Preparation is key when hypoglycemia strikes without symptoms

By Margaret Apedo, MD  |  10/25/2016

Irritability, dizziness, shakiness, sweating, chills, rapid heartbeat and blurred vision are some of the warning signs that your blood sugar is dropping rapidly.

Diabetics with these symptoms could be experiencing hypoglycemia and need immediate treatment. The Centers for Disease Control and Prevention estimates that nearly 300,000 people visit emergency rooms annually due to hypoglycemia, which can lead to seizures, unconsciousness and brain damage.

But for some, there are no symptoms when their blood sugar drops below 70mg/dl and the consequences can be life-threatening. Hypoglycemia unawareness risk factors include people who:

  • Have frequent low-blood-sugar episodes, including type 1 diabetics who have had the condition for five or more years.
  • Excessively use alcohol.
  • Are on certain blood pressure medications, such as beta blockers.
  • Tightly control diabetes with an intensive regimen of insulin therapy.
  • Have autonomic nerve damage.

You can avoid hypoglycemia by testing your blood sugar regularly.

Always be prepared to treat a low blood sugar level promptly. You should carry glucose tablets or other sources of fast-acting carbohydrates.

Here's how:

Consume 15 to 20 grams of glucose or simple carbohydrates, including three to four glucose tablets or a gel tube, 1 tablespoon of sugar or honey, six to eight hard candies, a half-cup of fruit juice or regular soda, or 8 ounces of nonfat or 1 percent milk.

Retest your blood sugar after 15 minutes. If your level is still below 70mg/dl, repeat treatment. When your level returns to normal, eat a small snack with protein.

Have your spouse, close friend or relative learn the signs of hypoglycemia and be prepared to help or administer glucagon in case of emergency. Glucagon is a hormone that raises blood sugar levels and is available as an emergency kit.

Eat meals and snacks on a regular schedule. Have a medical ID with you at all times to ensure proper emergency care when you are unable to speak for yourself.

See a healthcare professional who specializes in the management of diabetes to find out what improvements need to be made in your treatment plan and also to find outwhich of the newer medications or technology may improve your diabetes management.

Awareness is key. It's important for patients as well as their close family members to have adequate knowledge of diabetes and its complications. Hypoglycemia is the most common of these complications and can be prevented to avoid the long-lasting damage of its effects.

Dr. Margaret Apedo is an endocrinologist with Health Quest Medical Practice. Her office is based in Poughkeepsie and can be reached at 845-485-2500 (TTY 800-421-1220). Learn more about Health Quest endocrinology services, visit