What Causes Low Blood Sugar Without Diabetes?

A low blood sugar level and driving – You may still be allowed to drive if you have diabetes or you’re at risk of a low blood sugar level for another reason, but you’ll need to do things to reduce the chance of this happening while you’re driving. You also need to tell the Driver and Vehicle Licensing Agency (DVLA) and your car insurance company about your condition. For more information, see:

• Diabetes UK: driving and diabetes
• Diabetes.co.uk: driving and hypoglycaemia
• GOV.UK: hypoglycaemia and driving

Page last reviewed: 24 September 2020 Next review due: 24 September 2023

Why do I suddenly have low blood sugar?

Nighttime low blood sugar – While low blood sugar can happen at any time during the day, some people may experience low blood sugar while they sleep. Reasons this may happen include:

Having an active day. Being physically active close to bedtime. Taking too much insulin. Drinking alcohol at night.

Eating and not skipping them can help you avoid nighttime low blood sugar. Eating when you drink alcohol can also help. If you think you’re at risk for low blood sugar overnight, have a snack before bed. You may wake up when you have low blood sugar, but you shouldn’t rely on that. A continuous glucose monitor (CGM) can alert you with an alarm if your blood sugar gets low while you’re sleeping.

How do you feel when your sugar is low?

Symptoms of hypoglycaemia – Most people will have some warning that their blood glucose levels are too low, which gives them time to correct them. Symptoms usually occur when blood sugar levels fall below four millimoles (mmol) per litre. Typical early warning signs are feeling hungry, trembling or shakiness, and sweating.

1. In more severe cases, you may also feel confused and have difficulty concentrating.
2. In very severe cases, a person experiencing hypoglycaemia can lose consciousness.
3. It’s also possible for hypoglycaemia to occur during sleep, which can cause excess sweating, disturbed sleep, and feeling tired and confused upon waking.

Read more about the symptoms of hypoglycaemia

What organ causes low blood sugar?

Causes – Hypoglycemia can be caused by medications. Medication-related hypoglycemia occurs most commonly in people who have diabetes, especially type 1 diabetes (a type of diabetes where the pancreas does not make insulin). In both type 1 and type 2 diabetes it can occur when someone is given too much insulin or other medications for diabetes that promote the release of insulin from the pancreas in relation to their current level of exercise and diet.

1. This can drastically lower blood sugar, resulting in hypoglycemia.
2. There are also other medications that can cause hypoglycemia in people with diabetes and people that do not have diabetes, such as certain medications for high blood pressure (e.g., atenolol, metoprolol, propranolol), certain antidepressants (e.g., phenelzine, tranylcypromine), quinine, and certain antibiotics (e.g., trimethoprim – sulfamethoxazole, levofloxacin).* Other types of hypoglycemia include fasting hypoglycemia and reactive hypoglycemia,

In fasting hypoglycemia, a person gets low blood sugar if they haven’t eaten for a while. Reactive hypoglycemia is low blood sugar that occurs after eating, usually due to eating a meal high in carbohydrates. This causes the blood sugar to rise rapidly, which in some cases may stimulate excess secretion of insulin.

• People may also have reactive hypoglycemia if they have trouble digesting fructose and galactose (two types of sugars found in foods) or leucine (an amino acid found in foods).
• It may also occur after some types of stomach surgery, as this may cause sugars to be absorbed too quickly, leading to excessively high insulin levels, which can cause hypoglycemia.

Hypoglycemia can also be caused by a problem with the pituitary or adrenal glands, the pancreas, the kidneys, or the liver. The pituitary gland controls the body’s production of some of the hormones needed to raise the body’s blood sugar levels if they fall too low.

These hormones include cortisol, which is released from the adrenal glands; glucagon, which is released from the pancreas; and adrenaline, which is released from the adrenal gland medulla. These hormones all help raise blood sugar levels. If they are not working properly, this could cause hypoglycemia.

Hypoglycemia can also result when the liver can’t properly store carbohydrates or convert them into glucose. A tumour on the pancreas can also cause hypoglycemia by causing too much insulin to be released. In cases of severe kidney dysfunction, hypoglycemia might also develop.

Can low blood sugar correct itself?

No symptoms? Be alarmed – Surprisingly, the most dangerous episodes of hypoglycemia occur with little or no warning. When low blood glucose occurs on a regular basis, the body can become used to the warning signs and the person may stop noticing symptoms.

How long does it take to recover from low blood sugar?

Recovery of cognitive function and mood after severe hypoglycemia in adults with insulin-treated diabetes – PubMed Objective: Acute hypoglycemia in humans impairs cognitive functions and alters mood states. The time required for cognitive functions and moods to return to normal after an acute episode of severe hypoglycemia is unknown. Research design and methods: Cognitive functions and moods were studied prospectively in 20 subjects with insulin-treated diabetes who had recently experienced a spontaneous episode of severe hypoglycemia (“hypo” subjects) and 20 matched control subjects with insulin-treated diabetes who had not experienced severe hypoglycemia during the preceding year. The hypo subjects had a history of a greater number of episodes of severe hypoglycemia (P = 0.000). Cognitive function tests and mood scales were administered at 1.5, 9, and 30 days after the severe hypoglycemia and at similar intervals for the control subjects. Results: For most of the cognitive tests, no evidence of a “hangover” effect of the acute hypoglycemia on cognitive function was observed (P > 0.05). A trend was noted for levels of hedonic tone (P = 0.082) and energetic arousal (P = 0.053) to improve with time in the hypo subjects but not in the control subjects. However, the hypo subjects had chronically elevated levels of depression (P = 0.011) and anxiety (P = 0.049) and persistently performed more poorly in several cognitive tests, such as the Digit Symbol Test (P = 0.009) and the Stroop Task (P = 0.007). Conclusions: These results suggest that, in general, recovery from any acute cognitive decrement after severe hypoglycemia was complete by 1.5 days. The cognitive decrements and altered mood states noted in the hypo subjects may be persistent and may be a consequence of previous exposure to recurrent episodes of severe hypoglycemia. : Recovery of cognitive function and mood after severe hypoglycemia in adults with insulin-treated diabetes – PubMed

Can anxiety cause low blood sugar?

– Those diagnosed with diabetes are 20% more likely to have anxiety. So not only does managing a long-term condition like it cause significant stress and anxiety but how it affects your blood sugar also impacts your mood. How does this work? There are a couple of things that happen.

First, if you experience worry and stress, your body releases stress hormones that can raise or lower your blood sugar. Then, a 2016 study suggests that eating carbohydrates, also known as carbs, can impact our emotions and how it does this has to do with your glycemic index (GI). When you eat high GI foods, like white rice and sugar, the body receives a fast burst of glucose and energy into the blood.

In response, you then release large amounts of insulin to compensate. Sometimes, insulin can lower it too much, leading to low blood sugar. Finally, your body may release epinephrine in response to low blood sugar, which can cause mental health symptoms like anxiety.

What hormone deficiency causes low blood sugar?

Are you sure your patient has counter-regulatory hormone deficiency? What are the typical findings for this disease? – Glucagon, epinephrine, cortisol and growth hormone (GH) raise plasma glucose concentration and are referred to as glucose counterregulatory hormones.

Hypoglycemia due to deficiency of GH and/or cortisol most commonly occurs in neonates and children less than 5 years of age, but may also occur in older children and adults when food intake is limited; e.g., when an illness results in anorexia and/or vomiting or when the patient is fasted prior to undergoing a procedure.

Deficiency of GH and/or cortisol should always be considered in the differential diagnosis of non-hyperinsulinemic hypoglycemia. Measurement of serum GH and cortisol concentrations should routinely be included in the so-called “critical sample” obtained at the time of spontaneous hypoglycemia.

Elevated levels exclude deficiency, whereas random values that are not clearly elevated do not rule out the possibility of deficiency and a formal evaluation of GH or cortisol secretion will be required to definitively rule out GH or cortisol deficiency. The hormones that raise the plasma glucose concentration are referred to as glucose counterregulatory hormones.

These include glucagon, epinephrine, cortisol and growth hormone (GH). These hormones are involved in the prevention as well as the correction of hypoglycemia. Glucagon and epinephrine are important for the immediate restoration of the blood glucose concentration.

1. Although GH and cortisol are released immediately in response to hypoglycemia, their counterregulatory effects do not become manifest for several hours.
2. In adults, the glycemic thresholds for activation of glucose counterregulatory hormones lie within or just below the physiological blood glucose concentration and are slightly higher than the threshold for symptoms.

Because there are redundant glucose counterregulatory mechanisms, hypoglycemia caused by deficiency of counterregulatory hormones is uncommon. Deficiency of glucagon or epinephrine is extremely rare. GH and/or cortisol deficiency more commonly cause hypoglycemia, which results from decreased gluconeogenesis and increased glucose utilization (owing to increased tissue sensitivity to insulin in the absence of GH and cortisol).

• Whereas the vast majority of adults with GH and/or cortisol deficiency do not develop hypoglycemia, deficiency of these hormones not infrequently causes hypoglycemia in neonates and in children less than 5 years of age.
• Isolated cortisol deficiency can cause fasting hypoglycemia throughout childhood.

This observation suggests that cortisol, GH, or both play a more important role in the physiology of glucose counterregulation during fasting in infancy and early childhood than at an older age. Susceptibility to fasting hypoglycemia is greatest in but not confined to young children who are deficient in both GH and cortisol.

1. Hypoglycemia in infants and children with cortisol deficiency, GH deficiency, or both is generally preceded by a period of calorie deprivation, often the result of a delay in feeding or an intercurrent illness.
2. In adults, hypoglycemia is not a feature of the epinephrine deficient state that results from bilateral adrenalectomy when glucocorticoid replacement is adequate; nor does hypoglycemia occur during pharmacological blockade of catecholamine actions when other glucoregulatory systems are intact.

In children, there is a lack of data concerning the role of epinephrine deficiency in the pathogenesis of hypoglycemia. Reduced urinary and plasma epinephrine responses to insulin-induced hypoglycemia have been described in patients with ketotic hypoglycemia of childhood.

• The significance of this observation is unclear.
• Isolated glucagon deficiency would be expected to result in lower fasting plasma glucose concentrations but not hypoglycemia if epinephrine secretion were intact and insulin secretion were appropriately suppressed.
• Neonatal hypoglycemia has, rarely, been attributed to glucagon deficiency.

However, these reports are unconvincing and hypoglycemia may have been due to hyperinsulinism in which a blunted glucagon response to hypoglycemia has been described. Pituitary disorders Combined GH and ACTH deficiencies may occur in congenital or acquired disorders of pituitary function.

• Congenital hypopituitarism may present with life-threatening hypoglycemia, hyponatremia, shock and microphallus and/or cryptorchidism.
• Other congenital malformations (cleft lip and/or palate) can also be associated with hypopituitarism.
• Hypoglycemia from anterior hypopituitarism may be a cause of sudden death.

Growth failure becomes apparent later in childhood. The causes of congenital hypopituitarism are shown in Table I. Table I. n Causes of Congenital Hypopituitarism Acquired hypopituitarism may result from tumors (most common is craniopharyngioma), radiation, infection, hydrocephalus, trauma (including injury from surgery), vascular anomalies.

• GH deficiency is characterized by low serum IGF-1 and IGFBP-3 concentrations and low GH levels in response to pituitary stimulation with GH secretagogues such as arginine, clonidine, glucagon, insulin-induced hypoglycemia.
• Depending on the specific cause of GH deficiency, a cranial MRI may show an abnormality of the pituitary gland.

Primary adrenocortical insufficiency should be considered when there is a history of lack of appetite, unexplained fatigue, muscle weakness, nausea, vomiting, weight loss, salt craving, fasting hypoglycemia, hypotension, and increased skin pigmentation that cannot be explained by sun exposure.

Patients with both glucocorticoid and mineralocorticoid deficiency typically present with fasting hypoglycemia, hyponatremia, hyperkalemia, metabolic acidosis (with normal anion gap), low serum cortisol and markedly increased concentration of plasma ACTH and plasma renin activity (PRA). Other clinical and biochemical features depend on the specific cause of primary adrenocortical insufficiency.

Secondary adrenocortical insufficiency (ACTH deficiency) should always be considered when there is a history of glucocorticoid therapy (including topical steroid therapy, inhaled and intralesional injection of glucocorticoids) and in patients with other known pituitary hormone deficiencies.

1. If the dose of glucocorticoid administered was greater than required for physiological replacement then there may be adrenocortical suppression.
2. If the duration of therapy was less than 4 weeks, suppression will be transient and recovery will be prompt.
3. If the duration of therapy was more than 4 weeks, suppression will last for 1 week to 6 months.

In these patients, it would be appropriate to resume glucocorticoid replacement in cases of stress for up to 6 months after cessation of treatment. Patients with ACTH deficiency have glucocorticoid deficiency without mineralocorticoid deficiency. They present with fasting hypoglycemia and may have mild hyponatremia, but do not have hyperkalemia or metabolic acidosis.

Both serum cortisol and plasma ACTH concentrations are low. Primary adrenocortical insufficiency should be considered when there is a history of unexplained anorexia, fatigue, salt craving. Other symptoms include nausea and vomiting, abdominal pain, diarrhea, weakness, weight loss, apathy and confusion.

Examination findings include dehydration, hypovolemia and tachycardia, postural hypotension, increased skin pigmentation. Characteristic laboratory abnormalities are hypoglycemia, hyponatremia, hyperkalemia, metabolic acidosis. The electrocardiogram shows low voltages and chest X-ray shows a small cardiac silhouette.

What is the fastest way to bring up low blood sugar?

How Are Low Blood Sugar Levels Treated? – Your diabetes health care team will give you guidelines for treating low blood sugar levels, depending on your symptoms. If you can, try to test your blood sugar levels to make sure that your symptoms are because of hypoglycemia.

If you can’t test blood sugar immediately, don’t delay in treating your symptoms — you can always check your blood sugar after you’ve taken steps to get your blood sugar back up into the normal range. When blood sugar levels are low, the goal is to get them back up quickly. To do that, you should take in sugar or sugary foods, which raise the blood sugar level quickly.

Your health care team might suggest that you:

Eat, drink, or take something that contains sugar that can get into the blood quickly. Your doctor may tell you to have really sugary foods or drinks (like regular soda, orange juice, or cake frosting) or might give you glucose tablets or gel to take — all of these can help to raise your blood sugar level fast, which is what you need to do when it’s low. Wait about 10 minutes to let the sugar work. Recheck your blood sugar level with a to see if blood sugar levels are back to normal. Get a glucagon shot (see below), if your symptoms are severe or get worse after you eat, drink, or take glucose.

Sometimes, blood sugar levels can get so low that you may not be awake enough to eat or drink something to get them back up. When this happens, you may need a glucagon shot. Glucagon (pronounced: GLOO-kuh-gon) is a hormone that helps raise blood sugar levels quickly.

Your parents, teachers, and coaches should all know how to give shots in case of a low blood sugar emergency or at least know to call 911. Your doctor can prescribe a glucagon kit, which should be kept in a place where the people who are close to you can easily find it. Also, you should always wear a medical identification bracelet or necklace and/or carry an ID that says you have diabetes.

That way, if you are not feeling well, whoever’s helping you — even if the person doesn’t know you — will know to call for medical help. This medical identification also can also include your doctor’s phone number or a parent’s phone number.

Can low blood sugar be serious?

Your blood sugar fluctuates throughout the day, going up or down depending on the food you eat, how much you exercise, the medications you take, and even your stress level. Most of the time you probably won’t notice these fluctuations because they’re within what’s considered a target range.

1. However, if your blood sugar gets too low — below 70 mg/DL — it can be dangerous, especially if you have diabetes.
2. This condition is called hypoglycemia and it’s especially common among patients with diabetes who take certain types of medications.
3. A large global study found that 4 out of every 5 patients with type 1 diabetes, and nearly half of those with type 2 diabetes, reported low blood sugar at least once over a four-week period.1 As long as you’re aware of the symptoms of hypoglycemia, there are plenty of things you can do to bring your blood sugar back to a healthy level.

However, if left untreated, hypoglycemia can cause serious side effects and potentially land you in the hospital. The hypoglycemia-diabetes connection Your body converts carbohydrates in foods like fruits, vegetables, dairy, and bread products into glucose, and requires insulin to transport it into cells and tissues for energy.

Normally, when your blood sugar levels drop too low, your body either produces more glucose or releases extra glucose that has been stored in the liver and muscles. However, in some patients with diabetes, this response to normalize glucose is impaired. Certain medications used to treat diabetes, such as insulin, can also prevent glucose levels from easily returning to the normal range.

Know the warning signs of hypoglycemia For patients with diabetes, hypoglycemia occurs when there’s too much insulin in your system. This can happen if you eat less than normal, skip meals, exercise more than usual, or don’t eat enough carbohydrates for the amount of insulin (or other diabetes medication) that you take.

When this happens, you can experience symptoms like sweating, shaking, fast heartbeat, feelings of nervousness or anxiety, dizziness, hunger, and irritability. Some people, particularly those with type 1 diabetes, who experience repeated episodes of hypoglycemia, may develop hypoglycemia unawareness.

This is when you no longer experience the typical symptoms of low blood sugar and are therefore less likely to treat it. Hypoglycemia unawareness is dangerous and puts you at risk for developing severe symptoms like clumsiness, confusion, seizures, fainting, and even death.

1. Treating low blood sugar Your treatment for hypoglycemia depends on the severity of your symptoms.
2. If your symptoms are relatively mild, you’ll want to follow the 15-15 rule.
3. Eat or drink 15 grams of glucose or carbohydrates, wait 15 minutes, then check your blood sugar.
4. If it’s still too low, repeat this process until it’s back to your target range.

Eating or drinking won’t be enough if you’re prone to severe hypoglycemia. In this case, your doctor will prescribe glucagon. Glucagon is a hormone that raises your blood sugar levels and can be given as a nasal powder or by injection. Your doctor may also recommend keeping an emergency glucagon kit with you.

Just remember to check your kit periodically to ensure that it’s stocked and that the medication hasn’t expired. Tips to prevent hypoglycemia The best way to prevent hypoglycemia is to detect low blood sugar before you develop serious symptoms. You can do this with a meter or continuous glucose monitor (CGM).

Here are some other things you can do:

Time your medications. As with all medications, always take diabetes medication in the recommended dosage and at the recommended time. Some diabetes medications can cause hypoglycemia. If you have any questions, your doctor or pharmacist can help explain how and when to take these medications. Watch what you eat. Following a meal plan is important for managing diabetes. Have enough food during each meal, avoid skipping meals, and try healthy snacking. If you are struggling with your food intake, work with a registered dietitian who can help design a meal plan that fits your personal preferences and lifestyle. Eating right will help you manage your diabetes. Exercise responsibly. Check your blood glucose before sports, exercise, or other physical activity and adjust medication if necessary. Have a snack handy if your levels fall below 100 mg/dL. Also, check blood glucose at regular intervals during extended periods of physical activity and periodically after physical activity, and adjust medications if necessary. Limit alcohol consumption. Drinking a lot of alcohol, especially on an empty stomach, can block your liver from releasing stored glucose into your bloodstream. If you want a drink, do so in moderation and with a snack or meal.

Helping you manage your blood sugar Managing your blood sugar starts with getting a strong handle on your diabetes. Express Scripts® Pharmacy gives you 24/7 access to specially trained pharmacists who understand the complexities of your condition and can give you personalized care and guidance to manage your therapy.

Does low blood sugar damage your body?

Possible Complications – Severe low blood sugar is a medical emergency. It can cause seizures and brain damage. Severe low blood sugar that causes you to become unconscious is called hypoglycemic or insulin shock. Even one episode of severe low blood sugar may make it less likely for you to have symptoms that allow you to recognize another episode of low blood sugar.

How do I stop my blood sugar from dropping at night?

Before you go to bed, consider all of the causes of nighttime hypoglycemia, and if you think you’re at risk, have a snack before heading to bed. Try to be consistent with your meals and/or snacks; skipping dinner or snacks you usually have can put you at risk. Eat a meal or snack when consuming alcohol.

How do I know if my blood sugar is low without a meter?

You can check your blood sugar level without the need for finger sticks or needles by using a CGM or flash monitor. There are several on the market. These devices involve a sensor that measures the level of sugar in the interstitial fluid, which is a proxy for the amount of sugar in your blood.

Can stress cause hypoglycemia in non diabetics?

Consider going on a hypoglycemia diet. – A good hypoglycemia diet is designed to help you normalize your body’s blood sugar levels in the healthiest way possible. This diet utilizes foods rich in fiber such as chia seeds, pumpkin seeds, avocado, beans, artichokes, apples, and flaxseeds. At the same time, this diet also includes a variety of healthy carbohydrates, which are critical since this is what glucose is primarily made from. Recommended sources of carbohydrates include wild rice, brown rice, and sweet potatoes. In addition, the hypoglycemia diet also includes the consumption of healthy fats. These include extra virgin olive oil and virgin coconut oil.

When should you worry about low blood sugar?

After You Have Low Blood Sugar – If your low blood sugar was mild (between 55-69 mg/dL), you can return to your normal activities once your blood sugar is back in its target range. After you have low blood sugar, your early symptoms for low blood sugar are less noticeable for 48 to 72 hours.

Be sure to check your blood sugar more often to keep it from getting too low again, especially before eating, physical activity, or driving a car. If you used glucagon because of a severe low (54 mg/dL or below), immediately call your doctor for emergency medical treatment. If you have had lows several times close together (even if they’re not severe), you should also tell you doctor.

They may want to change your diabetes plan.