Overview of Hypoglycemia

Low blood sugar or hypoglycemia (کم خونی شکر/ کم شکر دمویت/ Kam Khooni Shakar) is a serious condition in which glucose level is lower than normal. Glucose is the main sugar in the blood that can be obtained from various sources (fruits, vegetables, milk and cereals). However, its level should be maintained within a certain level.

The pancreas produces insulin, a hormone that maintains the level of glucose in your blood. In diabetic patients in which insulin level is increased above the required level, hypoglycemia can occur. If the level of glucose is dropped below 70 mg/dL due to the excessive release of insulin it can cause hypoglycemia. In this case, you need immediate remedy/treatment to normalize the level of blood sugar.

Occurrence of Hypoglycemia

Hypoglycemia is most common in patients with insulin-dependent diabetes mellitus. They experience 1 to 2 episodes of symptomatic hypoglycemia in a week. Mostly, people experience 55% of episodes during sleep. It occurs both in males and females equally.

Signs and Symptoms of Hypoglycemia

Some common symptoms of low blood sugar are:

  • Blurred vision
  • Fast heartbeat
  • Sudden mood changes
  • Sudden nervousness
  • Fatigue
  • Pale skin
  • Headache
  • Hunger
  • Shaking
  • Dizziness
  • Sweating
  • Difficulty sleeping
  • Tingling on skin 
  • Trouble concentrating

Types of Hypoglycemia

Causes of Hypoglycemia

Causes of hypoglycemia vary depending upon the health condition of a person.

Causes of Hypoglycemia in People with Diabetes

  1. Diabetes Drugs: Insulin treatment can decrease your blood sugar level below a certain level. Similarly, some medications such as sulfonylureas can cause this condition. Commonly used sulfonylureas are:
  • Glimepiride (Amaryl)
  • Glipizide (Glucotrol)
  • Glyburide (Diabeta, Micronase)
  • Micronized glyburide (Glynase)
  • Chlorpropamide (Diabinese)
  • Repaglinide (Prandin)
  • Tolazamide (Tolinase)
  • Tolbutamide (Orinase)
  1. Alcohol: The use of alcohol can also lower your blood sugar. 
  2. Your Diet:You can get hypoglycemia if you take an excessive amount of insulin:
  • After eating a meal that has only simple sugars (glucose, fructose, galactose, sucrose, lactose and maltose)
  • Without taking a full meal
  • Drink alcohol without eating any food

Reactive Hypoglycemia and its Causes

Reactive hypoglycemia happens if you have too much insulin in your blood. Possible causes of this condition are:

  • Previous history of diabetes 
  • Stomach surgery
  • Rare enzyme defects

Causes of Fasting Hypoglycemia

Fasting hypoglycemia can occur due to:

  • Medicines, such as aspirin and sulfa drugs
  • Excessive use of alcohol
  • Diseases of the liver, kidney, heart, and pancreas
  • Low levels of some hormones
  • Certain tumors

Risk Factors of Hypoglycemia

Given below are some of the risk factors of hypoglycemia:

  1. Age
  2. Loss of appetite
  3. Heavy exercise
  4. Sudden weight loss
  5. Intake of beta-blockers
  6. Certain medications such as antidepressants
  7. The cognitive decline of memory
  8. Alcohol consumption
  9. Renal damage
  10. Thyroid issues
  11. Pregnancy

Health Complications Related to Hypoglycemia

People often don’t notice if their blood sugar level is dropping. Delays in treatment can lead to 



If you have diabetes, you can prevent low blood sugar by:

  • Follow your diet plan as provided by your nutritionist
  • Eating three balanced meals each day 
  • Eat your meals with 4 to 5 hours break
  • Moderate exercising for 30 minutes to 1 hour after meals
  • Checking your sugars before and after exercise
  • Eliminate drinking alcohol and monitor your blood sugar levels
  • Knowing the peak level of your medicine 

Testing your blood sugar more often as per the doctor’s suggestion



Hypoglycemia is diagnosed in the following manner:

  • Physical Examination: For the diagnosis of nondiabetic hypoglycemia the healthcare personnel perform a physical examination and get information about already prescribed medicines. The doctor would inquire about the health and any history of diseases or stomach surgery.
  • Glucose Test (A1C test): A glucose test is performed to check the level of glucose in the blood especially if the symptoms appear.
  • Fast Test: If hypoglycemia is suspected, a fast test is recommended by the doctor. The level of glucose is tested at different times when a person is not eating anything. You may have to fast for 72 hours or more until the symptoms appear.
  • Mixed-Meal Tolerance Test (MMTT): MMTT is performed if you have symptoms of reactive hypoglycemia. For this test, a special drink that raises blood glucose is used. Further, the doctor checks the blood glucose levels for the next few hours.

Treatment of Hypoglycemia | When to Consult a Doctor

Depending on your health condition, hypoglycemia can be treated in various ways.

  • If you are a diabetic patient, examine your blood sugar regularly. If it is below 70, eat or drink 15 to 20 grams of carbohydrates. It can be normalized by taking juice, hard candy, or glucose tablets. If the level is still low check your blood sugar every 15 minutes. Consult your doctor immediately if you don’t feel well and your blood sugar is not backing up.
  • If you are not diabetic, the treatment method depends on the cause. If a particular medicine is triggering it is changed. If it is caused by a tumor you may have to undergo surgery.

For a quick fix, eating or drinking 15 grams of carbohydrates, in the form of juice, glucose tablets, or hard candy can be helpful.

If your blood sugar level drops very low, you need to get it treated as soon as possible. If you are continuously experiencing other signs and symptoms of hypoglycemia you need to immediately consult a diabetologist