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Diabetes Health Center

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When Your Blood Sugar Gets Too Low

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People with diabetes get hypoglycemia (low blood sugar) when their bodies don't have enough sugar to use as fuel.

It can happen for several reasons, including diet, some medications and conditions, and exercise.

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The Daily Diabetes Care Checklist

When you have type 2 diabetes, it's often a juggling act to remember all of your daily tasks. Nora Saul, RD, CDE, a diabetes educator and manager for nutrition services at the Joslin Diabetes Center in Boston, offers this "healthy habits" checklist to guide you through the day. Check your blood sugar levels. Most people with type 2 diabetes need to check their blood sugar, also called glucose, at least once a day. "That's the minimum," Saul says. But the frequency depends on your treatment...

Read the The Daily Diabetes Care Checklist article > >

If you get hypoglycemia, write down the date and time when it happened and what you did. Share your record with your doctor, so she can look for a pattern and adjust your medications.

Call your doctor if you have more than one unexplained low blood sugar reaction in a week.


Most people feel symptoms of hypoglycemia when their blood sugar is 70 milligrams per deciliter (mg/dL) or lower.

Each person with diabetes may have different symptoms of hypoglycemia. You'll learn to spot yours.

Early symptoms include:

Without treatment, you might get more severe symptoms, including:

Diabetes Drugs Linked to Hypoglycemia

Ask your doctor if any of your medicines can cause low blood sugar.

Insulin treatment can cause low blood sugar, and so can a type of diabetes medications called "sulfonylureas."

Commonly used sulfonylureas include:

Older, less common sulfonlyureas tend to cause low blood sugar more often than some of the newer ones. Examples of older drugs include:

You can also get low blood sugar if you drink alcohol or take allopurinol (Zyloprim), aspirin, Benemid,probenecid (Probalan), or warfarin (Coumadin) with diabetes medications.

You shouldn't get hypoglycemia if you take alpha-glucosidase inhibitors, biguanides (such as metformin), and thiazolidinediones alone, but it can happen when you take them with sulfonylureas or insulin.

Diet and Hypoglycemia

You can get low blood sugar if you take too much insulin for the amount of carbohydrates you eat or drink.

For instance, it can happen:

  • After you eat a meal that has a lot of simple sugars
  • If you miss a snack or don't eat a full meal
  • If you eat later than usual
  • If you drink alcohol without eating any food

Don't skip meals if you have diabetes, particularly if you're taking diabetes medications.

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