Islets of Hope for persons with diabetes

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Article by Lahle Wolfe, Founder, Islets of Hope.  For article use and reprint permission please contact:

American Diabetes Association
Diabetes Health Net
EMedicine - Fred Smeeks, MD
EDoctor UK
Nat'l Diabete Info Clearinghouse
UVA Health

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Normal Blood Glucose

Information on normal and acceptable target blood glucose ranges for both diabetics and nondiabetics. Our chart considers factors such as age and whether or not a person is newly diagnosed.

(Low Blood Sugar)


(High Blood Sugar)


Hypoglycemia in Non-Diabetic Persons
Reactive Hypoglycemia
Fasting Hypoglycemia
Other Causes for Hypoglycemia

Two types of hypoglycemia can occur in people who do not have diabetes: reactive (postprandial, or after meals) and fasting (postabsorptive). Reactive hypoglycemia is not usually related to any underlying disease; fasting hypoglycemia often is.

(LOW Blood Glucose)

Onset:  Rapid; sudden, may not be preventable.

Causes Related to Diabetes: Missing snacks or meals, eating too little food, taking too much insulin, too much activity, side effects of medications taken, or a combination of these things.

ALERT:  All lows are potentially dangerous and can lead to seizure, convulsion, unconsciousness, and death if not treated.  If you are unable to test someone's blood glucose, always assume the person is low and treat for low blood glucose.  Call 911 and test blood glucose as soon as possible.


Mild Hypoglycemia
Increased or sudden hunger
Feeling shaky, dizzy or nervous
Pounding heartbeat
Drowsiness, feeling tired
Sweating (cold and clammy)
Numbness/tingling around mouth
Headache or stomachache

Moderate Hypoglycemia
Any mild symptoms above, plus:
Personality change
Confusion and/or difficulty      concentrating
Slurred or slow speech
Poor coordination

Severe Hypoglycemia
***CALL 911 ASAP!***

Any of the above symptoms plus:
Loss of consciousness
Seizures and/or convulsions

Severe hypoglycemia requires injection of glucagon!

Did You Know?

... preventing hypoglycemia while you are driving a vehicle is especially important? Checking blood glucose frequently and snacking as needed to keep your blood glucose above 70 mg/dL will help prevent accidents.

... that exercise can cause hypoglycemia? Check your blood glucose before you exercise and afterwards.  If you are active for a long time, or, feel any of the symptoms of abnormal blood glucose levels (high or low) check during exercise as well.

Hypoglycemia and Diabetes: Doing Your Part

Signs and symptoms of hypoglycemia can vary from person to person. Get to know your own signs and describe them to your friends and family so they will be able to help you. If your child has diabetes, tell school staff about low blood sugar and how to treat it.

If you suffer hypoglycemia several times a week, call your health care provider.


islets of hope diabetes medical library            back to main "Glycemia Information"
Diabetes Information                                                                        
Printable Version of this Article

Preventing diabetic hypoglycemia
(also called low blood glucose or low blood sugar)

Mini Site Index
Medications, Supplements and Hypoglycemia
Preventing Hypoglycemia During the Day
Preventing Hypoglycemia During the Night
Preventing Hypoglycemia Related to Exercise 

Medications, Supplements and Hypoglycemia

Certain medications can contribute to, or cause, hypoglycemia.  Diabetes medications including Glucophage (metformin), Actos, and Avandia, are a few.  Other medications and even certain over-the-counter supplements may also contribute to hypoglycemia.  It is important to tell your doctor and pharmacist all the medications and supplements that you are taking.

  • Could my diabetes medication cause hypoglycemia?
  • When should I take my diabetes medication?
  • How much should I take?
  • Should I keep taking my diabetes medication if I am sick?
  • Should I adjust my medication before exercise?


Preventing Hypoglycemia During the Day

Your diabetes treatment plan is designed to match your medication dosage and schedule to your usual meals and activities. If you take insulin but then skip a meal, the insulin will still lower your blood glucose, but it will not find the food it is designed to break down. This will result in hypoglycemia.

  • Eat and take your medications on time.
  • Make sure you eat enough food for the medication you are taking.
  • Do not drink alcohol without eating food.
  • Be prepared and carry some form of carbohydrates with you in case there is a meal delay.
  • Be aware of the time of day - if you are taking insulin, your blood sugar will be the lowest before a meal and you may be more sensitive to insulin or carbohydrates at various times of the day.
  • Plan your exercise. Eat more to cover unplanned exercise which may lower your blood sugar too much.  Exercise can also cause a rapid drop in blood sugar hours later, so monitor your sugars frequently post heavy exercise.
  • Record and report all unexplained hypoglycemia episodes to your doctor  


Preventing Hypoglycemia During the Night

Check your blood sugar at bedtime before an evening snack. If your reading is less than 120 mg/dL (or whatever pre-bedtime target your doctor has given you, i.e., Elizabeth, my 6-year-old's target is 140 mg/dL), you may need to eat a larger snack containing carbohydrates and protein.  For children, or those on an insulin pump, pre-bedtime target ranges may be slightly higher.  Be sure you understand what your doctor has recommended for you and if it is not working well for you be sure to consult your doctor.

You should check your blood glucose at least once during each night.  If you wake in the morning with a headache, or high fasting sugars, it may be a sign that low blood sugar occurring during the night.

If you suspect low blood glucose during the night check your blood sugar at 3:00 a.m.  If your blood glucose is low at that time, you may need a smaller dose of intermediate insulin (NPH) or long-lasting insulin (Lantus® or Ultralente) in the evening.  If you are on an insulin pump your basal rates may need adjusting.  Never change your insulin guidelines without discussing them with your doctor first!  

OH Medical Tip:  Consuming high-fat snacks late in the evening can keep blood glucose levels elevated.  See "Hyperglycemia" to learn more about high blood glucose levels.  

Preventing Hypoglycemia Related to Exercise

Exercise can cause either hypoglycemia or hyperglycemia.  To help avoid low blood glucose during exercise:

  • Do not inject insulin immediately before exercise
  • Do not inject insulin into large muscle groups you will be using during exercise - either use your tummy, or wait one hour after injecting into muscles
  • Check your blood glucose before, during, and after exercise
  • Have a carbohydrate snack before exercising
  • Know that exercise burns glycogen from muscles and liver -- these glycogen stores will need to be replenished.  Be sure to eat after working out!  
  • Be alert to nighttime lows after working out.  When glycogen stores are depleted during exercise, your liver may rob glucose from your bloodstream causing lows up to 12 hours after exercising.  Having a pre- and post-exercise snack can help avoid delayed hypoglycemia reactions.
  • Do not work out close to bedtime.
  • Do not work out in really hot weather.  Hot weather can increase how fast insulin is absorbed and cause lows.
  • Do not use saunas or hot tubs -- both can increase blood circulation and cause insulin to work faster in the body which may result in hypoglycemia (the same is true for hot baths after injecting insulin).
  • Make sure your doctor has approved your exercise plan in advance!

See our Lifestyles section for more information on sports, exercise, and diabetes.

More Information About Hypoglycemia

People with diabetes
Symptoms of Hypoglycemia in Diabetes
Causes of Hypoglycemia in Diabetes
Treating Hypoglycemia in Diabetes
Printable Hypoglycemia Guides
Normal Blood Glucose Ranges
Normal and Target Blood Glucose Ranges for Diabetics

People that do not have diabetes
Hypoglycemia in People Who Do Not Have Diabetes
Symptoms of Non-Diabetes Related Hypoglycemia
Reactive Hypoglycemia
Fasting Hypoglycemia
Conditions Occurring in Childhood and Infancy

Related Information
Insulin Shock
Diabetic Seizures and Coma from Hypoglycemia 
Shot Therapy
Insulin Pump Therapy
Types of Insulin
Tips from Others Living With Diabetes
Lifestyle Changes
Diets for Diabetes and Hypoglycemia



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Page Updated 03/10/2006