Atlantic Endocrinology New York City

Handling Hypoglycemia

Do you get a buzz from your morning coffee or smoothie, but lose steam with each passing hour?

Maybe you get cranky, tired, shaky, and light-headed; it’s harder to stay focused.

And then you feel a lift after lunch, but you crash in the late afternoon?

You eagerly await your 4 o’clock coffee or chocolate chip muffin – and that almost holds you until dinnertime… If these ups and downs sound familiar, you may be struggling with low blood sugar, or hypoglycemia.


What Are The Symptoms Of Hypoglycemia?

Low blood sugars are one of the sucky realities of living with diabetes. Luckily, the symptoms are easy to spot if you can feel them and know what to look for!

Education is key for early intervention to reverse hypoglycemia. Specifically, the most common signs of low blood sugar are:

  • Fatigue, Weakness, or Clumsiness
  • Feeling Lightheaded or Dizzy
  • Anxiety, Irritability, Impatience
  • Sweating or Clamminess
  • Feeling of Shakiness
  • Pale Skin
  • Ravenous Hunger
  • Rapid/Racing Heartbeat
  • Numbness/Tingling of the face

If the blood glucose drops are more severe, the symptoms can also include:

  • Confusion
  • Erratic Behavior
  • Blurred Vision
  • Seizures
  • Loss of Consciousness

“Hidden” Low Blood Sugar

At Atlantic Endocrinology & Diabetes Center we know you may not have the classic symptoms of low blood sugar, like those mentioned above. Blood sugar dysregulation may show in less obvious ways, such as:

You may even have a very healthy diet and normal body weight but still have many of these symptoms.

If so, what’s going on? Let’s look at one of the regulators of blood sugar, your adrenal glands.

Tired Adrenals

Your adrenals are a pair of small, triangular-shaped glands that sit on top of your kidneys. They have several important roles, including:

  • Initiating the fight or flight response
  • Regulating sodium/potassium levels
  • Sex hormone production (androgens and estrogens)

After acute or prolonged periods of long days, little sleep, tons of work, and high stress, adrenals can get taxed and no longer function optimally. (Oh and let’s not forget our days of junk food and partying until the wee hours!) and adrenals play a big role in regulating blood sugar.

Excessively craving salt can be a sign of low adrenal function

Once you’ve used up the glucose from a meal, your central nervous system signals your adrenals to produce cortisol, the hormone that liberates glucose reserves and maintains a reliable, steady supply of glucose to all the cells in your body. This gives you constant ATP, or energy.

Along with classic signs of hypoglycemia, you may notice a cluster of symptoms associated with low adrenal function. These include:

  • Low blood pressure
  • Craving salt
  • Frequent urination
  • Muscle cramps
  • Exhaustion after workouts

If your adrenals are not up to par, then you may be susceptible to low blood sugar.

What Causes Hypoglycemia?

In simplest terms, low blood sugar is derived from an imbalance between insulin and glucose levels in the body. Outside of diabetes, hypoglycemia is rare but can happen as a byproduct of non-diabetes related illnesses or certain medications. However, hypoglycemia for people with diabetes usually occurs due to too much insulin. This can occur for a multitude of reasons:

  • Exercise – While it has a host of benefits, exercise can be tricky to navigate for people with who take insulin since it utilizes the free glucose floating in your bloodstream up to 4-48 hours post-workout depending on the activity. Overcorrection of a high blood sugar can send you plummeting later.
  • Miscalculation of Carbs – Different types  of carbohydrates can all impact your body in fun and unique ways. Variety is the spice of life! Understanding how carbs affect your body is vital in preventing a correction factor snafu.
  • Illness or Vomiting – If you throw-up your carbs, the end result is too much insulin in the bloodstream. Beyond that, illness can mess with a whole host of biological processes, including a temporary shift in insulin sensitivity.
  • Hormones – Women in all phases of life can enjoy the added perk that hormone fluctuations can impact insulin sensitivity cyclically. What a bloody mess!
  • Alcohol Consumption – Booze impacts your liver’s natural glucose release. A little precaution before, during and after a night out is critical for people with diabetes. Typically people with diabetes see a drop in glucose 6-10 hours after starting drinking.

QUICK TIP: Being drunk can sometimes look a lot like low blood sugar. Weird, right!? So take extra precautions to educate yourself and your companions on hypo-protocols before a night out.

Don’t let the above list scare you! As much as it can sometimes feel like the hypo-monster is always looming. With a little preparation, and an ounce of prevention, you can be well-guarded from some of the more common causes of hypoglycemia.

Can hypoglycemia be prevented?

Yes, hypoglycemia can be avoided with preventive steps—whether you have diabetes or not.

If you have hypoglycemia with diabetes, it’s all about sticking to your diabetes management plan. Double-check your insulin or medication dosage before taking it, and let your healthcare provider know if you change your eating or exercise habits. It might affect your glucose levels.

Or, consider a continuous glucose monitor (CGM). It transmits blood sugar to a receiver, and alerts you if it’s dropping too low. Then, be sure to always have glucose tablets or injectable glucagon on hand. If you pass out from low blood sugar and require immediate treatment, your friends or loved ones can administer a dose.

If you have hypoglycemia without diabetes, diet and exercise adjustments should prevent many episodes of hypoglycemia if there is no underlying condition. Your healthcare provider may recommend eating frequent small meals, consuming a varied diet of fats, protein, and carbohydrates, or only exercising after eating.

Just remember, snacks and diet changes aren’t a long-term cure if it’s due to a health condition or medication. Work with your healthcare provider to find and resolve the true cause of your hypoglycemia.