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HomeHealth articleshypoglycemiaWhat Is Emergency Treatment for Hypoglycemia?

Hypoglycemia - Causes, Symptoms, and Prevention of Severe Hypoglycemia.

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We can manage low blood sugar levels at home. However, emergency medical care is required if the patient passes out and does not respond to home treatment.

Medically reviewed by

Dr. Zulfiqar Ahmed

Published At March 9, 2023
Reviewed AtMarch 9, 2023


A person is said to have hypoglycemia when blood sugar levels drop below a healthy range. Low blood glucose (sugar) or hypoglycemia is common in diabetic patients. Blood sugar levels vary between individuals. The normal blood sugar levels are between 80 and 120 milligrams per deciliter (80 to 120 mg/dL). A blood sugar level below 70 milligrams per deciliter (mg/dL) is considered hypoglycemia. If blood sugar levels fall way below 70 milligrams per deciliter (mg/dL), it can be life-threatening and require immediate medical attention.

What Are the Causes of Hypoglycemia?

Hypoglycemia is also known as insulin shock or insulin reaction and is most commonly seen in diabetic patients. Insulin is a hormone that helps the body cells and tissues to utilize glucose for energy. Too much insulin in the body can lead to hypoglycemia. People with diabetes often take medications and insulin shots to lower their blood sugar. Unfortunately, most of these antidiabetic medications and insulin injections increase blood insulin levels. If there is a medication overdose or the person has not taken food but has taken the usual dose of medication or insulin injections, there is a chance for hypoglycemia. Thus, their blood sugar levels can fall below normal when they skip meals, fast, and exercise more than usual. Mismatch between blood sugar levels and medication dosages (improper glucose monitoring) can also cause hypoglycemia. In addition, impaired renal function, renal dialysis, incorrect prescription of diabetic medication, a higher dose of insulin injection, drug interactions, and other risk factors that can lower blood glucose levels can cause hypoglycemia.

What Are the Warning Signs of Hypoglycemia?

When the blood sugar levels drop below normal, the person experiences unpleasant signs and symptoms, and severe hypoglycemia can even be life-threatening. Therefore, it is important to identify these symptoms and immediately take action before it worsens. The warning signs of low blood sugar include:

  • Dizziness.

  • Hunger.

  • Trembling or shaking.

  • Chills and sweats.

  • Nervousness and restlessness.

  • Irritability.

  • Increased heart rate.

  • Nausea.

  • Weak and tired.

  • Confusion.

What Happens in Severe Hypoglycemia?

It is known as severe hypoglycemia when the blood sugar levels fall so low that the brain and other vital organs do not get enough glucose for energy. It can present with the following symptoms initially,

  • Confusion.

  • Blurry vision.

  • Tingling in the face or mouth.

  • Sleepiness.

  • Trouble concentrating.

  • Slurred speech.

Warning signs of hypoglycemia that require immediate medical attention include:

  • Inability to eat or drink.

  • Seizures or convulsions (the body jerks out of control).

  • Unconsciousness.

  • Coma.

How to Check if the Blood Sugar Is Low?

Hypoglycemia is diagnosed with a blood glucose meter, a device that measures blood glucose levels. Blood from a tiny prick on the finger can be used to measure blood sugar levels using the blood glucose meter. It is a small and compact device that all can use at home. In addition, there are other wearable devices known as continuous glucose monitors used to measure blood glucose levels day and night continuously. If the blood sugar levels drop below normal, the device sounds an alarm.

What to Do if You Feel That Your Sugar Level Is Low?

It is better to check the blood sugar levels if one feels that it has gone down. However, if one cannot test the blood sugar levels, go ahead and treat it. Untreated hypoglycemia is dangerous, and it is essential to know what to do in case of low blood sugar. To treat an episode of hypoglycemia, follow the 15 to 15 rule recommended by the American diabetes association. The rule states that if the blood sugar falls below normal and is between 55 to 69 milligrams per deciliter (mg/dL), take 15 grams of carbohydrates. Then, recheck the blood glucose level after 15 minutes. If the blood sugar is still below normal, take another 15 grams of carbs to raise the glucose levels and recheck after 15 minutes. One must repeat this until the blood sugar levels normalize and one feels better. Once the blood glucose levels enter the normal range, eat healthy meals and snacks to prevent another episode of hypoglycemia. One should remember that it takes time for blood glucose levels to rise after taking carbs or food. Young children, infants, and toddlers need less than 15 grams of carbs. Avoid taking carbs with lots of fiber or fat, such as beans or chocolate, as these can slow down sugar absorption. The following items are examples of food with 15 grams of carbs:

  • Half a cup of regular soda or juice.

  • One tablespoon of honey, sugar, or syrup.

  • Three to four glucose tablets.

  • Hard candies or jelly beans, as mentioned on the food label.

  • One dose of glucose gel.

What to Do in Cases of Severe Hypoglycemia?

It is severe hypoglycemia if the blood sugar levels fall below 55 milligrams per deciliter (mg/dL). The 15 to 15 rule does not help severely low blood sugar levels. Also, patients with severe symptoms such as dizziness or confusion cannot check or treat hypoglycemia alone. Friends, family, and caregivers must be aware of the warning signs of hypoglycemia to help the patients when needed. During severely low blood sugar emergencies:

  • Use injectable glucagon. It is considered the best treatment for severe hypoglycemia. The doctor may prescribe a glucagon kit if the patient is at a high risk of hypoglycemia. The patients, their caregivers, and family members need to learn when and how to use the glucagon kit to manage hypoglycemia.

  • Contacting a doctor for emergency medical care immediately after receiving a glucagon injection is essential.

  • If the patient passes out due to low sugar, they will wake up within 15 minutes of glucagon injection administration. Repeat the glucagon injection if they do not wake up within 15 minutes of the first injection.

  • When the patient wakes up and can swallow, give regular soda or fruit juice that contains fast-acting sugar. After that, the patients can have food such as crackers or sandwiches.

  • Call for emergency medical help if:

    • The patient passes out, and no glucagon is available.

    • If the patient requires a second dose of glucagon.

    • The patient does not respond to glucagon injections and still shows symptoms such as confusion.

    • If the patient’s blood sugar remains severely low 20 minutes after initiating treatment.

What to Do After a Low Blood Sugar Episode?

Suppose one had mild hypoglycemia with blood sugar levels between 55 to 69 milligrams per deciliter (mg/dL). In that case, returning to normal day-to-day activities is fine once the blood sugar levels normalize. However, checking the blood sugar more often after a hypoglycemic event is recommended to prevent it from getting too low. If one had severe hypoglycemia, a blood glucose level below 54 milligrams per deciliter (mg/dL), and had used a glucagon injection, visit the doctor immediately for emergency care. The doctor might modify the prescription and change the diabetic plan. A medical tag such as a necklace or bracelet can help keep one safe if one passes out during severe hypoglycemic episodes.

How to Prevent Hypoglycemia?

The following can help prevent low blood sugar levels:

  • Manage diabetes and follow the recommended diabetic plan.

  • Check the blood sugar levels regularly.

  • Take the prescribed medications regularly.

  • Keep track of the hypoglycemic events and understand the food and exercise routines that might have caused them.

  • Talk to the doctor whenever one needs more information.


Hypoglycemia or low blood sugar levels are common in diabetic patients. If symptoms of low blood sugar are ignored, it can lead to severe complications and even be life-threatening. Simple changes such as modifying the diet and changing the time of food, medication, and exercise can help to manage the blood sugar levels. In case of mild hypoglycemia, follow the 15 to 15 rule to get the sugar levels back to normal. If hypoglycemia is severe, use a glucagon injection and get immediate medical help. Call for emergency medical help if the patient passes out and does not respond to treatment at home. Fortunately, routine blood sugar monitoring and home care can prevent low blood sugar.

Frequently Asked Questions


What Are the Clinical Sign and Symptoms of Hypoglycemia?

The most commonly seen clinical manifestations of hypoglycemia or low blood sugar may include:
- Heartbeat increases or becomes fast.
- Sweating and shaking
- Anxiousness.
- Confusion and irritation.
- Dizziness.
- Feeling hungry.


What Actions Can Be Taken to Reduce or Alleviate?

Consider the following to lower the risk of hypoglycemia:
- Maintain a specific range of blood sugar levels by routinely monitoring them.
- Keep a balanced diet that contains a range of carbohydrates, proteins, and healthy fats at frequent mealtimes.
- Smaller portions of meals should be eaten, and avoid skipping meals.
- Eat fewer foods that are high in refined sugars.
- Adjusting medication dosages, especially for insulin or other blood sugar-lowering drugs, should be done with the healthcare team if one has diabetes.


What Are the Delayed Clinical Manifestations of Hypoglycemia?

The late clinical manifestations of hypoglycemia are pain in the head, dizziness, seizures, difficulty in speaking, confusion, and coma.


What Test Identifies Hypoglycemia?

Most frequently, a glucagon test is done to aid in diagnosing hypoglycemia, which is a state of abnormally low blood sugar. Blood sugar levels are often measured as part of the hypoglycemia test. A finger-prick blood glucose test utilizing a glucose meter can determine this. Continuous glucose monitoring (CGM) equipment may occasionally be employed to provide real-time blood sugar measurements.


How Is Diagnosis for Hypoglycemia Diagnosis Made?

If a person experiences any warning signs or symptoms of low blood sugar, a blood glucose meter is used to measure and check the blood sugar level. They have hypoglycemia if the blood sugar level falls below 70 mg/dL. The doctors also give the diagnosis considering the patient's medical history and after conducting a medical examination.


What Does a Critically Low Blood Sugar Level Mean?

Medical attention for hypoglycemia is needed when a person's fasting blood sugar is 70 mg/dL (milligrams per deciliter), or 3.9 mmol/L (millimole per liter), or below. Severe hypoglycemia is defined as blood sugar below 55 mg/dL.


What Are the Causes of Hypoglycemia?

There are many causes of hypoglycemia. Hypoglycemia occurs in diabetic patients as a result of overdosage of diabetic medication. It might also occur if a diabetic patient exercises more than normal or has a smaller portion of food than the normal diet after taking diabetic medication. In non-diabetic people, hypoglycemia can occur due to starvation, medications (diabetic drugs or Quinine), alcohol consumption, hormonal imbalance, overproduction of insulin, and certain illness like kidney disease and liver cirrhosis.


Can Hypoglycemia Progress to Diabetes?

It is not necessary to have diabetes to have symptoms linked to mild low blood sugar or hypoglycemia; however, both conditions co-exist in many patients. 


Can Hba1c detect hypoglycemia?

The reason behind frequent episodes of hypoglycemia may not be apparent from the HbA1c result alone, as it provides an average measure of blood glucose levels over a span of two to three months and does not reflect the day-to-day or real-time fluctuations within that period.


Which Hormones Result in Hypoglycemia?

The primary hormones in hypoglycemia episodes are cortisol, epinephrine, and glucagon. Although each of these hormones makes the liver secrete glucose into the blood, occasionally, they cannot elevate the blood glucose level high enough to prevent hypoglycemia. 


What Are Some Effective Ways to Rapidly Increase Blood Sugar Levels?

The doctor may advise the patient to consume foods or drinks high in sugar, such as regular soda, orange juice, or cake frosting, or provide glucose tablets or gel for immediate consumption. These measures are intended to rapidly increase the patient's blood sugar level when it is low. It is recommended to wait approximately 10 minutes to allow the sugar to take effect.


Is It Possible for Hypoglycemia to Occur Suddenly?

Reactive hypoglycemia refers to a condition experienced by the patient within a few hours after a meal, characterized by a drop in blood sugar levels. This condition occurs due to excessive production of insulin in the body. It is important to note that having reactive hypoglycemia may indicate an increased risk of developing diabetes for the patient.


Hypoglycemia: Is It Transient?

Hypoglycemia can be temporary or chronic, depending on the underlying cause. Temporary hypoglycemia is often a result of certain factors such as missed meals, excessive physical activity, or consuming high-sugar foods that lead to a rapid drop in blood sugar levels. In these cases, the hypoglycemic episode is resolved once the underlying cause is addressed and blood sugar levels stabilize. 


Can Hypoglycemia Result from Stress?

The patient should be aware that experiencing frequent episodes of stress can significantly impact their blood sugar levels. This can pose challenges for individuals with diabetes, as it becomes more difficult to effectively manage their condition, thereby increasing the risk of hypoglycemia.


Which Foods Are Beneficial for Hypoglycemia?

When managing hypoglycemia, consuming foods that steadily release glucose into the bloodstream is essential. Optimal choices include complex carbohydrates such as whole grains, legumes, and fruits, as well as lean proteins and healthy fats. These foods help maintain stable blood sugar levels and prevent rapid fluctuations, offering sustained energy and balanced nutrition for individuals with hypoglycemia.


How Can Blood Sugar Levels Be Maintained?

The patient should adhere to regular meal schedules and avoid skipping meals. It is advisable to select foods that are lower in calories, saturated fat, trans fat, sugar, and salt. Monitoring food intake, beverages, and physical activity is important. Opting for water as a beverage instead of juice or soda is recommended.
Dr. Zulfiqar Ahmed
Dr. Zulfiqar Ahmed



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