Hypoglycemia, or low blood glucose (sugar), can be a complication of type 1 diabetes. Though it’s normal for a person’s blood sugar levels to rise and fall throughout the day, many people with diabetes experience sudden drops in blood sugar. Hypoglycemia can result in a range of symptoms, including anxiety, sweating, hunger, and nausea. When left untreated, it can lead to more serious or potentially life-threatening complications.

If you’re living with type 1 diabetes, it is important to understand hypoglycemia — including why it happens and what actions you can take when it occurs. Here are five facts about hypoglycemia that every person diagnosed with type 1 diabetes should know. If you have more questions about hypoglycemia or your particular symptoms, always talk to your health care provider for information tailored to you.

1. Hypoglycemia Can Occur for a Number of Reasons

Hypoglycemia often occurs when people who take insulin shots get more insulin than they currently need. Insulin doses are usually calculated based on your current and projected calorie and carbohydrate intake for the day. If you don’t eat when you planned to or you end up skipping a meal or snack, you could have too much insulin in your body for the amount of food you consumed.

Similarly, getting more vigorous physical activity than usual can cause your body to use up its available glucose. If you take insulin and then exercise without balancing that activity by eating more food, you might end up with low blood glucose. Hypoglycemia can occur during or shortly after the exercise or even 6 to 15 hours after vigorous exercise — including at night while you’re asleep.

Drinking alcohol can also cause hypoglycemia in people who have type 1 diabetes. Additionally, insulin combined with alcohol can cause blood sugar levels to dip. Because of this, it’s important to have a meal or snack and carefully track your blood sugar levels while drinking alcohol.

Other potential causes of hypoglycemia include:

• Spending time at a higher altitude than normal
• Being in unusually hot and/or humid weather
• Menstruating (having your period)

2. Hypoglycemia Usually Means Feeling Shaky or Nervous

Hypoglycemia may result in a variety of symptoms, and each person can experience a hypoglycemic episode differently. However, two of the most common early symptoms are feeling shaky or anxious (nervous).

Other symptoms of low blood sugar or signs of hypoglycemia can include:

• Sweating or chills
• Lightheadedness or dizziness
• Nausea
• Sleepiness
• Confusion

As hypoglycemia worsens, you may feel weak, experience coordination issues and headaches, or have numbness in or around your mouth. Hypoglycemia can cause seizures or be life-threatening if left untreated.

Some people will not experience all of these warning signs, so it’s important to learn what happens in your body when you experience hypoglycemia.

3. Careful Monitoring Can Often Prevent Hypoglycemia

If you aren’t sure how much insulin you need or you know you’re in a situation that could lead to hypoglycemia, make sure you understand how to monitor your glucose or have someone else present who can monitor it for you if you can’t.

Some situations may call for checking your glucose more frequently, especially if you’re exercising longer or harder than you usually do. If you have to skip a meal, you should check your blood glucose levels as soon as possible to ensure they aren’t too low. In general, more frequent monitoring can help you catch low blood sugar levels before you become hypoglycemic.

Continuous glucose monitoring systems, which can track a person’s blood glucose every few minutes, are useful for people who experience frequent episodes of hypoglycemia. Additionally, devices called insulin pumps automatically can regulate insulin and blood sugar. Getting approval from your insurance provider for these types of devices can take a while, as can installing and calibrating the system.

Talk to your doctor about your hypoglycemia episodes and ways to prevent them. They may add certain medicines to ensure enough glucose stays in the blood, especially during the night to prevent hypoglycemia in sleep.

4. If You Experience Hypoglycemia, Try the 15-15 Rule

If you realize you’re experiencing hypoglycemia and it’s not urgent, try the 15-15 rule. Eat 15 grams of carbohydrates, then test your blood sugar again after 15 minutes pass. If it’s not yet at 70 milligrams per deciliter or the target range your health care provider advised you to aim for, repeat the process again. Once your sugar is back in the normal range, have a complete meal to prevent delayed hypoglycemia.

This rule helps you get the carbs you need to raise your blood sugar without going overboard, which can happen if being hypoglycemic leaves you feeling panicked or anxious.

If you’re having extreme or severe hypoglycemia, you may need an injection of glucagon, a hormone that can help you regulate your blood sugar. If you don’t carry glucagon with you, you’ll need to call in an emergency medical team, which can administer it for you. This can raise your blood sugar much faster than food alone.

5. People With Type 1 Diabetes Should Carry Glucose

If you’ve been diagnosed with type 1 diabetes, you should always have a source of glucose on hand. Even if you have never experienced hypoglycemia or haven’t had a problem in a long time, carrying glucose could help you avoid reaching lower-than-usual blood sugar levels.

Some people choose to carry glucose tablets or gel packets specifically designed for individuals with diabetes. Others might carry fruit juice, hard candy, sugar, or honey. Choose the option that works best for you and that sounds appealing, and have it with you at all times. You may want to show others where you keep it, just in case you need it and can’t get to it yourself.

Find Your Team

At myT1Dteam, the site for people with type 1 diabetes and their loved ones, people come together to learn more about type 1 diabetes and share their stories with others who understand life with the condition.

Have you ever experienced hypoglycemia? What steps do you take to avoid low blood sugar? Share your experience in the comments below.