Managing diabetes can be a balancing act. Your body might not always respond in exactly the same way to the things that make your blood sugar levels rise and fall. Even when you are very careful about control, your blood-sugar might go too high or too low.

Having a blood-sugar level that’s too high, called hyperglycemia, often will lead to feelings of fatigue or moodiness. However having your blood sugar go too low, hypoglycemia, can be equally scary for you and those near you and needs immediate attention. That’s why it’s important to educate yourself - and those who care for you - about hypoglycemia and what to do if it happens.

Causes of Low Blood-Sugar Any number of things, working together, may cause your blood-sugar to drop too low:

• The amount of medicine (pills and/or insulin) you have taken
• Too little food or a delayed meal
• Too much exercise
• Drinking alcohol

Sometimes the cause may not be something that you can easily pinpoint. If your blood-sugar levels aren’t on track, use your blood-sugar checks to find out why. You can help prevent low blood sugar by watching how and when you eat and exercise. And it is a good idea to always carry glucose with you in case you need it.

Low Blood-Sugar Warning Signs People have different physical reactions to low blood sugar. You need to know what signals your body may give you when your blood sugar is too low. Check your blood sugar levels if you suddenly experience any of the following:

• Dizziness, shakiness or trembling
• Nervousness
• Rapid heartbeat
• Trouble concentrating
• Headache
• Irritability, moodiness or anger
• Sweating, chills or clamminess
• Tingling in your face or lips
• Extreme hunger

Also check your blood sugar levels if you wake up in the middle of the night with a nightmare or restlessness, or if your pajamas are damp with sweat when you wake up. These may also be symptoms of low blood sugar. Remember, low blood sugar may occur without symptoms so it is important to regularly check blood sugar throughout the day.

Make sure your loved ones know the signs of low blood sugar and to call 911 in an emergency. Raising Your Low Blood-Sugar When you think your blood glucose is too low, you should check your blood glucose level. If the level is below 70 mg/dL, one of these quick-fix foods should be consumed right away to raise blood glucose:

• 3 or 4 glucose tablets
• 1 serving of glucose gel - the amount equal to 15 grams of carbohydrate
• 1/2 cup, or 4 ounces, of any fruit juice
• 1/2 cup, or 4 ounces, of a regular - not diet - soft drink
• 1 cup, or 8 ounces, of milk
• 5 or 6 pieces of hard candy
• 1 tablespoon of sugar or honey

The next step is to recheck your blood glucose in 15 minutes. Make sure it is 70 mg/dL or above. If it is still too low, eat another serving of a quick-fix food. Repeat these steps until the blood glucose level is 70 mg/dL or above.

After the quick-fix foods have raised the blood glucose level to 70 mg/dL or above, you should eat. If your next meal is an hour or more away, have a snack. Ask your healthcare team for advice on what will work best for you. If you experience hypoglycemia several times in a week, you should call your healthcare team. They may need to change your treatment plan.

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