Managing Diabetes: Symptoms of Low Blood Sugar

If left untreated, hypoglycemia can cause serious complications.

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A key to keeping your diabetes under control and avoiding serious complications is to be able to identify symptoms of low and high blood sugar—and have a plan of action to get your levels stable again.

This is especially true when it comes to low blood sugar, or hypoglycemia, when your blood glucose measures less than 70 mg/dL. “A misconception in diabetes is that high sugars are very bad for you,” says Ana Kausel, MD, endocrinologist in New York City. “Actually what’s most dangerous for you is low sugar.”

While untreated high blood sugar levels can cause damage to your body over time, very low blood sugars can result in a medical emergency. “Hypoglycemia can lead to more immediate complications,” says Dr. Kausel. Learn more about the complications of low blood sugar here.

Decoding Low Blood Sugar Symptoms

Alongside checking your blood sugar levels regularly, it’s important to watch out for low blood sugar symptoms so you can treat it ASAP. Symptoms of low blood sugar can vary from person to person, but some early signs may be:

  • Feeling excessively hungry

  • Sweating

  • Feeling anxious or worried

  • And feeling tremors or palpitations

If low blood sugar levels are not treated, severe symptoms can occur, such as:

  • Trouble walking or feeling weak

  • Trouble seeing clearly

  • Being confused or acting in a strange way

  • Passing out

  • Or having a seizure

Some people in the early stages of low blood sugar may not notice symptoms right away—this is called hypoglycemia unawareness. People with hypoglycemia unawareness are more likely to have severe symptoms, since they might not realize that they have low blood sugar until it gets severe. Hypoglycemia awareness can happen for many reasons—like if you’re tired, you drank a lot of alcohol, or take certain medicines—so it’s important to check your blood sugar regularly.

How to Treat Low Blood Sugar—Fast

“Most of the time, patients are able to treat their own hypoglycemia. You should always have a glucagon kit with you, and also carry glucose tabs that can be fast-acting,” says Dr. Kausel.

Fast-acting carbohydrate sources (15 g):

  • 3 to 4 glucose tablets

  • milk (8 oz) or juice (4 oz)

  • a spoonful of sugar or honey (1 Tbsp)

  • a couple spoonfuls of raisins (2 Tbsp)

  • 6 to 8 hard candies

Learn more about the best foods for low blood sugar.

Follow the 15/15 rule for low blood sugar: A good way to make sure your blood sugar has returned to a healthy level without going too high is to apply the 15/15 rule, or eating 15 grams of carbs and checking your blood sugar after 15 minutes. If your blood glucose is 51 to 70 mg/dL, eat 10 to 15 grams of a fast-acting carbohydrate. If it’s less than 50 mg/dL, eat 20 to 30 grams.

Learning from Low Blood Sugar

“The most important thing after a severe hypoglycemia is knowing what caused it. What scenario led to that hypoglycemic event? Talk to your doctor if this is a frequent situation,” says Dr. Kausel. Whether it’s adjusting your medication or offering diabetes lifestyle advice, if you’re having trouble managing your blood sugar, your doctor can help.