family does NOT mean you aren’t at risk for hypoglycemia. In fact, ANYONE can experience hypoglycemia (or its opposite, hyperglycemia)!

Reactive hypoglycemia is the most common reason for hypoglycemia in non-diabetics. Basically, after eating a large amount of carbohydrates, the pancreas overproduces insulin, causing too much of a drop in blood sugar.

So, you’re at risk for hypoglycemia if you’re eating too much high-carbohydrate food — especially if those foods are processed.

This automatically includes anyone eating the Standard American Diet (SAD) which is loaded with high-carb, processed foods.

What if you eat Real Food? Can you still be hypoglycemic?

Unfortunately, yes.

Although traditionally preparing carb-rich foods like grains and beans through soaking, sprouting, or souring does reduce the glycemic load of these foods, they are STILL high in carbs and will STILL cause hypoglycemia when eaten in excess.

If soaked or sprouted beans, rice, or grains and/or sourdough bread make up a large percentage of your daily diet, you may be unknowingly causing blood sugar spikes and drops which could lead to hypoglycemic symptoms.

Finally, are you under a lot of stress? Or do you suffer anxiety? If so, you’re at risk for hypoglycemia. (Read more about this below!)

Break The Cycle Of Hypoglycemia

Unfortunately, if you don’t stop the cycle — and insulin resistance turns into diabetes — you’re in real trouble.

Hypoglycemia is often an indication that more serious blood sugar problems (ie. insulin resistance, then diabetes) are on the horizon.

So, the million-dollar question is…

How do you break the cycle of hypoglycemia?

#1 — Eat A High-Protein, High-Fat Breakfast TODAY

Ok, breakfast skippers… today’s the day! Carpe Diem! It’s time to start eating breakfast — a high-protein, high-fat breakfast — TODAY!

If you’re powering through your morning on nothing more than coffee, I’d bet money that you’re cold, peeing every 20 minutes, and a hot mess by the time lunch rolls around. (Or you’re sneaking doughnuts from the break room at 10 a.m.)

The caffeine jitters, the frequent urination, the dizziness every time you stand up, the doughnut cravings — they’re all bright red flags that are trying to alert you.

Warning! Your blood sugar is low.

This doesn’t mean that you can never again have carbs at breakfast! But, you have to give your pancreas a break from all the insulin-secreting it’s been doing. It’s overworked and underpaid, ya know?

It’s time to pay up with protein and fat! And if you’re hypoglycemic, this is the quickest, easiest step!

Eat breakfast… Preferably no more than 45 minutes after waking. Do not add carbs to this meal — no oatmeal, no toast, no muffin, no cereal, no cinnamon roll, no doughnut, no milk, no fruit, no juice.

A high-protein/high-fat breakfast looks like:

  • 2 eggs fried in butter, sliced avocado, bacon or sausage
  • 2 slices Pepperoni Pizza Crust-less Quiche and a Sugar-Free Dandy Blend Latte
  • Full fat yogurt or Greek yogurt bowl — like my DIY Chobani Flip: Coconut Yogurt with Sliced Almonds & Dark Chocolate, add another protein source like boiled eggs, sausage, or grain-free waffles
  • An omelet with sauteed onions, peppers, spinach, and cheese with a Chocolate-Orange Smoothie
  • Grain-Free Low-Carb Belgian Waffles with butter, but no syrup. Try Sugar-Free Lemon Curd on top instead!

No breakfast or lots of carbs at breakfast should never again be your normal. Your body is screaming for nourishing fats and plenty of protein to keep that blood sugar (and your mood) stable.

#2 — Stay Away From Refined, High-Glycemic Carbs

My nickname for hypoglycemia is pre-pre-diabetes.

Whether or not diabetes runs in your family, you have blood sugar issues if you’re hypoglycemic. Period.

Because hypoglycemia is often an indicator of worse things to come, refined, high-glycemic carbohydrates should no longer be regulars on your menu.

First and foremost, this means a departure from processed foods. Processed foods are the most refined and contain the most sugar.

Furthermore, checking the ingredients list for sugar isn’t enough. For instance, there may be no sugar listed in the ingredients of potato chips, however potatoes are very high-glycemic and will spike blood sugar even WITHOUT actual sugar added. Just because it’s a savory food doesn’t mean it won’t spike your blood sugar.

Sugar is not the only thing to aware of. Be wary of fructose (fruit sugar), starches (potatoes, tapioca, arrowroot, rice), and whole grains (like oatmeal and whole grain bread).

So if you truly want to break the cycle of hypoglycemia today, you have to understand that these foods (even the super healthy ones) are contributing to the cycle and must be eliminated or significantly reduced:

  • High-sugar fruits like mango, banana, and pineapple
  • Bread, even soaked, sprouted, or sourdough
  • Sodas and juice, even fresh-pressed juice
  • Any ingredient with the suffix -ose — sucrose, dextrose, sucralose, fructose
  • White foods — potatoes, rice, sugar, white flour, popcorn
  • Anything in a box or bag (chips, crackers, pretzels)
  • Dried fruits — raisins, dates, and especially those that are juice- or sugar-sweetened
  • Anything with high fructose corn syrup
  • Grains and beans
  • Pastries, doughnuts, bagels, cookies, cake, brownies, etc. — even “Paleo” versions. They’re usually made with insane amounts of starch (see next point) and/or whole sweeteners (see the point after that).
  • Starches like tapioca, arrowroot, and cassava
  • Whole sweeteners like raw honey, maple syrup, coconut sugar, muscovado sugar, etc.

Not to worry! You won’t starve! Now that you’re aware of the foods that are causing the hypoglycemia cycle to be on repeat, here’s how to nourish your body out of that cycle:

#3 — Focus On Protein, Veggies, & Fat At Each Meal

First of all, you need to eat protein, at every meal and snack. Period.

Of the macro-nutrients (protein, fat, carbs), protein is the most satiating. Your body burns through carbs quickly; yet, protein is a slower burning energy source, so it keeps you fuller longer!

Protein sources include:

  • Eggs of any sort — boiled, fried, scrambled, deviled, quiche — the sky’s the limit!
  • Any and all cuts of pastured animal protein — chicken, beef, lamb, bison, turkey
  • Wild-caught fish and shellfish — salmon, white fish, tuna, shrimp, lobster
  • Gelatin and collagen — stir into hot and cold drinks for extra protein!
  • 24-hour fermented yogurt or Greek yogurt

Nourishing fat sources include:

  • Coconut oil
  • Olive oil
  • Rendered animal fats like tallow and lard
  • Pastured butter and ghee
  • Avocados and avocado oil
  • Pastured egg yolks, like for mayo and salad dressing
  • Raw heavy cream
  • Coconut butter

What about low-glycemic fiber sources? While it’s true that whole grains, beans, oats, and fruit contain fiber, they aren’t the best sources of fiber when trying to break the cycle of hypoglycemia.

Still, you’ll experience other negative symptoms (ie. constipation and bloating) if you aren’t eating enough fiber. Low-glycemic fiber sources include:

  • Leafy greens — in salad, steamed, kale chips, in smoothies
  • Microgreens — sunflower sprouts, wheat grass, buckwheat sprouts, alfalfa sprouts, radish sprouts, etc.
  • Any and all veggies!
  • Low-glycemic fruits — strawberries, raspberries, stone fruits — 1 handful a day is plenty
  • Sprouted beans, sprouted brown rice, sprouted or soaked quinoa — about 3/4 cup per day is plenty
  • Chia seeds, flax seeds, and psyllium husks
  • Coconut flour

Protein + Nourishing Fat + Low-Glycemic Fiber Source = Balanced Blood Sugar!

#4 — Start Snacking

… especially if you’ve been restricting calories, dieting, or fasting!

If you’ve ever been told that snacking is bad or snacking will ruin your dinner or snacking causes weight gain…

I’m telling you the opposite!

Eating the wrong types of snacks? Sure, that will ruin your appetite for more nourishing foods and probably cause weight gain. Eating the wrong types of snacks (ie. high-carb, sugary snacks) will also fuel the cycle of hypoglycemia.

On the flip side, the snacks that satiate you with protein, keep you full, and keep your blood sugar stable — those are the snacks to reach for!

I understand that you don’t want to be in the kitchen all. the. time. You need quick and easy things to reach for, especially during those hangry moments you may still experience in the first few days of breaking the cycle of hypoglycemia.

It goes without saying — read labels on anything you buy pre-packaged. Sugar is hiding everywhere, and the last thing you need right now is more sugar.

Here are the blood sugar-balancing snacks I recommend:

  • Epic Bars, jerky, nitrate-free pepperoni or salami
  • Nuts and seeds — soaked and dehydrated or sprouted, preferred (Buy pre-soaked/dehydrated nuts and seeds or learn how to do it yourself!)
  • Nut and seed butters — I love this brand of soaked/dehydrated nut butters!
  • Coconut Butter and Toasted Coconut Butter
  • Pork rinds
  • Avocado
  • Raw veggies, like celery and nut butter or your favorite veggies and Quick Probiotic Ranch
  • Raw cheese
  • Boiled eggs
  • Parmesan crisps
  • Low-Carb Classic Chocolate Chip Cookies
  • Low-carb smoothies and shakes
  • Frozen Berry Kebabs or fresh berries
  • DIY Chobani Flip
  • Kale Chips

Once your blood sugar returns to normal, you’ll likely find that you aren’t as hungry and don’t require many snacks. That’s great… exactly what we want! However, while your body heals, give it what it needs and craves — plenty of protein and fat!

#5 — De-Stress

Stress hormones cause the blood sugar to rise, signalling the pancreas to produce insulin — even when we’ve had nothing to eat.

I highly recommend reading this entire post, How Stress Hormones Raise Blood Sugar. Although I don’t completely agree with the author’s recommendation of insulin injections before stressful events, I love the explanation he provides about how stress hormones raise blood sugar. He says:

…he liver serves as a storehouse for glucose , keeping it in a concentrated form called glycogen. The liver breaks down small amounts of glycogen all the time, releasing glucose into the bloodstream to nourish the brain, nerves, heart and other ‘always active’ organs.

The liver’s release of glucose depends largely on the presence of certain hormones. Of all the hormones in the body, only insulin causes the liver to take sugar out of the bloodstream and store it in the form of glycogen. All the other hormones—including stress hormones, sex hormones, growth hormones and glucagon—cause the liver to secrete glucose back into the bloodstream.

Growth hormone is produced in a 24-hour cycle and is responsible for the blood sugar rise that we sometimes see during the night or in the early morning. The other ‘stress’ hormones, particularly epinephrine (adrenaline) and cortisol, are produced when our body needs a rapid influx of sugar for energy purposes.

… Emotional stress (fear, anxiety, anger, excitement, tension) and physiological stress (illness, pain, infection, injury) cause the body to secrete stress hormones into the bloodstream.

Basically, even when your diet is ideal, stress hormones may still trigger your liver to secrete glucose into your blood stream during stressful situations.

Living with clinical anxiety is even worse. Your body perceives itself in a constant fight-or-flight (stressed out) state all the time.

I have personally experienced this. I felt like I was going crazy when I couldn’t figure out why I was still getting hangry, shaky, dizzy when standing, and irritable — even on a low-glycemic, low-carb diet!

You can read about the 5 things that *really* helped my anxiety to see if some of these things will work for you, too.

Ways to de-stress:

  • go for a walk, preferably in the sunshine
  • guided meditation (these are paid/these are free)
  • deep breathing
  • yoga

#6 — Be Prepared For Cravings

Have you decided enough is enough? Are you ready to break the cycle of hypoglycemia once and for all?

Hold your horses… because we’ve got one more hurdle to jump.


You’re already experiencing serious cravings, if you have hypoglycemia. You may not recognize them as cravings because reaching for the carbs and/or sweets when those symptoms strike is probably completely normal for you.

Furthermore, you’ve likely been experiencing those cravings for a long time.

Now that you’re ready to break the cycle of hypoglycemia, you’re going to have to break up with some favorite foods, too.

And sugar is first on the list.

Quitting sugar can make you feel awful. Some report that it even makes them feel like they have the flu — completely with body aches, headaches, nausea, fever, and vomiting.

Please don’t let this scare you away! Quitting sugar is also the best choice you can make right now!

To fight the inevitable cravings you’re about to experience, you’ll want to have low-carb, low-glycemic sweets ready to go.

This is absolutely a crutch — and one I don’t want you to lean on too heavily. If you’re addicted to sugar, eating sugar-free sweets isn’t going to break your addiction. However, having some treats around while you’re trying to break the habit can make the transition easier on you mentally and emotionally.

First and foremost, fill up on nourishing foods — the protein, fat, and fiber-rich veggies.

Second, remember that these are treats. They’re not meant to be eaten instead of nourishing, blood sugar-balancing foods.

These Low-Carb Classic Chocolate Chip Cookies or these Sugar-Free Death By Chocolate Cookies are quick and easy go-tos. Nourishing White Hot Chocolate is great on a cold day or when you want to get in some extra nourishing fat.

If you’re used to relying on coffee without breakfast, try this caffeine-free Dandy Blend Latte; it contains MCT oil to provide a quick source of energy.

Finally, my cookbook Sweet Without Sugar: A Collection Of Allergy-Friendly, Low-Carb Desserts is loaded with sugar-free, high-protein, high-fat desserts to satisfy those cravings!

This eCookbook uses my DIY Sugar Alternative Blend, a blend of erythritol and stevia, instead of white sugar and whole sweeteners to satisfy your sweet tooth without contributing to hypoglycemia. Unfamiliar with erythritol? Get my FREE Guide To Alternative Sweeteners!

  • Blood Sugar Imbalance: 11 Signs Your Body Is Crying For Help
  • FREE Guide To Alternative Sweeteners
  • Sweet Without Sugar: A Collection Of Nourishing, Allergy-Friendly, Low-Carb Desserts
  • How Stress Hormones Raise Blood Sugar
  • Women’s Health eCourse, Lesson

It will take some work, but it is possible to break the cycle of hypoglycemia. In fact, you can start TODAY and feel like a completely different person in just a few days!

Hypoglycemia occurs when blood glucose levels fall below 4 mmol/L (72mg/dL).

Whilst many of us think of diabetes as being a problem of high blood sugar levels, the medication some people with diabetes take medication that can also cause their sugar levels to go too low and this can become dangerous.

What is hypoglycemia?

Hypoglycemia occurs when the level of glucose present in the blood falls below a set point:

  • Below 4 mmol/L (72mg/dL)

Being aware of the early signs of hypoglycemia will allow you to treat your low blood glucose levels quickly – in order to bring them back into the normal range.

It is also recommended to make close friends and family aware of the signs of hypoglycemia in case you fail to recognise the symptoms.

What are the symptoms of hypoglycemia?

The main symptoms associated with hypoglycemia are:

  • Sweating
  • Fatigue
  • Feeling dizzy

Symptoms of hypoglycemia can also include:

  • Being pale
  • Feeling weak
  • Feeling hungry
  • A higher heart rate than usual
  • Blurred vision
  • Confusion
  • Convulsions
  • Loss of consciousness
  • And in extreme cases, coma

Who is at risk of hypos?

Whilst low blood sugar can happen to anyone, dangerously low blood sugar can occur in people who take the following medication:

  • Insulin
  • Sulphopnylureas (such as glibenclamide, gliclazide, glipizide, glimepiride, tolbutamide)
  • Prandial glucose regulators (such as repaglinide, nateglinide)

If you are not sure whether your diabetes medication can cause hypos, read the patient information leaflet that comes with each of your medications or ask your doctor.

It is important to know whether your diabetes medication puts you at risk of hypos.

What are the causes of hypoglycemia?

Whilst medication is the main factor involved in hypoglycemia within people with diabetes, a number of other factors can increase the risk of hypos occurring.

Factors linked to a greater risk of hypos include:

  • Too high a dose of medication ( insulin or hypo causing tablets)
  • Delayed meals
  • Exercise
  • Alcohol

You can take steps to minimise the risk of these factors causing hypos.


Hypoglycemia is when blood glucose levels fall below 4 mmol/L. Hypoglycemia in relation to diabetes is often abbreviated and referred to as a hypo. Hypos are more likely to occur for people taking insulin or a type of tablets called sulfonylureas.

If you’re on medication that can cause hypos, it’s important to be aware of the signs of hypoglycemia, which include:

  • feeling tired or weak
  • being hungry
  • becoming pale
  • sweating
  • becoming anxious or irritable
  • a tingling sensation in tongue or lips
  • trembling or shakiness

In more severe cases of hypoglycemia, someone with diabetes may experience:

  • confusion
  • convulsions
  • loss of consciousness

The NHS lists the following as reasons why hypos may occur:

  • If you have too much diabetes medication for the amount of carbohydrate you’ve had
  • If you miss a meal
  • If you take more exercise than normal
  • If you drink alcohol on an empty stomach

It is advisable to treat a hypo as soon as you recognise the symptoms.

Diabetes UK recommend that you treat a hypo by taking 15-20g of a short-acting carbohydrate.
Having 3 or more glucose tablets will raise your blood sugar the quickest. If glucose tablets are not available, other options can include:

  • 250ml of a non-diet soft drink
  • 250ml of fruit juice
  • Five sweets such as jelly babies

If your next meal is not due, follow the short acting carbohydrate with some longer acting carbs such as a slice or bread or a portion of fruit. It is recommended to re-test your blood sugar after 15 to 20 minutes and re-treat if your sugar levels are still less than 4 mmol/L.

If someone experiencing hypoglycemia is unconscious, the NHS advises that they are put into the recovery position and either given glucagon or an ambulance called. If no-one has been trained to give glucagon, an ambulance should be called.

Download a FREE hypo factsheet for your phone, desktop or as a printout.

How is hypoglycemia diagnosed?

Hypoglycemia is detected by measuring blood sugar levels with a glucose meter. Any blood glucose level below 4.0 mmol/L indicates that the individual has hypoglycemia. Urine tests do not detect hypoglycemia.

If taking a blood test is not possible or would take too much time, it may be better to treat the hypo straight away.

How do I treat hypoglycemia?

A mild case of hypoglycemia can be treated through eating or drinking 15-20g of fast acting carbohydrate such as glucose tablets, sweets, sugary fizzy drinks or fruit juice.

Some people with diabetes may also need to take 15-20g of slower acting carbohydrate if the next meal is not due.

A blood test should be taken after 15-20 minutes to check whether blood glucose levels have recovered. Severe hypoglycemia may require an ambulance, for example if loss of consciousness occurs or a seizure persists for more than 5 minutes.

Severe hypos can be treated with glucagon if a glucagon injection kit is available and in date.

  • Read more detail on how to treat hypoglycemia

How serious is hypoglycemia?

Hypoglycemic episodes can range from mild to severe.

Mild hypoglycemia can usually be treated by the individual and are to be expected to some degree in people on insulin. Mild hypos are not associated with significant long term health problems unless they are occurring very regularly or for long periods of time.

Severe hypoglycemia, however, will require treatment from someone else and may require an ambulance. Severe hypos can lead to immediate danger if not treated immediately. Whilst rare, severe hypos can potentially lead to coma and death.

  • What is dead in bed syndrome ?

Do symptoms always occur before hypoglycemia?

Most people experience some warnings before the onset of hypoglycemia. However, some diabetics may experience little or no warning before the onset of sudden or severe hypoglycemia.

An impaired ability to spot the signs of hypoglycemia is known as loss of hypo awareness (or hypo unawareness ).

Preventing hypoglycemia

The key to preventing hypos is understanding why hypos occur and then taking actions to stop this happening. If you know that a hypo is likely to occur soon, carbohydrate can be taken to raise sugar levels and prevent the hypo.

If your doctor is happy for you to adjust your medication doses, you can also lower your dose during or following certain activities (eg exercise or after having alcohol) to prevent a hypo occurring.

Testing blood sugar levels regularly can help you to understand when your sugar levels are dropping too low.

Your diabetes health team can help you with making changes to your diabetes management.

Are hypos catching you without warning? Join the Hypo Awareness Program for a comprehensive guide towards recovering your hypo awareness ”

Hypoglycemia Treatment

Your treatment plan for hypoglycemia (low blood sugar) depends on what is causing your blood sugar level to drop too low. As you can learn in the causes article, hypoglycemia causes fall into two categories: low blood glucose caused by diabetes and low blood glucose not caused by diabetes.

Diabetes-related Hypoglycemia
If your hypoglycemia is caused by certain medications used for diabetes (people with either type 1 or type 2 diabetes can become hypoglycemic), your healthcare professional may suggest several things to help you treat hypoglycemia when it happens. He or she may also suggest adjustments in your diabetes treatment plan to help you prevent hypoglycemia.

The doctor may suggest:

  • Medication (e.g., insulin certain oral medications) dose adjustment: This may also include changing when you take your medication.
  • Working with a dietitian to develop or adjust your meal plan: A dietitian can help you figure out a good meal plan—for example, one that maintains consistency in carbohydrates at meals. A dietitian can also help you learn how to count grams of carbohydrates so that you can better plan your medication and/or insulin.
  • Increase (or more closely follow) self-monitoring of blood glucose levels: Knowing your blood glucose level throughout the day—when you get up, before meals, after meals, etc.—can help you avoid going low.
  • Limit consumption of alcoholic beverages: Alcohol can affect the way your body metabolizes glucose, so if you’re already prone to hypoglycemia, you should cut back on how much alcohol you drink.
  • Carry glucose tablets (dextrose) or hard candy: With your healthcare professional’s recommendation, make sure you always have glucose tablets or hard candy with you. You can stick them in your briefcase, purse, car, at your desk, school locker, etc. 15 minutes after eating the tablets or candy you will need to recheck your blood sugar. If your blood sugar has not returned to normal, you will need to give yourself glucose again. If you are having trouble raising your blood sugar to normal, you should contact your doctor.
  • To help bring blood sugar levels back to normal, an adult (with their healthcare professional’s recommendation) can consume one of the following:
    • 1/2 cup fruit juice
    • 1/2 cup cola or soft drink (not sugar-free variety)
    • 1 cup milk

Safety tip: Wear medical identification (e.g., a bracelet or necklace) that tells others you have diabetes. Then, if you do become hypoglycemic, people may be better able to help you.

Contact your endocrinologist or healthcare professional to discuss your health changes, concerns, and/or questions.

Hypoglycemia Not Caused by Diabetes
If you experience multiple episodes of hypoglycemia and you don’t have diabetes, your doctor will try to figure out what’s causing your blood glucose to go too low. With that information, he or she is better able to suggest a treatment plan.

Your treatment plan may include lifestyle changes to help you avoid hypoglycemia. You’ll also need to learn how to treat hypoglycemia as soon as you notice symptoms.

Hypoglycemia treatments may include:

  • Self-monitor your blood glucose: This is something that people with diabetes do, but if you have many episodes of hypoglycemia, the doctor may suggest you check your blood glucose level throughout the day for awhile, at least until your hypoglycemia is well controlled. Self-monitoring your blood glucose level should give you an idea of what makes your blood glucose level drop.
  • Work with a dietitian to develop or adjust your meal plan: What you eat plays a big part in your blood glucose level. A dietitian can teach you about healthy, well-balanced food choices that will make it easier for you to maintain an acceptable blood glucose range.
  • Carry glucose tablets (dextrose), hard candy, and/or other snacks: With your doctor’s recommendation, make sure you always have glucose tablets or hard candy with you. You can stick them in your briefcase, purse, car, at your desk, school locker, etc. You may also want to keep snacks on hand—for example, cheese or peanut butter crackers.

Contact your endocrinologist or healthcare professional to discuss your health changes, concerns, and/or questions.

Updated on: 01/29/18 View Sources


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No matter what we’re doing, even during sleep, our brains depend on glucose to function. Glucose is a sugar that comes from food, and it’s also formed and stored inside the body. It’s the main source of energy for the body’s cells and is carried to them through the bloodstream.

When blood glucose levels (also called blood sugar levels) drop too low, it’s called hypoglycemia. Very low blood sugar levels can cause severe symptoms that need immediate medical treatment.

Blood sugar levels in someone with diabetes are considered low when they fall below the target range. A blood sugar level slightly lower than the target range might not cause symptoms, but repeated low levels could require a change in the treatment plan to help avoid problems.

The diabetes health care team will find a child’s target blood sugar levels based on things like the child’s age, ability to recognize hypoglycemia symptoms, and the goals of the diabetes treatment plan.

Causes of Low Blood Sugar Levels

Low blood sugar levels are fairly common in people with diabetes. A major goal of diabetes care is to keep blood sugar levels from getting or staying too high to prevent both short- and long-term health problems. To do this, people with diabetes may use insulin and/or pills, depending on the type of diabetes they have. These medicines usually help keep blood sugar levels in a healthy range, but in certain situations, might make them drop too low.

Hypoglycemia can happen at any time in people taking blood sugar-lowering medicines, but is more likely if someone:

  • skips or delays meals or snacks or doesn’t eat as much carbohydrate-containing food as expected when taking the diabetes medicine. This is common in kids who develop an illness (such as a stomach virus) that causes loss of appetite, nausea, or vomiting.
  • takes too much insulin, takes the wrong type of insulin, or takes insulin at the wrong time
  • exercises more than usual without eating additional snacks or adjusting the dosage of diabetes medicines to help prevent drops in blood sugar level

A low blood glucose level also can happen:

  • during sleep, known as nocturnal hypoglycemia
  • several hours after exercise, known as delayed postexercise hypoglycemia
  • after someone drinks alcohol or uses drugs. Alcohol hurts the body’s ability to keep blood glucose in a normal range, which can cause a sudden drop in blood sugar. Drug or alcohol use also can make it hard for someone to sense low blood sugar levels. Talk to your child or teen about the health risks of alcohol and drug use.

Certain conditions also can increase how quickly insulin is absorbed into the bloodstream and make hypoglycemia more likely. For example, taking a hot shower or bath right after having an insulin injection increases blood flow through the blood vessels in the skin, which can cause the insulin to be absorbed more quickly than usual.

Insulin also can be absorbed more quickly when it’s injected into a muscle instead of into the fatty layer under the skin. And giving a shot in a part of the body most used in a particular sport (like injecting in the leg right before soccer practice) can make the insulin be absorbed more quickly. All of these situations increase the likelihood of hypoglycemia.

Signs and Symptoms of Low Blood Sugar

The signs and symptoms of low blood sugar can vary depending on the person and how quickly the level falls. Also, problems other than hypoglycemia or diabetes can cause similar symptoms.

Warning signs of low blood sugar include:

  • extreme hunger (some kids complain of a gnawing stomachache or “hunger pain”)
  • shakiness or tremors
  • rapid heart rate
  • cold sweat
  • a pale, gray skin color
  • headache
  • moodiness or crankiness/irritability
  • drowsiness
  • weakness
  • dizziness
  • unsteadiness/staggering when walking
  • blurred or double vision
  • confusion
  • seizures or convulsions
  • loss of consciousness

Kids who have nocturnal hypoglycemia may have bouts of crying, nightmares, or night sweats (with damp sheets and/or pajamas), and might wake up groggy or with a headache.

Checking for Low Blood Sugar Levels

When blood sugar levels fall too low, the body releases the hormone adrenaline, which helps get stored glucose into the bloodstream quickly. Paleness, sweating, shakiness, and increased heart rate are early warning signs of this adrenaline release.

More severe symptoms — such as confusion, drowsiness, seizures, and loss of consciousness — may happen if the hypoglycemia isn’t treated and the brain doesn’t get enough glucose to work properly.

The only way to know for sure if your child has low blood sugar levels is to test them. Blood sugar levels can be tested with a glucose meter, a computerized device that measures and displays the amount of glucose in a blood sample. However, if the situation makes it impossible or inconvenient to quickly check the blood sugar, it’s important to treat your child for hypoglycemia immediately to prevent symptoms from getting worse.

Sometimes a child with diabetes may have symptoms of low blood sugar, but the levels are not actually low. This is a called a false reaction. Adrenaline also can be released when blood sugar levels fall rapidly from a high level to a normal level. Testing blood sugar levels before giving treatment for hypoglycemia can help you identify false reactions.

Also, some kids may learn to fake symptoms of low blood sugar to get a sugary treat or avoid something unpleasant. Again, checking the blood sugar level can confirm the presence of hypoglycemia.

It’s important to discuss the signs and symptoms of low blood sugar with your child. Even younger kids who can’t verbalize symptoms should learn how to alert their parents when they don’t feel well. This will help kids make the connection between how they feel and the need for treatment. Kids also should know when and how to find an adult for help.

Some people with diabetes don’t have or can’t sense the early warning signs of low blood sugar, a condition known as hypoglycemic unawareness. They’re at greater risk for not recognizing the need to get treatment for hypoglycemia promptly. This could lead to more serious symptoms, such as loss of consciousness or seizures, as their blood sugar falls.

If you think your child is having trouble sensing low blood sugar, be sure to let the diabetes health care team know.

Treating Low Blood Sugar Levels

The diabetes health care team will give you clear guidelines about how to treat hypoglycemia, depending on the severity of the symptoms.

If it’s convenient, test the blood sugar levels before treating your child to confirm that the symptoms are due to hypoglycemia. If blood sugar can’t be checked immediately, don’t delay treating your child’s symptoms — you can always do a test after getting the blood sugar back into the normal range.

When blood sugar levels are low, the goal is to get them back up quickly. To do that, give your child sugar or sugary foods that raise the blood glucose level quickly. In general, treatment for hypoglycemia involves:

  • having your child eat or drink a form of glucose that works fast, like regular soda, orange juice, or cake frosting
    having your child take special tablets or gels that contain glucose. Generally, symptoms will stop about 10 minutes after your child takes sugar.
  • rechecking your child’s blood sugar to make sure that the level is no longer low and giving your child food to help prevent the blood sugar from dropping again
  • giving glucagon (see below), if symptoms are severe or get worse after your child is given sugar by mouth

For more severe cases of hypoglycemia in which seizures or loss of consciousness happen, giving sugar by mouth may be very difficult or even dangerous. In that case, a glucagon injection should be given.

Glucagon is a hormone that helps raise blood sugar levels quickly. Treatment with glucagon should be given as soon as severe hypoglycemia is suspected and not delayed to call a doctor or ambulance.

After receiving glucagon, a child should wake up within about 10 to 15 minutes and be able to take sugar or food by mouth to help prevent the blood sugar from falling again. Call 911 if your care team has advised you to do so at this point.

Call the doctor after any severe low blood sugar reaction requiring glucagon treatment — it could be a sign that the diabetes management plan needs to be changed to help prevent future hypoglycemia episodes.

When possible, adult family members and your child’s caregivers and school staff should know:

  • the signs of hypoglycemia
  • when and how to give glucagon shots
  • when to get emergency medical care

Your doctor can prescribe a glucagon kit, which should be kept where you and your child’s caregivers can easily find it.

Preventing Low Blood Sugar Levels

By knowing what causes low blood sugar levels and being prepared, you and your child can make them less likely and help prevent severe symptoms.

Remember: You can’t turn off the action of insulin once it’s been injected. So to avoid low blood sugar episodes, insulin doses need to be matched to your child’s needs each day — taking meals, exercise, and other things into consideration.

More tips to help avoid low blood sugar levels:

  • Give your child the correct dose and type of insulin at the right time in the appropriate injection site.
  • Check your child’s blood sugar regularly and whenever necessary to confirm that symptoms are due to hypoglycemia.
  • Your child shouldn’t take baths or hot showers right after an insulin shot.
  • Check blood glucose levels before and during exercise and make sure your child eats snacks as needed to keep or bring blood sugar levels into target range.
  • Make sure your child follows the suggested timing of meals, injections, and exercise, based on the diabetes management plan.
  • Your child should keep something containing sugar with him or her at all times and take it right away if symptoms of low blood sugar appear.

No matter how careful parents and children are, kids with diabetes at some point will have episodes of low blood sugar. So they should always wear and/or carry some sort of medical identification (like a bracelet or necklace). Besides identifying your child as having diabetes, this can provide emergency contact information.

If you have any questions about how to prevent or treat low blood sugar levels, call your child’s doctor or diabetes health care team.

Reviewed by: Mauri Carakushansky, MD and Jennifer L. Seekford, ARNP Date reviewed: October 2016

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