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Hypoglycemia

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Hypoglycemia

Hypoglycemia - low blood sugar level(L) and normal blood sugar level(R)

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What Is

Diabetics must monitor their blood sugar carefully.

Image by formulatehealth

What Is Hypoglycemia?

Hypoglycemia means low blood glucose, or blood sugar. Your body needs glucose to have enough energy. After you eat, your blood absorbs glucose. If you eat more sugar than your body needs, your muscles, and liver store the extra. When your blood sugar begins to fall, a hormone tells your liver to release glucose.

In most people, this raises blood sugar. If it doesn't, you have hypoglycemia, and your blood sugar can be dangerously low. Signs include :

Hunger
Shakiness
Dizziness
Confusion
Difficulty speaking
Feeling anxious or weak

In people with diabetes, hypoglycemia is often a side effect of diabetes medicines. Eating or drinking something with carbohydrates can help. If it happens often, your health care provider may need to change your treatment plan.

You can also have low blood sugar without having diabetes. Causes include certain medicines or diseases, hormone or enzyme deficiencies, and tumors. Laboratory tests can help find the cause. The kind of treatment depends on why you have low blood sugar.

Source: NIH MedlinePlus Magazine

Additional Materials (21)

Hypoglycemia - What is hypoglycemia?

Video by Diabetes.co.uk/YouTube

What is Hypoglycemia? (Conditions A-Z)

Video by Healthguru/YouTube

What is hypoglycemia? - DiaBiteSize

Video by St. Michael's Hospital/YouTube

Severe Hypoglycemia - Ask The Expert

Video by Hormone Health Network/YouTube

Hypoglycemia vs Hyperglycemia | Endocrine System (Part 3)

Video by ICU Advantage/YouTube

Safe at School: Chapter 3 - Hypoglycemia

Video by American Diabetes Association/YouTube

Hypoglycemia and Diabetes

Video by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)/YouTube

Understanding Hypoglycemia

Video by Hormone Health Network/YouTube

Hypoglycemia for Patients

Video by The Endocrine Society/YouTube

Hypoglycemia, Glucose-Lowering Therapy, US Adults, & Diabetes

Video by Mayo Proceedings/YouTube

Hypoglycemia- Low Blood Sugar Levels

Video by How To Gastro/YouTube

Diabetes in children (6 of 9): Hypoglycemia

Video by Nicklaus Children's Hospital/YouTube

Diabetes Basics: Hypoglycemia and Hyperglycemia

Video by American Diabetes Association/YouTube

Understanding Diabetes: Insulin & Preventing Hypoglycemia (Low Blood Glucose Levels)

Video by SingHealth/YouTube

Hypoglycemia: Definition, Identification, Prevention, and Treatment

Video by Boston Medical Center/YouTube

How to Handle Low Blood Sugar (Conditions A-Z)

Video by Healthguru/YouTube

Hypo- and Hyperglycemia: Glucose Metabolism & Diabetic States – Emergency Medicine | Lecturio

Video by Lecturio Medical/YouTube

Low Blood Sugar vs High Blood Sugar

Video by Doctablet/YouTube

Diabetes & Associated Complications

Video by Boehringer Ingelheim/YouTube

Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy

Video by khanacademymedicine/YouTube

Acute complications of diabetes - Hyperosmolar hyperglycemic nonketotic state | Khan Academy

Video by khanacademymedicine/YouTube

2:15

Hypoglycemia - What is hypoglycemia?

Diabetes.co.uk/YouTube

1:19

What is Hypoglycemia? (Conditions A-Z)

Healthguru/YouTube

4:11

What is hypoglycemia? - DiaBiteSize

St. Michael's Hospital/YouTube

6:12

Severe Hypoglycemia - Ask The Expert

Hormone Health Network/YouTube

17:00

Hypoglycemia vs Hyperglycemia | Endocrine System (Part 3)

ICU Advantage/YouTube

3:12

Safe at School: Chapter 3 - Hypoglycemia

American Diabetes Association/YouTube

4:42

Hypoglycemia and Diabetes

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)/YouTube

2:22

Understanding Hypoglycemia

Hormone Health Network/YouTube

2:59

Hypoglycemia for Patients

The Endocrine Society/YouTube

9:31

Hypoglycemia, Glucose-Lowering Therapy, US Adults, & Diabetes

Mayo Proceedings/YouTube

8:32

Hypoglycemia- Low Blood Sugar Levels

How To Gastro/YouTube

3:18

Diabetes in children (6 of 9): Hypoglycemia

Nicklaus Children's Hospital/YouTube

1:06

Diabetes Basics: Hypoglycemia and Hyperglycemia

American Diabetes Association/YouTube

1:18

Understanding Diabetes: Insulin & Preventing Hypoglycemia (Low Blood Glucose Levels)

SingHealth/YouTube

5:42

Hypoglycemia: Definition, Identification, Prevention, and Treatment

Boston Medical Center/YouTube

1:29

How to Handle Low Blood Sugar (Conditions A-Z)

Healthguru/YouTube

21:27

Hypo- and Hyperglycemia: Glucose Metabolism & Diabetic States – Emergency Medicine | Lecturio

Lecturio Medical/YouTube

3:32

Low Blood Sugar vs High Blood Sugar

Doctablet/YouTube

5:50

Diabetes & Associated Complications

Boehringer Ingelheim/YouTube

11:26

Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy

khanacademymedicine/YouTube

10:25

Acute complications of diabetes - Hyperosmolar hyperglycemic nonketotic state | Khan Academy

khanacademymedicine/YouTube

How Common Is It?

Low Blood Glucose Levels in Capillary

Image by TheVisualMD

How Common Is Low Blood Glucose?

Low blood glucose is common among people with type 1 diabetes and among people with type 2 diabetes who take insulin or some other diabetes medicines. In a large global study of people with diabetes who take insulin, 4 in 5 people with type 1 diabetes and nearly half of those with type 2 diabetes reported a low blood sugar event at least once over a 4-week period.

Severely low blood glucose, defined as when your blood glucose level drops so low you can’t treat it yourself, is less common. Among U.S. adults with diabetes who take insulin or some diabetes medicines that help the pancreas release insulin into the blood, 2 in 100 may develop severely low blood glucose each year.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (2)

3:32

Low Blood Sugar vs High Blood Sugar

Doctablet/YouTube

2:40

Insulin Questions: How do I treat my low blood sugar?

Diabetes Canada/YouTube

Hyperglycemia and Hypoglycemia

Simple Carbohydrates

Image by TheVisualMD

Hyperglycemia and Hypoglycemia

Impaired insulin function can lead to a condition called diabetes mellitus, the main symptoms of which are illustrated in Figure 37.10. This can be caused by low levels of insulin production by the beta cells of the pancreas, or by reduced sensitivity of tissue cells to insulin. This prevents glucose from being absorbed by cells, causing high levels of blood glucose, or hyperglycemia (high sugar). High blood glucose levels make it difficult for the kidneys to recover all the glucose from nascent urine, resulting in glucose being lost in urine. High glucose levels also result in less water being reabsorbed by the kidneys, causing high amounts of urine to be produced; this may result in dehydration. Over time, high blood glucose levels can cause nerve damage to the eyes and peripheral body tissues, as well as damage to the kidneys and cardiovascular system. Oversecretion of insulin can cause hypoglycemia, low blood glucose levels. This causes insufficient glucose availability to cells, often leading to muscle weakness, and can sometimes cause unconsciousness or death if left untreated.

Figure 37.10 The main symptoms of diabetes are shown. (credit: modification of work by Mikael Häggström)

When blood glucose levels decline below normal levels, for example between meals or when glucose is utilized rapidly during exercise, the hormone glucagon is released from the alpha cells of the pancreas. Glucagon raises blood glucose levels, eliciting what is called a hyperglycemic effect, by stimulating the breakdown of glycogen to glucose in skeletal muscle cells and liver cells in a process called glycogenolysis. Glucose can then be utilized as energy by muscle cells and released into circulation by the liver cells. Glucagon also stimulates absorption of amino acids from the blood by the liver, which then converts them to glucose. This process of glucose synthesis is called gluconeogenesis. Glucagon also stimulates adipose cells to release fatty acids into the blood. These actions mediated by glucagon result in an increase in blood glucose levels to normal homeostatic levels. Rising blood glucose levels inhibit further glucagon release by the pancreas via a negative feedback mechanism. In this way, insulin and glucagon work together to maintain homeostatic glucose levels, as shown in Figure 37.11.

Figure 37.11 Insulin and glucagon regulate blood glucose levels.

Source: CNX OpenStax

Additional Materials (3)

17:00

Hypoglycemia vs Hyperglycemia | Endocrine System (Part 3)

ICU Advantage/YouTube

21:27

Hypo- and Hyperglycemia: Glucose Metabolism & Diabetic States – Emergency Medicine | Lecturio

Lecturio Medical/YouTube

1:06

Diabetes Basics: Hypoglycemia and Hyperglycemia

American Diabetes Association/YouTube

Causes

Blood Sugar Gone Awry

Image by TheVisualMD

What Causes Low Blood Glucose in People with Diabetes?

Low blood glucose levels can be a side effect of insulin or some other medicines that help your pancreas release insulin into your blood. Taking these can lower your blood glucose level.

Two types of diabetes pills can cause low blood glucose

sulfonylureas, usually taken once or twice per day, which increase insulin over several hours
meglitinides, taken before meals to promote a short-term increase in insulin

Insulin and some other diabetes medicines can lower your blood glucose level.

The following may also lower your blood glucose level

Not eating or drinking enough carbohydrates (carbs). When you eat foods or drink beverages that contain carbohydrates, your digestive system breaks down the sugars and starches into glucose. Glucose then enters your bloodstream and raises your blood glucose level. If you don’t eat enough carbohydrates or skip or delay any meals, your blood glucose level could drop lower than what is healthy for you.
Fasting. Continuing to take medicines that lower your glucose level while fasting for a medical procedure or for other purposes can also increase the risk for low blood glucose.
Increasing physical activity. Increasing your physical activity level beyond your usual routine can lower your blood glucose level for up to 24 hours after the activity. Learn more about diabetes, eating, and physical activity.
Drinking too much alcohol without enough food. Alcohol makes it harder for your body to keep your blood glucose level steady, especially if you haven’t eaten in a while. Alcohol can also keep you from feeling the first symptoms of low blood glucose, which can lead to severe symptoms.
Being sick. When you’re sick, you may not be able to eat as much or keep food down, which can lower blood glucose.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (1)

1:19

What is Hypoglycemia? (Conditions A-Z)

Healthguru/YouTube

Symptoms

Adult Female Eating Apple with Visible Heart and Digestive System

Image by TheVisualMD

What Are the Symptoms of Low Blood Glucose?

Symptoms of low blood glucose tend to come on quickly and can vary from person to person. As Table 1 below shows, symptoms can range from mild to severe.

Table 1. Symptoms of low blood glucose

Mild-to-Moderate

Severe

If your blood glucose level is low, you may feel

shaky or jittery
hungry
tired
dizzy, lightheaded, confused, or irritable
your heart is beating too fast or not steadily
you have a headache
you can’t see or speak clearly

If your blood glucose level is very low, your brain may stop working as it should. You may

lose consciousness
have a seizure

Severe hypoglycemia is dangerous and needs to be treated right away.

Low blood glucose during sleep

Your blood glucose level can drop while you sleep and stay low for several hours, causing serious problems. Symptoms of low blood glucose while you sleep can include

crying out or having nightmares
sweating enough to make your pajamas or sheets damp
feeling tired, irritable, or confused after waking up

Although you may not wake up or notice any symptoms, low blood glucose can interfere with your sleep, which may affect your quality of life, mood, and ability to work. Having low blood glucose during sleep can also make you less likely to notice and respond to symptoms of low blood glucose during the day.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (2)

1:55

Symptoms of low blood glucose and how to spot it

Diabetes.co.uk/YouTube

8:32

Hypoglycemia- Low Blood Sugar Levels

How To Gastro/YouTube

Diagnosis

Blood Glucose Test

Also called: Blood Sugar Level, Glucose Test, Random Plasma Glucose, Random Glucose, Random Blood Glucose (RPG)

A blood glucose test measures the amount of glucose (sugar) in your blood. It may be used to help diagnose or monitor diabetes. The test can involve a finger prick or a blood draw from your vein.

Blood Glucose Test

Also called: Blood Sugar Level, Glucose Test, Random Plasma Glucose, Random Glucose, Random Blood Glucose (RPG)

A blood glucose test measures the amount of glucose (sugar) in your blood. It may be used to help diagnose or monitor diabetes. The test can involve a finger prick or a blood draw from your vein.

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Use the slider below to see how your results affect your health.
mg/dL
70
100
125
Your result is Normal.
A healthy (normal) fasting blood glucose level for someone without diabetes is 70 to 99 mg/dL (3.9 to 5.5 mmol/L). Values between 50 and 70 mg/dL (2.8 to 3.9 mmol/L) for people without diabetes can be "normal" too.
Related conditions
{"label":"Glucose (random) reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":30,"max":80},"text":"Low blood sugar, also known as hypoglycemia, can be a dangerous condition. Low blood sugar can happen in people with diabetes who take medicines that increase insulin levels in the body.","conditions":["Medications, such as quinine","Hepatitis or kidney disorders","Tumor that produces excess insulin","Endocrine disorders, such as adrenal gland deficiency"]},{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":80,"max":140},"text":"In a random blood glucose test, a normal result depends on when you last ate. You may start your day at below 100 mg\/dL in the morning before breakfast and your blood glucose may rise as high as 140 mg\/dL about 2 hours after meals during the day. Most of the time, the blood glucose level will be below 125 mg\/dL (6.9 mmol\/L).","conditions":[]},{"flag":"borderline","label":{"short":"H","long":"High","orientation":"horizontal"},"values":{"min":140,"max":200},"text":"A level of between 140\u2013200 mg\/dl is considered pre-diabetes.","conditions":["Prediabetes"]},{"flag":"abnormal","label":{"short":"VH","long":"Very high","orientation":"horizontal"},"values":{"min":200,"max":500},"text":"A level of 200 mg\/dL (11 mmol\/L) or higher paired with the classic symptoms of high blood sugar (excessive thirst, urination at night, blurred vision and, in some cases, weight loss) often means you have diabetes.","conditions":["Diabetes"]}],"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"value":110,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0},{"borderline":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
mg/dL
80
140
200
Your result is Normal.
In a random blood glucose test, a normal result depends on when you last ate. You may start your day at below 100 mg/dL in the morning before breakfast and your blood glucose may rise as high as 140 mg/dL about 2 hours after meals during the day. Most of the time, the blood glucose level will be below 125 mg/dL (6.9 mmol/L).
Related conditions
{"label":"Glucose (postprandial) reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":65,"max":140},"text":"Within 2 hours of eating, your insulin and blood glucose levels should return to normal. Normal blood glucose values in people who don't have diabetes are less than 140 mg\/dL, and in people with diabetes are less than 180 mg\/dL.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":140,"max":200},"text":"If your blood glucose level is still high 2 hours after you've eaten, it could mean you have diabetes.","conditions":["High blood sugar","Type 2 diabetes"]}],"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"value":102.5,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
mg/dL
140
Your result is Normal.
Within 2 hours of eating, your insulin and blood glucose levels should return to normal. Normal blood glucose values in people who don't have diabetes are less than 140 mg/dL, and in people with diabetes are less than 180 mg/dL.
Related conditions
Your health care provider may order a blood glucose test if you have symptoms of high glucose levels or low glucose levels.
Symptoms of high blood glucose levels include:
- Increased thirst and urination (peeing)
- Blurred vision
- Fatigue
- Sores that don't heal
- Weight loss when you're not trying to lose weight
- Numbness or tingling in your feet or hands
Symptoms of low blood glucose levels include:
- Feeling shaky or jittery
- Hunger
- Fatigue
- Feeling dizzy, confused, or irritable
- Headache
- A fast heartbeat or arrhythmia (a problem with the rate or rhythm of your heartbeat)
- Having trouble seeing or speaking clearly
- Fainting or seizures
You may also need a blood glucose test if you have a high risk for developing type 2 diabetes. You're more likely to develop diabetes if you:
- Are overweight or have obesity
- Are age 45 or older
- Have a family history of diabetes
- Have high blood pressure
- Don't exercise enough
- Have a history of heart disease or stroke
- Have had gestational diabetes (diabetes that happens only during pregnancy)
If you are pregnant, you will likely get a blood glucose test between the 24th and 28th week of your pregnancy to check for gestational diabetes.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out.
For some types of glucose blood tests, you will drink a sugary liquid and wait for an hour before your blood sample is taken:
- A glucose challenge test is used to test for gestational diabetes in pregnancy. If your blood glucose level is higher than normal, you may have gestational diabetes. You'll need an oral glucose tolerance test (OGTT) to get a diagnosis.
- An oral glucose tolerance test (OGTT) is used to diagnose gestational diabetes, and type 2 diabetes and prediabetes in people who aren't pregnant. A blood sample will be taken before you have a sugary drink and then again, every hour for the next 2 or 3 hours.
If your results show higher than normal glucose levels, it may mean you have or are at risk for getting diabetes. High glucose levels may also be a sign of:
- Hyperthyroidism
- Pancreas disorders
- Stress from surgery, very serious illness, or trauma
If you have diabetes, lower than normal glucose levels may be caused by:
- Side effects from certain diabetes medicines
- Not eating enough, especially after taking diabetes medicine
- Being more physically active than usual
If you don't have diabetes, low blood glucose levels may be a sign of:
- Liver disease
- Kidney disease
- Underactive adrenal, pituitary, or thyroid gland (hypothyroidism)
- Alcohol use disorder (AUD)
If your glucose results are not normal, it doesn't always mean you have a medical condition that needs treatment. Certain medicines and stress can affect glucose levels. To learn what your test results mean, talk with your health care provider.
If you have diabetes, you may need to do blood sugar testing at home every day to help manage your blood glucose levels. There are two ways to do this:
- Blood glucose meters require you to prick your finger with a small device called a lancet. You apply a drop of blood to a test strip and insert it into a small, electronic glucose meter, which measures the glucose is in your blood.
- Continuous glucose monitors (CGM) use a tiny sensor that you insert under your skin. Every few minutes, the sensor measures glucose levels in fluids between your cells. If your glucose is too high or too low, you use a blood glucose meter to check your blood levels before making changes to raise or lower your glucose level.
1. Blood sugar test: Health Article | MedlinePlus - NIH [accessed on Sep 07, 2018]
2. Random glucose test - Wikipedia [accessed on Sep 07, 2018]
3. 001032: Glucose | LabCorp [accessed on Sep 07, 2018]
4. 001818: Glucose, Plasma | LabCorp [accessed on Sep 07, 2018]
5. 090400: Diabetes Risk–Asymptomatic Adults | LabCorp [accessed on Sep 07, 2018]
6. Glucose (Blood) - Health Encyclopedia - University of Rochester Medical Center [accessed on Sep 07, 2018]
7. Blood Glucose Test: MedlinePlus Medical Test [accessed on Dec 12, 2022]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (12)

Glucose: Pancreas

The pancreas is a large gland (located behind the stomach) that secretes digestive enzymes into the duodenum (small intestine), which then combine with bile, produced in the liver. The pancreas also produces the hormone insulin, which helps control blood sugar levels.

Image by TheVisualMD

Glucose: Neurons (Utilize Glucose)

Our brains need a continuous supply of fuel in the form of glucose because they can't store energy as fat or glycogen. Though the brain represents only about 2% of the body's mass, it consumes 60% of the sugar coursing through our bloodstreams.

Image by TheVisualMD

Glucose: Insulin & Glucose

The body's ability to use glucose depends on the hormone insulin, produced by the pancreas. Blood levels of glucose rise after meals, but insulin keeps glucose levels within a narrow range; excess glucose is stored in the liver as glycogen.

Image by TheVisualMD

Molecular structure of glucose | Macromolecules | Biology | Khan Academy

Video by Khan Academy/YouTube

Glucose Insulin and Diabetes

Video by Khan Academy/YouTube

How do carbohydrates impact your health? - Richard J. Wood

Video by TED-Ed/YouTube

Diabetes and insulin injection

There are 3 main types of diabetes. Type 1 diabetes develops when the body's immune system destroys the pancreatic cells that produce the hormone insulin. Type 2 diabetes develops when cells can no longer use insulin effectively, which can result in the pancreas gradually losing its ability to produce insulin. Both types of diabetes can require insulin injections to compensate for this deficiency. A third type, gestational diabetes, is a form of glucose intolerance that appears in some women during pregnancy.

Image by TheVisualMD

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Blood Glucose and Baselining Your Health

Our bodies and brains run on glucose, a simple sugar produced by the digestion of carbohydrates. The body's ability to use glucose depends on the hormone insulin, which is produced by the pancreas. Blood sugar levels naturally rise after meals, but insulin from a healthy pancreas keeps these levels within a narrow range. In diabetes, however, this balance is disrupted because either the body loses its ability to respond to insulin or the pancreas loses its ability to produce insulin. Too much or too little glucose in the bloodstream can damage blood vessels in the kidneys and eyes, as well as nerve cells; acute disruptions of the insulin/glucose balance can be life threatening. Blood and urine tests can determine whether someone is diabetic or pre-diabetic. Diabetes is looming as a major public health concern; an estimated 25 million people in the U.S. have diabetes, with more than a quarter of them undiagnosed.

Video by TheVisualMD

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Fasting Plasma Glucose

The fasting plasma glucose (FPG) test, also known as the fasting blood sugar test, measures blood sugar levels and is used to diagnose diabetes.

Video by TheVisualMD

This browser does not support the video element.

What Is Type 2 Diabetes?

Go deep inside your body to see how type 2 diabetes happens, what it does to your body-and what you can do about it. Diabetes expert Dr. David Katz of the Yale Prevention Research Center talks about the frightening future of diabetes: in just a few decades, one third of all Americans may have diabetes. See the pancreas, where insulin is produced. Real imaging data reveals the body's inner anatomy slice by slice, from brain to base of spine. Dr. Cynthia Geyer of Canyon Ranch talks about how insulin resistance develops. View its results, as visceral abdominal fat builds up and chokes the vital organs. Discover the symptoms of type 2 diabetes and find out if you should be tested. See the complications of diabetes, including cardiovascular disease, hypertension, vision damage, kidney disease, and gangrene. The good news? Diabetes is a highly manageable disease. Dr. Mark Liponis of Canyon Ranch talks about controlling your risk for type 2 diabetes and, by managing it, reversing its symptoms and literally slowing the aging process.

Video by TheVisualMD

This browser does not support the video element.

What are Carbohydrates?

Most of the foods we consume, including fruits and vegetables, contain carbohydrates. Once metabolized, these macronutrients become the body's primary source of energy, providing food to cells. And while nature never produced any "good" or "bad" carbs, it's also true that excessive carbohydrate consumption can lead to unwanted weight gain. Before you strike carbs from your diet, though, learn more about how this important nutrient supports your good health.

Video by TheVisualMD

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Simple Carbohydrates

Because only the smallest molecules of sugar can pass through the intestinal walls and into the blood stream, foods ingested as simple carbohydrates (single- and double-molecule sugars) can be used immediately while complex carbohydrates (three or more molecules) require more time and action to break down and be absorbed. Some simple sugars occur naturally in vegetables, milk, honey, and other unprocessed foods. Synthetic sweeteners such as corn syrup and high fructose are simple sugars as well. Simple carbs cause a rapid rise and fall in glucose, leaving you feeling hungry faster.

Video by TheVisualMD

Glucose: Pancreas

TheVisualMD

Glucose: Neurons (Utilize Glucose)

TheVisualMD

Glucose: Insulin & Glucose

TheVisualMD

9:19

Molecular structure of glucose | Macromolecules | Biology | Khan Academy

Khan Academy/YouTube

7:24

Glucose Insulin and Diabetes

Khan Academy/YouTube

5:11

How do carbohydrates impact your health? - Richard J. Wood

TED-Ed/YouTube

Diabetes and insulin injection

TheVisualMD

1:36

Blood Glucose and Baselining Your Health

TheVisualMD

0:23

Fasting Plasma Glucose

TheVisualMD

4:22

What Is Type 2 Diabetes?

TheVisualMD

1:11

What are Carbohydrates?

TheVisualMD

1:09

Simple Carbohydrates

TheVisualMD

Treatment

Feeding a Hypoglycemia attack

Image by TheVisualMD

How Do I Treat Low Blood Glucose?

If you begin to feel one or more symptoms of low blood glucose, check your blood glucose level. If your blood glucose level is below your target or less than 70 mg/dL, follow these steps

Eat or drink 15 to 20 grams of glucose or carbohydrates right away. Examples include
- four glucose tablets or one tube of glucose gel.
- 1/2 cup (4 ounces) of fruit juice—not low-calorie or reduced-sugar juice. If you have kidney disease, don’t drink orange juice because it has a lot of potassium. Apple, grape, or cranberry juice are good options.
- 1/2 can (4 to 6 ounces) of soda—not low-calorie or reduced-sugar soda.
- 1 tablespoon of sugar, honey, or corn syrup.
Wait 15 minutes and check your blood glucose level again. If your glucose level is still low, eat or drink another 15 to 20 grams of glucose or carbohydrates.
Check your blood glucose level again after another 15 minutes. Repeat these steps until your glucose level is back to your target range.
If your next meal is more than 1 hour away, have a snack to keep your blood glucose level within a range that is healthy for you. Try crackers or a piece of fruit.

If your blood glucose is below your target, take 15 to 20 grams of glucose or carbohydrates right away.

Treating low blood glucose if you take medicines that slow down digestion

Some diabetes medicines slow down the digestion of carbohydrates to keep blood glucose levels from rising too high after you eat. If you develop low blood glucose while taking these medicines, you will need to take glucose tablets or glucose gel right away. Eating or drinking other sources of carbohydrates won’t raise your blood glucose level quickly enough.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (2)

2:40

Insulin Questions: How do I treat my low blood sugar?

Diabetes Canada/YouTube

1:29

How to Handle Low Blood Sugar (Conditions A-Z)

Healthguru/YouTube

See a Doctor

Physician Palpating Neck of Male Patient

Image by TheVisualMD

What If I Have Severe Low Blood Glucose and Can’t Treat Myself?

Glucagon—a hormone that raises blood glucose levels—is the best way to treat severely low blood glucose. Available as an injection or a nasal spray, glucagon will quickly raise your blood glucose level. Your doctor can prescribe you a glucagon kit for use in case of an emergency.

If your blood glucose level drops very low, you won’t be able to treat it by yourself. Be prepared to address severely low blood glucose by

talking with your doctor or health care team about when and how to use a glucagon emergency kit. If you have an emergency kit, regularly check the date on the package to make sure it hasn’t expired.
teaching your family, friends, and coworkers when and how to give you glucagon. Tell them to call 911 right away after giving you glucagon or if you don’t have a glucagon emergency kit with you.
wearing a medical alert identification bracelet or pendant. A medical alert ID tells other people that you have diabetes and need care right away. Getting prompt care can help prevent the serious problems that low blood glucose levels can cause.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (2)

6:12

Severe Hypoglycemia - Ask The Expert

Hormone Health Network/YouTube

10:34

Low Blood Sugar and Using Glucagon

Ann & Robert H. Lurie Children's Hospital of Chicago/YouTube

Prevention

Keeping Tabs on Glucose

Image by TheVisualMD

How Can I Prevent Low Blood Glucose If I Have Diabetes?

If you take insulin or other medicines that lower blood glucose, the following actions may help you prevent low blood glucose levels.

Ask your doctor or health care team how to check your blood glucose level. The most common way to do so is by using a blood glucose meter. If you have hypoglycemia unawareness or have low blood glucose often, a continuous glucose monitor (CGM) may be a good option. The CGM measures your blood glucose level at regular times and can sound an alarm if it drops below your target range.
Make sure your regular eating plan includes meals, snacks, and beverages with enough carbohydrates to help keep your blood glucose level in your target range. Carry a source of fast-acting carbohydrate, such as glucose tablets or a juice box, with you. Also, if you drink alcoholic beverages, it’s safer to eat some food at the same time.
Be safe during exercise or physical activity. Physical activity can lower your blood glucose during the activity and for hours afterward. You may need to check your blood glucose before, during, and after physical activity and adjust your medicine or carbohydrate intake to prevent low blood glucose. For example, you might eat a snack before physical activity to prevent low blood glucose.
Work with your doctor or health care team to prevent low blood glucose. Ask your team if any of your diabetes medicines can cause low blood glucose and how you can prevent and treat symptoms. Work with your doctor or health care team to adjust your diabetes management plan as needed.

Some CGMs let you track your blood glucose levels using a small sensor attached to your arm or abdomen and view the information on your smartphone.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (2)

Monitoring Glucose - Know Your Blood Sugar Numbers: Use Them to Manage Your Diabetes

TheVisualMD

5:42

Hypoglycemia: Definition, Identification, Prevention, and Treatment

Boston Medical Center/YouTube

Complications

Healthy Capillary Blood Vessel

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2

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Healthy Capillary Blood Vessel and and Damaged Capillary Blood Vessel Caused by High Levels of Blood Glucose

Interactive by TheVisualMD

Healthy Capillary Blood Vessel

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Healthy Capillary Blood Vessel and and Damaged Capillary Blood Vessel Caused by High Levels of Blood Glucose

1) Healthy Capillary Blood Vessel - This image depicts a healthy capillary. Capillaries are the smallest blood vessels in your body. They can be so thin in diameter that blood cells have to bend in order to pass through. Capillaries are where the transfer of nutrients from the blood to cells, and the transfer of waste from cells to blood, takes place. In a healthy body, the blood vessels are smooth and elastic. 2) Cross-Section of Healthy Capillary Blood Vessel with Normal Glucose and Insulin Levels - This image depicts a healthy capillary. The body's cells depend on sugar in the blood, which is derived from carbohydrates, for food and energy. Allowing for the innumerable differences among individuals, the threshold for a normal blood sugar (glucose, pink) level in healthy people is 100 mg/dL; that is, 100 milligrams of glucose per deciliter of blood. Lower-than-normal levels characterize hypoglycemia and higher-than-normal levels characterize hyperglycemia. Without insulin (yellow), glucose is not able to enter cells to be used as fuel. Because of this, healthy insulin levels are a key factor in keeping blood glucose levels normal. 3) Cross-Section of Damaged Capillary Blood Vessel with Very High Glucose and Insulin Levels - This image depicts an unhealthy, damaged capillary with very high levels of insulin and glucose. Higher than normal levels of blood glucose lead to hyperglycemia. Hyperglycemia is the hallmark of prediabetes (between 100 and 125 mg/dL) and diabetes (126 mg/dL and higher). It is caused by either too little insulin being released by the pancreas or the body's inability to use insulin properly. Hyperglycemia leads to microangiopathy, marked by endothelial cell apoptosis (programmed cell death), accumulation of AGEs (advanced glycation end products), and thickening of the basement membrane, which can lead to the development of lesions, vasoconstriction, and altered vessel function

Interactive by TheVisualMD

What Are the Complications of Low Blood Glucose?

Mild-to-moderate low blood glucose can be easily treated. But severely low blood glucose can cause serious complications, including passing out, coma, or death.

Repeated episodes of low blood glucose can lead to

high blood glucose levels, if worry or fear of low blood glucose keeps you from taking the medicines you need to manage your diabetes
hypoglycemia unawareness, a condition in which you don’t notice any symptoms of low blood glucose until your blood glucose level has dropped very low

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

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