Diabetics Care

Hypoglycemia In People With Diabetes

Diabetic tips

Hypoglycemia is a common condition that can affect the quality of life of people with diabetes and their families. It is important to know the symptoms and how to treat it, as well as the causes and steps to take to prevent it.


Hypoglycemia is defined as a drop in blood sugar below 4 mmol / L, with or without symptoms.

People at risk

Some people with diabetes are at greater risk of hypoglycemia than others:

Those treated with insulin ;

Those treated with medicines that increase the production of insulin by the pancreas (insulin secretagogues *).

* gliclazide (Diamicron MD and Diamicron MR MD ), glimepiride (Amaryl MD ), glyburide (Diabeta MD ), repaglinide (GlucoNorm MD ).


The symptoms of hypoglycemia fall into two categories.

Symptoms caused by the secretion of adrenaline (adrenergic or neurogenic)

They are usually the first to appear and can be called “red flags”:

  • Tremors
  • Palpitations
  • Sweat
  • Anxiety
  • Hunger
  • Nausea
  • Tingling

Symptoms caused by a lack of glucose in the brain (neuroglycopenics)

If left unchecked, the following symptoms may occur:

  • Concentration disorders
  • Mood changing
  • Confusion
  • Weakness
  • Drowsiness
  • Blurred vision
  • Speech disorders
  • Headache
  • Dizziness

Moreover, if hypoglycemia occurs during the night, it is possible to have these manifestations:

Profuse sweating


Agitated sleep

Headache upon waking up

Symptoms can vary from person to person and from episode to episode. Sometimes it happens that no symptoms appear, for example in people with long-standing diabetes or if the blood sugar level is slowly falling.

3 severity levels

  • Mild hypoglycemia
  • Symptoms caused by the production of adrenaline;
  • The person is able to treat himself.

Moderate hypoglycemia 

Symptoms caused by the production of adrenaline and a lack of glucose in the brain;

The person is able to treat himself.

  Severe hypoglycemia  

  • Blood sugar generally less than 2.8 mmol / L;
  • The person needs help to treat hypoglycemia;
  • The person may lose consciousness.
  • Some people with diabetes are at risk for severe hypoglycemia:
  • Those who have already presented with severe hypoglycemia;
  • Those in which the glycated hemoglobin  is less than 6% (type 1);
  • Those who do not perceive their hypoglycemia;
  • Those whose diabetes has been present for several years (type 1);
  • Those who have damage to the nerves (neuropathy);
  • Preschool children and adolescents (type 1);
  • Those who have recurrent hypoglycemia;
  • Those who have hepatic (related to the liver) or kidney failure.
  • Treatment
  • Consult the PDF documents opposite.

Also read our article about glucagon .


Most hypoglycemia is caused by actions related to the management of diabetes. For example, this may be due to:

A lack of carbohydrates, following a snack or a meal that is omitted or delayed, a meal that contains less carbohydrates than expected or an error in the counting of the carbohydrates consumed;

Psychological or physical stress (ex .: hormonal changes);

An error in the schedule or the dose of insulin or drugs to treat diabetes;

A surplus of physical activity, either in terms of the duration or the intensity of the effort;

Alcohol consumed without food;

It should be noted that the hypoglycaemic effect of physical activity or alcohol can last up to 24 hours.


It is important to take the necessary measures to prevent hypoglycemia, because:

In the short term, confusion or fainting can lead to a fall or an accident.

In the long term, repeated hypoglycemia can have serious health consequences.

Here are some recommendations for preventing hypoglycemia:

Respect your diet plan regarding the amount of carbohydrates to consume;

Respect the meal and snack schedule;

Take insulin or medication as prescribed;

Measure blood sugar regularly and adjust treatment if necessary, as recommended;

Make the necessary adjustments to the level of diet or insulin, according to the recommendations of the care team, if there is an increase in physical activity or during an unplanned physical activity;

Avoid consuming alcohol without food;

Check with a pharmacist for the effect on blood sugar of any over-the-counter medication or natural health product before starting to use it.


 In addition to these preventive measures, certain precautions can be added:

Always carry sugar reserves and snacks with you;

Wear identification stating that you have diabetes;

Keep your blood glucose meter handy at all times;

Inform those around you about the symptoms, the use of the blood glucose meter and the treatment of hypoglycemia;

Ask the doctor for a prescription for glucagon , a hormone produced by the pancreas, which increases the level of glucose in the blood and which can be given to a person being treated with insulin who has severe hypoglycemia;

Make sure that those around you have received instruction on the administration of glucagon by a healthcare professional and that they know where the glucagon is stored;

Note the expiration date of the glucagon and obtain a new kit, when expired.

In summary, hypoglycemia is a serious situation that should not be trivialized. It can be a source of concern and that is why it is important to consult a health professional to learn how to recognize it, treat it quickly and take measures to prevent it. It is your quality of life that will be improved!

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