Hypoglycemia or low blood sugar: symptoms

Hypoglycemia or abnormally low blood sugar levels (usually less than 70 mg/dl) is a significant risk factor in diabetics being treated with insulin or some oral drugs.

It may be precipitated by skipping a meal, excessive physical activity or accidentally taking a bigger dose of insulin/drug alcohol intake

Each person’s reaction to hypoglycemia is different, therefore, the range of low blood sugar symptoms in diabetics is wide and includes:

  • Shakiness, nervousness, irritability
  • Sleepiness or confusion
  • Sweating, chills and clamminess,
  • Rapid heartbeat, lightheadedness or dizziness
  • Hunger and nausea, weakness or fatigue
  • Headaches
  • Blurred/impaired vision, tingling or numbness in the lips or tongue, lack of coordination
  • Nightmares or crying out during sleep
  • Seizures or fits
  • Unconsciousness

Low blood sugar: how to check and what to do

If you suspect you are having a hypoglycemic episode, then do a glucometer testing immediately. If your blood sugar sugar level is less than 70mg/dL, then you should:

  1. Consume 15-20 grams of glucose or simple carbohydrates such as 1 tablespoon sugar, glucose powder or honey or 2 tablespoons of raisins
  2. Check sugar level after 15 minutes, if still low, repeat the dose and test again after 15 minutes
  3. Even if your sugar level improves to more than 70, but your regular meal is more than an hour away, eat a snack such as a small banana
  4. If you can identify any precipitating event such as exercise etc. then make a note and discuss with your doctor

If  you have had a few episodes of hypoglycemia, you should:

  1. Discuss with your doctor regarding drug dose adjustment and glucometer schedule for hypoglycemia detection
  2. Prepare a hypoglycemia kit to carry along at all times including sugar sachet or glucose tablet etc.
  3. Get a medical ID which should have your details, alert for you being a diabetic and your medication summary; discuss the need of a glucagon kit with your doctor
  4. Discuss with your doctor whether you need to check your sugar levels before exercise, driving or any potentially hazardous activity


Drugs used to treat diabetes (oral hypoglycemics)

  1.  Sulphonylureas
Generic Brand Name
Acetohexamide Dymelor
Chlorpropamide Diabinese
Tolazamide Tolinase
Tolbutamide Orinase
Glipizide Glucotrol, Minidiab, Glibenese
Glyburide (glibenclamide) Diabeta, Micronase, Glynase, Daonil, Euglycon
Glimepiride Amaryl
Gliclazide Uni Diamicron
Glyclopyramide Deamelin-S
Gliquidone Glurenorm

2. SGLT2 inhibitor drugs

Generic Brand Name
Canagliflozin Invokana
Dapagliflozin Forxiga, Farxiga
Empagliflozin Jardiance

3. Glitazones

Generic Brand Name
Rosiglitazone Avandia
Pioglitazone Actos

4. Meglitinides

Generic Brand Name
Nateglinide Starlix
Repaglinide Prandin, NovoNorm

5. Insulin

Other drugs

Beta blockers used to treat blood pressure or heart problems

Antibiotics or anti infection drugs: Bactrim, pentamidine, quinine, quinidine

Drugs used in mental health treatment: haloperidol, MAO inhibitors

CHECK OUT: Our references for diabetes mellitus