LOW BLOOD SUGAR SYMPTOMS
The symptoms of low blood sugar vary from person to person, and can change over time. During the early stages low blood sugar, you may:
- Feel hungry
- Feel anxious
If untreated, your symptoms can become more severe, and can include:
- Difficulty walking
- Difficulty seeing clearly
- Bizarre behavior or personality changes
- Unconsciousness or seizure
When possible, you should confirm that you have low blood sugar by measuring your blood sugar level. (See ”Patient information: Self-blood glucose monitoring in diabetes mellitus”.) Low blood sugar is generally defined as a blood sugar of 60 mg/dL (3.3 mmol/L) or less.
Some people with diabetes develop symptoms of low blood sugar at slightly higher levels. If your blood sugar levels are high for long periods of time, you may have symptoms and feel poorly when your blood sugar is closer to 100 mg/dL (5.6 mmol/L). Getting your blood sugar under better control can help to lower the blood sugar level when you begin to feel symptoms.
Hypoglycemia unawareness — Hypoglycemia unawareness occurs when you do not have the early symptoms of low blood sugar. As a result, you cannot respond in the early stages, and severe signs of low blood sugar, such as passing out or seizures, are more likely. Being unaware of low blood sugar is a common occurrence, especially in people who have had type 1 diabetes for greater than five to 10 years.
Hypoglycemia and hypoglycemia unawareness occur more frequently in people who tightly control their blood sugar levels with insulin (called intensive therapy).
People who drink excessive amounts of alcohol, are tired, or who take a beta-blocker (commonly used to control high blood pressure) may not notice their low blood sugar symptoms, or may not recognize that the symptoms are due to low blood sugar.
Hypoglycemia unawareness can also occur in people who take certain oral diabetes medications (eg, Micronase® [glyburide]), especially in elderly people with heart or kidney disease.
Nocturnal hypoglycemia — Low blood sugar that occurs when you are sleeping (nocturnal hypoglycemia) can disrupt sleep but often goes unrecognized. Nocturnal hypoglycemia is a form of hypoglycemia unawareness. Thus, if you have nocturnal hypoglycemia, you are less likely to have symptoms that alert you to the need for treatment. Nocturnal hypoglycemia can be difficult to diagnose, and can increase the risk of hypoglycemia unawareness in the 48 to 72 hours that follow.
Low bloodsugar and personality changes
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