Low blood sugar levels? Here is what to do….

If you are suffering from diabetes and have been taking treatment for it, you would know that missing meals or taking too much insulin or to many tablets can cause the blood sugar levels to drop to a dangerously low level. Such a situation is called hypoglycaemia. Hypoglycaemia requires urgent treatment as low blood sugar levels can have an impact on the functioning of the brain and other vital organ systems.

In this article, we shall briefly review the steps that patients must take in case they feel that their blood sugar levels are low or the reading on the glucometer demonstrates very low blood sugar levels. But before we discuss that, it is important to recognise what exactly hypoglycaemia is and what the symptoms that the patient experiences can be.

What is hypoglycaemia?

Hypoglycaemia is defined as a blood sugar level of less than 70 mg/dl on a fasting blood test. The normal blood glucose levels lie between 80 to 100 mg/dl. It is maintained at this level by the food that we eat at meal times and by the secretion of insulin from the pancreas into the bloodstream. In patients with diabetes, missing a meal can result in the blood sugar levels dropping remarkably low.  In addition, if a patient misses a meal and still takes the medication required for diabetes such as tablets or insulin, this can drop the blood sugar levels dangerously low. This requires urgent treatment.

What are the risk factors for developing hypoglycaemia?

Hypoglycaemia can occur due to a number of different factors. These are listed in the table below.

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  • Poor absorption of glucose from the gut (called malabsorption)
  • Excessive physical activity
  • Insufficient food intake
  • Alcohol intake
  • Injection into sites where fat has accumulated from repeated insulin injections (called lipohypertrophy)
  • Drug interactions with the diabetes drugs
  • Poor kidney function or kidney failure
  • Error in prescription of insulin



What are the symptoms that patients with hypoglycaemia experience?

drowsySymptoms of low blood sugar can include sweating, blurred vision, shaking of the hands (tremors), irritability, headache and altered consciousness levels (feeling drowsy). In more advanced cases, patients may lose consciousness, suffer from fits or seizures, can develop weakness of their arms or legs (like a stroke) and may go into a deep coma. Low blood glucose levels can also affect the heart and can cause irregular heartbeats and damage to the heart muscle from a heart attack.

A worrying aspect of low blood sugar levels is them dropping to dangerously low levels when driving. This can increase the chances of suffering from a road traffic accident.

Managing low blood sugar levels at home

If your blood sugar levels are low and you are experiencing symptoms similar to what have just been described, it is essential to receive some form of treatment immediately. Below are some steps that you or a family member can take to bring the blood glucose levels up immediately.


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  • Stop what you are doing and find a safe place to sit down or lie down.
  • Always carry sugary sweets or biscuits in your pocket or your purse. Pop this into your mouth immediately if your blood sugar levels are low.
  • If you do not have any sweets, take two spoons of sugar immediately. This can be powdered sugar or granulated sugar.
  • Fruit juice or sugary soft drinks such as Coca – Cola are helpful as well. A glass of that should be sufficient.
  • Toast with jam can also bring the blood glucose level up as well.
  • Rest until you feel better. You may need a bit more sugar if your symptoms do not subside after 15 – 20 minutes.
  • If blood glucose levels remain low despite the above measures, then it is essential that you see a doctor as soon as possible.


Are you aware that you have low blood sugar?

One of the most important aspects of hypoglycemia is the ‘awareness’ that the blood glucose levels are low. Most patients experience a combination of symptoms that we have mentioned above, and will be able to take the required treatment immediately. But sometimes, patients may be unaware that their glucose levels are low. This is called hypoglycemia unawareness.

The worry about hypoglycemia unawareness is that it can occur at night when patients are asleep. In such cases, family members may find it difficult to wake patients up from their sleep in the morning. Obviously, this is cause for concern.

Hypoglycemia unawareness is seen in patients who have suffered from diabetes for a number of years, have had multiple episodes of low blood sugar levels and control their blood sugar levels very stringently. Whatever the reason, it is important to see your doctor if this occurs.

Finally, we strongly recommend that patients who develop hypoglycemia unawareness DO NOT drive until they have seen their doctor. They can be a danger to themselves and to the people around them as their response time and brain function is not 100%.

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Check your blood sugar regularly

The best way to keep an eye on your blood sugar levels is to monitor them regularly at home using a glucometer. Check your blood sugar 2 to 3 times a day, ideally before food. If you do not have a blood glucometer, you can purchase one from our online store here.


Need help?

If you are having trouble managing your blood sugar level at home, or wish to have a full check up done, feel free to give us a call and we will be happy to see you!


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Dr Vivek Baliga
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