“Hypoglycemia” is the medical term for low blood sugar (glucose).

People with diabetes who use medications, particularly insulin, to control their blood glucose sometimes develop hypoglycemia. This can be caused by not having a stable intake of carbs—not eating enough of them, eating them erratically, or not adjusting for an increase in physical activity—to balance the blood glucose-lowering effect of these medications.^{1, 2}

Early symptoms of hypoglycemia typically come on quickly and can include shakiness, anxiety, irritability, hunger, confusion, light headedness, and rapid heartbeat, but some people do not experience or detect these early symptoms.³ Hypoglycemia can contribute to falls, accidents, and other kinds of injuries; if untreated, it can progress from severe confusion to unconsciousness, seizure, coma, or even death.⁴ In addition, over time, people with diabetes who have repeated episodes of hypoglycemia appear to have a higher risk of dementia.⁵

People who use insulin to control their diabetes can generally prevent hypoglycemia by using their insulin as prescribed and sticking to an eating pattern that provides the same amounts of carbs at the same times each day. Using a blood glucose monitor can help people identify when their blood glucose is getting low so they can take steps to prevent hypoglycemia. Alcohol makes controlling blood glucose levels with insulin difficult, so drinking alcohol in moderation is best.⁶

People with diabetes using diabetes medications other than insulin can usually prevent hypoglycemia by eating on a regular schedule, making wise food choices, and having a consistent exercise program. Fasting for lab tests, delaying meals, increasing physical activity, and sleeping are examples of situations that increase the risk of hypoglycemia. Being aware of the risks, watching for symptoms, and monitoring blood glucose can help people with diabetes act fast to avoid hypoglycemia.⁷