Early symptoms of hypoglycemia

The early symptoms of hypoglycemia (low blood sugar or glucose) can appear suddenly and are usually moderate and quickly and easily treated. However, they can worsen if not treated and eventually lead to serious complications.

Hypoglycemia symptoms include:

·         Palpitations.

·         Fatigue.

·         Pale skin.

·         Shakiness.

·         Anxiety.

·         Sweating.

·         Hunger.

·         Irritability.

·         Tingling around the mouth.

·         Dizziness.

·         Lightheadedness.

·         Headache.

·         Drowsiness.

·         Confusion.

·         Difficulty speaking.

·         Weakness.

·         Unsteadiness.

·         Staggering when walking.

·         Blurry or double vision.

 Symptoms of low blood sugar can also occur while the person is asleep (nocturnal hypoglycemia), such as crying out, having nightmares, finding pajamas or sheets drenched with sweat, and feeling tired, irritable, or confused upon waking. Given the relationship between hypoglycemia and glucose levels, this condition is often associated with diabetes. However, non-diabetic people can experience ebbing levels of blood sugar.

Causes of hypoglycemia

With diabetes

Low blood sugar may be a side effect of the following diabetic medications or combination of medications:

·         Chlorpropamide.

·         Glimepiride.

·         Glipizide.

·         Glyburide.

·         Nateglinide.

·         Repaglinide.

·         Sitagliptin.

·         Tolazamide.

·         Tolbutamide.

·         Glipizide + metformin.

·         Glyburide + metformin.

·         Pioglitazone + glimepiride.

·         Rosiglitazone + glimepiride.

·         Sitagliptin + metformin.

·         Pramlintide + insulin.

·         Exenatide with chlorpropamide, glimepiride, glipizide, glyburide, tolazamide, and tolbutamide.

And insulin with any of these pills (which do not cause hypoglycemia by themselves):

  • Acarbose.
  • Metformin.
  • Miglitol.
  • Pioglitazone.
  • Rosiglitazone.

Without diabetes

·         Taking someone else’s oral diabetes medication.

·         Drinking too much without eating.

·         Severe hepatitis and other liver diseases.

·         Skipping or delaying meals.

·         Exercise – aka delayed post-exercise hypoglycemia.

·         Long-term starvation; e.g., as a result of anorexia nervosa.

·         Insulin overproduction.

·         Hormone deficiencies.


People who do not have diabetes can experience low blood glucose levels within four hours after a meal – known as postprandial hypoglycemia. Neglecting to treat the early symptoms of hypoglycemia can result in more severe symptoms such as loss of consciousness, seizures, and death. Other complications include the following:

·         Hypoglycemia unawareness. The body and brain may fail to produce any symptoms after a series of hypoglycemic episodes, increasing the risk of lethal effects.

·         Undertreated diabetes. Diabetics may start reducing their insulin dose to prevent glucose from sinking too low, with the consequent risk of high blood sugar and its equally dangerous complications.

An easy, quick, and affordable way to find out whether one has low blood sugar is using a glucose meter. This can be helpful to determine glucose levels on the spot – results are ready as quickly as 5 seconds – and once again 15 minutes after receiving immediate treatment (fast-acting carbohydrate such as candy, fruit juice, regular soft drinks, or glucose tablets). Having established that, it is also important to see a doctor if hypoglycemia doesn’t respond to immediate treatment or if one has recurring episode of hypoglycemia in order to determine an underlying cause and treat it. Fortunately, hypoglycemia may be prevented by taking medications as prescribed, following a customized meal plan, and abstaining from alcohol, among other measures that patients should discuss with their healthcare providers.

Related: How does a blood glucose meter work?