What is Hypoglycemia?

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  • Simply put, Hypoglycemia means “low blood sugar.”
  • You are experiencing hypoglycemia if your current blood-sugar (glucose) reading (taken by finger-stick or similar means) is below 70 mg/dl (“below 70”)
  • Severe hypoglycemia occurs when your blood sugar (glucose) drops below 60 mg/dl
  • Hypoglycemia can be very ominous...

Please select from the following topics for more information

What Does Hypoglycemia
Feel Like?

What Causes Hypoglycemia?

Who is at Risk for
Hypoglycemia?

Why is Hypoglycemia
Dangerous?

Working with Your
Healthcare Provider

How to Talk to Your Doctor
About Hypoglycemia

Diet and Exercise

Personal Stories

Personal Stories

What Does Hypoglycemia Feel Like?
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  • Can you explain what someone might experience if they are having a low blood sugar event?

  • Recognizing and managing low blood sugar/hypoglycemia

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Have you ever experienced a hypoglycemic event?
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If so, how scary was your hypoglycemia event?
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You may be experiencing hypoglycemia if you display one or more of the following symptoms:

  • Shakiness, dizziness
  • Agitation, nervousness
  • Blurry vision
  • Heart palpitations, sweating
  • Tingling feeling in fingers, hands or face/lips
  • Unusual behavior, slurred speech
  • Fainting
  • Generally feeling unwell or “off”

Your friends or family may recognize signs that you are experiencing hypoglycemia before you, especially if you are acting unusual, confused, or agitated. They should also be familiar with the signs and know how to help you.

What Causes Hypoglycemia?
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What do you do to prevent hypoglycemia?
(Select all that apply)
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Quick Tips

  • Diabetes patients should carry glucose tablets or other foods/drinks which can raise blood sugars in hypoglycemic emergencies. Talk to your doctor or diabetes educator on what makes sense for you.

  • All diabetes patients should have a glucagon emergency kit for hypoglycemic emergencies. If you don’t have one, talk to your doctor or diabetes educator about where to get one and how to use it.

  • Some diabetes medications increase your risk of hypoglycemia.

  • Even 1 hypoglycemic event is too many.

  • If you have had even 1 hypoglycemic event in the past year, talk to your doctor about possibly changing your medications to lower your risk.

When you have diabetes, hypoglycemia can happen if you skip a meal, exercise strenuously, start a new medication, miss a dose of medication, or drink alcohol among other situations. Some diabetes medications increase your risk of hypoglycemia. Click here to view a list of diabetes medications, which may increase y our risk of hypoglycemia.


For a detailed list of medications for diabetes and other conditions that may have an affect blood sugar, check out this article :

"The best way to manage hypoglycemia is to stop it before it starts."

You can manage your hypoglycemia risk through a combination of healthy eating, working closely with your doctor to select appropriate medications for you and monitoring your blood sugar (glucose) daily. Setting and following a regular daily routine for meals, exercise, medication, and glucose checks is a great first step. Talk to your doctor or diabetes educator for daily diabetes care routines that can work for you.

Click on the above infographic to learn more.
Who is at Risk for Hypoglycemia?
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  • How would you counsel patients about detecting low blood sugar?

  • What might put someone more at risk for hypoglycemia?

  • How do you counsel patients in order to reduce their risk of low blood sugar (hypoglycemia)?

  • Medications that may reduce the risk of hypoglycemia

  • Accepting Reality?

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Have you ever asked your doctor if there were medications that reduced your risk for hypoglycemia?
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Have you talked to your doctor about medication that may increase your risk for hypoglycemia?
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Quick Tips

Simple Ways to Prevent Hypoglycemia

  • Monitor your blood sugar regularly. Consider using a continuous blood-sugar monitoring device (implants under your skin) connected to a smartphone app like Dario® or Freestyle Libre®, which will signal you automatically when your blood sugar gets too low or too high.

  • Get your family or friends involved. Make sure your loved ones, neighbors, friends, co-workers, or roommates are aware of your condition and that they should be on the lookout if you show any signs of hypoglycemia, and how to help if it happens. They may recognize the symptoms before you do!

  • Carry a glucose source. Keep some portable sugar sources (jelly beans, gumdrops, glucose tablets) which can reverse a hypoglycemia emergency in your pocket or purse at all times—just in case.

  • Take all diabetes medications as directed. Don’t skip doses or meals. If your current medication regimen isn’t working well for you, it might be time to change it.

  • Talk to your doctor. Your current diabetes medications or lifestyle routine could be putting you at increased risk for hypoglycemia. Your doctor or diabetes educator could help you change your medications or your routine (or both) in ways that will reduce hypoglycemia risk. For example, your doctor could switch you to a different medication that is associated with less risk of hypoglycemia.

People with diabetes or prediabetes are generally at increased risk for hypoglycemia—especially if they are taking oral diabetes medications called sulfonylureas. Examples of sulfonylureas include:

  • Glimepiride (Amaryl®)
  • Glipizide (Glucotrol®)
  • Glyburide (Glynase®, DiaBeta®, Micronase®)
  • Tolazamide (Tolinase®)

Diabetes patients who take mealtime insulin— especially rapid-acting insulin. Examples include:

  • Aspart insulin injection (NovoLog®)
  • Insulin glulisine injection (Apidra®)
  • Insulin lispro injection (Humalog®)
  • Insulin human injection (Humulin®; rapid-acting insulin)
  • Regular human insulin DNA recombinant (Novolin® rapid-acting insulin)
  • Neutral protamine Hagedorn, or NPH (intermediate-acting insulin)
Why is Hypoglycemia Dangerous?
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Severe hypoglycemia, when blood sugar become extremely low, is rare; but it can affect how your body functions. Hypoglycemia also affects the overall control of your blood sugar, which is important to prevent diabetes complications.

Accidents are another concern with hypoglycemia. The biggest risk is having a motor vehicle accident during a hypoglycemia episode, but other accidents such as falling are also a risk. If you feel you are experiencing hypoglycemia while or before driving or engaging in a risky activity, it is best to stop and check your blood sugar.

Working with Your Healthcare Provider
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  • What recommendations do you have for someone who is struggling with their diabetes?

  • What are your strategies for reducing patients’ risk for hypoglycemia?

  • How can you work with your clinician to reduce the risk of hypoglycemia?

  • What are Diabetes Educators?

  • Who do you think should provide education to patients?

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Do you get the information and guidance you need from your healthcare providers to effectively reduce your risk for hypoglycemia?
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Signs of hypoglycemia should always be taken seriously. You will not have total control over your diabetes all the time. And, being afraid of hypoglycemia might prevent you from taking the best care of yourself. Working with your healthcare provider to understand the results of your blood sugar monitoring and the effects of diet and exercise on your levels can help you feel more confident and prepared if you experience signs of hypoglycemia.

Your current diabetes medications or lifestyle routine could be putting you at increased risk. If you experience hypoglycemia, your doctor or diabetes educator could help you change your medications or your routine (or both) in ways that will reduce your risk. For example, your doctor could switch you to a different medication that is associated with less risk of hypoglycemia.

How to Talk to Your Doctor About Hypoglycemia
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If you’ve had a hypoglycemic event, have you told your doctor?
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If not, why?
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Are you willing to speak with your doctor about treatments that may reduce your risk for hypoglycemia?
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Quick Tips

  • If experiencing hypoglycemia, speak with your healthcare provider. There are options for medications that may reduce your risk of experiencing a hypoglycemic event

  • Educate yourself! Do research to gain a better understanding of diabetes to help you be more confident when speaking with your physician

After looking through the materials on this site, are you concerned about your risk of hypoglycemia? Have you had a hypoglycemic event already? If you answered ‘yes’ to either of these questions, then it is time to talk to your doctor about hypoglycemia and how to manage your risk. Before you forget, pick up the phone and make an appointment with your diabetes care provider right now.

Depending on where you are on your diabetes journey, here are some sample questions to consider asking your doctor or diabetes educator during your next visit. You don’t have to ask all of them—just pick the ones which apply to you. If these sample questions spark more ideas, jot them down and bring those notes with you to your next appointment.

  • Is my A1C at the right target? If not, what medications should I switch to/add? What are the hypoglycemia risks of those medications?
  • Should I use a continuous blood glucose monitor? Where can I get one?
  • Do I need to start taking insulin? If the answer is yes, can I take a basal (long-acting) insulin?
  • What foods/beverages should I avoid eating/drinking to minimize hypoglycemia risk?
  • I like to go to the gym, but I am worried about developing hypoglycemia after a workout. What can I do to prevent that from happening?
  • I work long hours and my shift schedule changes a lot, and I have struggled with blood-sugar lows and highs several times on the job. What can I do/what medications can I take to lower my hypoglycemia risk?
  • I am pre-diabetic. I am not taking any medications yet but trying lifestyle changes. I think I might have had a hypoglycemic event once already and didn’t recognize the symptoms when it happened. Can we talk about that?
Diet and Exercise
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Do you routinely exercise?
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Have you ever avoided exercise because you were scared of experiencing hypoglycemia?
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Quick Tips

  • Be ready to test your blood sugar

  • Be prepared with a source of carbs in order to quickly raise your low

  • If you experience a blood sugar reading of 100mg/dl or less while exercising: STOP exercising and take 15-20 grams of carbs to raise your blood sugar (1 tablespoon of honey, or 4 glucose tabs, or ½ cup of juice or soda (not diet) Wait 15 mints and check blood sugar Make sure you blood sugar rises above 100 mg/dl before you resume exercising

You probably already know that eating a balanced, healthy diet is essential for managing your diabetes. Skipping or eating a smaller meal while taking your diabetes medication or insulin places you at risk for hypoglycemia. The content of your meal may also contribute to hypoglycemia, so it is best to work with your healthcare provider or a dietitian if you experience hypoglycemia after a meal.

Many people with diabetes believe they should avoid sugar (glucose) at all costs, but this is not the case. Glucose is the main fuel that runs our bodies. Our brains, muscles, nerves and bloodstream all need glucose to function. The key is keeping our blood sugar levels in balance—neither too high nor too low. If our blood sugar becomes too low (hypoglycemia) our body’s cells do not have enough fuel to function—and our bodies can actually shut down. This is why hypoglycemia is so dangerous.

Drinking alcohol, even in moderation, can cause hypoglycemia. If you do drink, have the alcohol with a meal and do not skip a meal. You should also understand how alcohol affects you by monitoring your blood glucose.

Physical activity (including walking, dancing, or going to the gym) is especially important for people with diabetes. Exercise can have a different effect on your blood sugar depending on how long you exercise and the level of intensity. In general, exercise does lower your blood sugar level so it’s important to become familiar with how your body responds to exercise.

If you are taking insulin or sulfonylureas and glinides (medication that increases insulin production from your pancreas), you are at risk for hypoglycemia while exercising. It’s important talk to your healthcare provider about ways to exercise safely. Additionally, make sure to check your blood sugar before and during exercise in order to take the necessary steps to prevent low blood sugar while exercising.

New to Exercise Two things You Should Know
Additional information related to diabetes, low blood sugar, and exercise are below:
Proper Nutrition Before and After a Workout Why some exercises can make your blood sugar increase How to manage your blood sugar when exercising with diabetes Webinar: Diabetes and Physical Fitness
Personal Stories and Additional Support
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  • It Takes a Team

  • It Takes a Team

  • How have your own personal experiences influenced how you interact with diabetes patients?

  • How can a Diabetes Educator help?

  • How has this changed your life?

  • What are your fears?

  • The Importance of Self-management

  • What was your Lowest low?

You are not alone in your diabetes journey. Support is available in a variety of forms and will provide the information and guidance you may need to make decisions and live your best life. Below are patient stories, some you may be able to relate to. Also included in this section are available resources and additional websites for support. Remember to communicate with your healthcare provider often.

My Health Journey-Diabetes (diabetes overview)
Our best blood sugar tips! Minority Initiatives 2019 Minority Initiative This is What Diabetes Looks Like
Diabetes Self-Care

Simple Ways to Prevent Hypoglycemia

  • Monitor blood sugar regularly

  • Carry a source of glucose

  • Educate yourself to increase your confidence when speaking with your healthcare provider

  • Follow your diabetes treatment regimen

  • Talk to your doctor to see if diabetes medications that reduce your risk of hypoglycemia are appropriate

  • Work with a Diabetes Educator

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How will you use this information? (Select all that apply)
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Are you comfortable with your diabetes treatment regimen?
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Where do you go to learn about diabetes management tips and strategies? (Select all that apply)
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Additional Support

American Association of Diabetes Educators

AADE’s mission is to empower diabetes educators to expand the horizons of innovative education, management, and support.
American Diabetes Association

The ADA’s mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes.
Diabetes In Control

The Mission of Diabetes In Control is to be the world leader of current and accurate on-line diabetes information for medical professionals, and to promote increased understanding of the care and treatment of diabetes, ultimately helping the medical professional to empower the patient to better self-care.
Diabetes Sisters

DiabetesSisters is a 501(c)3 nonprofit organization whose mission is to improve the health and quality of life of women with diabetes, and to advocate on their behalf.
How Do You Treat Hypoglycemia?
¿Cómo se trata la hipoglucemia?
Diabetes Strong

The goal of Diabetes Strong is to provide a platform where people living with (any type) of diabetes can find all the information they need to live healthy and active lives.
National Diabetes Education Initiative

NDEI is a multi-component educational initiative that addresses issues spanning the diabetes continuum, from epidemiology and pathophysiology of the disease and its associated complications and comorbidities, to the therapeutic options for prevention and treatment.
National Diabetes Education Program

National Diabetes Education Program (NDEP) resources help reduce the burden of diabetes and prediabetes by providing culturally and linguistically appropriate diabetes education resources for a range of individuals and groups — ethnic minorities, hard-to-reach populations, community-based organizations, faith-based organizations, and healthcare providers. NDEP materials are provided through a joint effort of the Centers for Disease Control and Prevention and the National Institutes of Health.
Taking Control of Your Diabetes

Guided by the belief that every person with diabetes has the right to live a healthy, happy, and productive life, Taking Control Of Your Diabetes educates and motivates people with diabetes to take a more active role in their condition and provides innovative and integrative continuing education to medical professionals caring for people with diabetes.