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Know Your Lows: Recognizing and Treating Low Blood Sugar

Edited by Olivia McPherson

Our bodies have a very methodical way of regulating our blood sugar. When we eat carbohydrates, they are broken down into different sugar molecules, including glucose. Glucose is the body’s main source of energy; it circulates in our bloodstream until it enters the cells of nearly every tissue in our bodies. Extra glucose that is not needed immediately by the cells is stored as glycogen in the liver and in our muscles. Our blood sugar is regulated by insulin, an important hormone made by the pancreas. It is what allows glucose to enter cells and provide the energy that our cells need. If the glucose levels in our blood begins to decline, the glycogen being stored in our body can be broken down by the liver and released as glucose into the bloodstream. This cycle ensures that our blood sugar levels are maintained at an optimal level.

Hypoglycemia, also known as low glucose or low blood sugar, can be a complication that occurs in individuals living with Type 1 or Type 2 Diabetes. This is when the blood sugar levels drop below 4 mmol/L (72 mg/dL). People with diabetes are often unable to effectively regulate their blood glucose and will often require medications, such as insulin injections or oral anti-diabetic medications, to assist in the regulation of their blood glucose. However, it is important to understand that insulin injections and many other anti-diabetic medications can cause low blood sugar. This is because they act to drive glucose into our cells and reduce the amount circulating in our blood, similarly to how insulin made by the body works! Some other causes of hypoglycemia for individuals with diabetes could be eating too little or exercising more than usual.

If someone is experiencing hypoglycemia, it may be a medical emergency. Our brains require glucose to function, so a severe drop in blood glucose can lead to seizures, coma, and death. Recognizing the symptoms of hypoglycemia will allow treatment to be initiated faster and can be lifesaving.


The symptoms of low blood sugar are different for every individual. Common early symptoms may include sweating, light-headedness, shaking, racing heart rate, nausea, headache, or feeling nervous, anxious or irritable. More severe signs of hypoglycemia include vision changes, drowsiness, difficulty speaking, seizures, and unconsciousness.

Some medications, such as beta-blockers (bisoprolol, atenolol, etc), may hide the symptoms of low blood sugar. The only symptom that individuals taking these medications typically experience is sweating. Speak with your doctor or pharmacist about recognizing the signs of low blood sugar if you are diabetic and are taking a beta-blocker.

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