Hypoglycemia or low blood sugar occurs when a person’s glucose or blood sugar goes below the typical range. If a person has diabetes, hypoglycemia takes place when their blood sugar level goes below 70 milligrams per deciliter (mg/dL), which is also written as 3.9 millimoles per liter (mmol/L).
If a person is not diabetic, they have hypoglycemia when their blood sugar level falls below 55 mg/dL or 3.1 mmol/L.
Hypoglycemia occurs when blood glucose levels fall too low, impairing brain function and potentially leading to seizures or unconsciousness
Signs & Symptoms
- Sweating and pale skin
- Shakiness, tremors, or weakness
- Anxiety, irritability, or confusion
- Dizziness or headache
- Hunger or nausea
- Rapid or irregular heartbeat
- Severe cases: seizures or loss of consciousness
Causes of Hypoglycemia
The causes of hypoglycemia in people with diabetes could be:
- Consuming too much medication, which includes insulin or medicines that increase the production of insulin.
- Eating less than usual.
- Being sick and not being able to keep food down.
- Fasting or skipping meals.
- Planning to consume a big meal and taking your medicine accordingly, and then not eating enough.
- Drinking alcohol.
- Eating later than usual but taking the medicine at the usual time.
- Participating in excessive or unplanned physical activities without eating much.
If a person doesn’t have diabetes, the causes of hypoglycemia might include:
- Consuming certain medications
- Drinking alcohol excessively
- Being malnutritional or being starved for long periods of time
- Suffering from endocrine disorders
- Having hormone deficiencies
- Overproduction of insulin
- Suffering from certain severe illnesses
First Aid for Hypoglycemia
Hypoglycemia, or low blood sugar, can be a serious emergency—especially in people with diabetes. Prompt recognition and treatment are crucial to prevent more severe complications. Here’s a comprehensive guide for administering first aid for hypoglycemia:
1. Recognize the Symptoms
Watch for early signs of low blood sugar, which include:
- Shakiness or trembling
- Excessive sweating or clamminess
- Hunger, nausea, or a rapid heartbeat
- Dizziness, weakness, or lightheadedness
- Confusion, irritability, or unusual behavior
In severe cases, a person may experience blurred vision, seizures, or even lose consciousness. Awareness of these symptoms is key so you can respond immediately 2.
2. Determine if the Person is Conscious
- If Conscious: The person should be able to swallow safely. Explain what is happening and reassure them.
- If Unresponsive: Do not try to give anything by mouth. Instead, immediately call emergency services (911 or your local emergency number) and check that they have open airways, followed by initiating CPR if trained and necessary until help arrives .
3. Administer Fast-Acting Carbohydrates
For a conscious person, aim to provide approximately 15–20 grams of simple sugars. Options include:
- Glucose Tablets: Follow the dosage instructions on the package.
- Sugary Drinks: About 4 ounces (half a cup) of fruit juice or regular (non-diet) soda.
- Alternative Sources: A tablespoon of honey or sugar mixed in water can also work well.
After giving the fast-acting sugar, wait for about 15 minutes and closely monitor their symptoms. If they do not improve, repeat the treatment with another 15–20 grams of carbohydrate 2.
4. Follow-Up Measures
- When Improved: Once the person’s condition stabilizes and they become more alert, encourage them to eat a more substantial snack or a small meal containing complex carbohydrates (like a sandwich or fruit) to help sustain blood sugar levels.
- Continued Monitoring: Keep an eye on the individual. If symptoms persist or worsen, seek medical advice even if they initially seem to improve .
- Preventive Actions: If hypoglycemia occurs frequently, it’s important for the individual to consult with their healthcare provider. Adjustments may be needed in their diabetes management plan (such as medications, diet, or exercise regimens) to prevent future episodes
5. Special Considerations for Unconscious Individuals
If the person is unresponsive:
- Do Not Give Food or Drink: Oral administration of sugars in an unconscious person can lead to choking.
- Administer Glucagon if Available: If the person has a prescription glucagon kit and you are familiar with its use, follow the instructions to help raise their blood sugar.
- Call Emergency Services Immediately: Unresponsiveness indicates a severe episode that requires prompt professional intervention
Prevention
If a person suffers from diabetes, it could be difficult for them to prevent hypoglycemia. However, their diabetes management plan can be adjusted so as to decrease the number of hypoglycemia episodes they could experience.
Listed below are some of the steps to take to prevent low blood sugar:
- Consume your medicines exactly how they have been prescribed by your doctor.
- If your healthcare provider has given you certain instructions about exercising and eating, make sure to follow them diligently.
- Check your blood sugar every day or make use of a continuous glucose monitor (CGM) before and after working out, before and after having your meals, and before going to bed.
- Once you have suffered an episode of low blood sugar levels, remember to jot down all the details of the episode. The details would include the time at which the episode took place, the symptoms you experienced, what your glucose levels were, whether you had exercised, and the food you had consumed recently. By showing these details to your healthcare provider, they can help in tweaking your management plan in a way such that this situation doesn’t arise again or happens as little as possible.
Do’s and Don’ts
| Do | Don’t |
|---|---|
| Offer measured fast-acting carbs and follow with a snack | Give insulin or diabetes medications |
| Reassess after 10–15 minutes and repeat treatment if needed | Leave the person alone or allow them to drive |
| Keep the person seated and supervised until fully recovered | Force large volumes of food or drink at once |
| Seek professional medical advice for non-diabetic cases | Delay calling EMS for loss of consciousness |
When to Seek Emergency Help
Call emergency services immediately if the person:
- Loses consciousness or has a seizure
- Is confused or cannot swallow safely
- Does not improve after two rounds of treatment
- Experiences hypoglycemia without a known cause (non-diabetic)
REFERENCES
- Ahmed FW, Majeed MS, Kirresh O. Non-diabetic Hypoglycemia (https://www.ncbi.nlm.nih.gov/books/NBK573079/). Updated 2022 Jul 18. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2022 Jan
- Mathew P, Thoppil D. Hypoglycemia. https://www.ncbi.nlm.nih.gov/books/NBK534841/). Updated 2022 Jul 23. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2022 Jan
- Vital First Aid, First Aid For Hypoglycaemia: Management, Treatment & Prevention, https://vitalfirstaid.com.au/news/hypoglycemia-first-aid-management/
- John Furst, First Aid for Hypoglycemia: 8 Essential Steps, April 24, 2024, https://www.firstaidforfree.com/first-aid-for-hypoglycemia/
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