Symptoms of hypoglycaemia

The symptoms of hypoglycaemia (low blood glucose levels) vary from person to person and it is not always easy to recognise them. Some people say they don’t realise they are developing hypoglycaemia when they are working, but do when they are relaxing at home. Others have found that caffeine makes them more aware of the symptoms, but it is not clear why. Hypoglycaemia can be more difficult to detect if you are lying down.

Your brain controls your blood glucose levels in a similar way to a thermostat. It detects when your blood glucose has fallen too low and responds by triggering a series of reactions in your body to restore it to a healthy level. These reactions cause the symptoms of hypoglycaemia, which can be divided into two categories:

 

Symptoms that come from the body (autonomic and adrenergic symptoms):

  • hunger or feeling sick
  • feeling shaky or trembling
  • anxiety and irritability
  • heart palpitations
  • throbbing pulse in chest and abdomen
  • numbness in the lips, fingers, and tongue
  • looking pale
  • cold sweats

Symptoms that come from the brain (neuroglycopenic symptoms):

  • weakness, dizziness
  • difficulty concentrating
  • double or blurred vision
  • disturbed colour vision
  • difficulties with hearing
  • feeling warm or hot
  • headache
  • drowsiness
  • odd behaviour, poor judgement
  • confusion
  • poor short-term memory
  • slurred speech
  • lack of co-ordination
  • loss of consciousness
  • seizures

You should check your blood glucose levels as soon as you notice any warning signs that you are becoming hypoglycaemic. You are more likely to notice the symptoms that come from your body first. They usually start when your blood glucose level drops below 4mmol/L. At this point your body releases hormones (such as adrenaline) in an attempt to raise your blood glucose, which results in the symptoms listed above.

Symptoms that come from your brain tend to appear when your blood glucose level falls even lower, usually at around 2.8-3mmol/L. You are less likely to be aware of the symptoms coming from your brain, although it may be obvious to other people that something is not quite right. Sometimes people do strange things when they are hypoglycaemic, so it is very important that the people around you understand that you may not be in control of yourself and could need help.

If you have Type 2 diabetes and take sulphonylureas or insulin therapy, you are more likely to get hypoglycaemia. Your diabetes healthcare team should explain the symptoms of hypoglycaemia and encourage you to test your blood glucose levels at home. This will teach you to recognise how your body reacts to hypoglycaemia. They will also be able to give you information about treating hypoglycaemia and how to raise your blood glucose quickly.

 

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