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Feeling Shaky? The Difference Between Hypoglycemia and Severe Hypoglycemia
18 Sep 2025 By Karen Grothe, Ph.D., L.P.

Feeling Shaky? The Difference Between Hypoglycemia and Severe Hypoglycemia

Ever felt that sudden wave of shakiness, maybe accompanied by sweating, dizziness, or confusion? It could be hypoglycemia, a condition where your blood sugar level drops too low. While often associated with diabetes, hypoglycemia can affect anyone. Understanding the difference between regular hypoglycemia and severe hypoglycemia is crucial for timely and appropriate intervention. This article will delve into the nuances of each, equipping you with the knowledge to recognize, respond to, and potentially prevent these conditions.

What is Hypoglycemia?

Hypoglycemia, also known as low blood sugar, occurs when the glucose level in your blood falls below a certain threshold. This threshold generally sits around 70 mg/dL, but symptoms can vary from person to person. Glucose is the primary energy source for your body, especially your brain, so when it dips too low, you experience a range of uncomfortable symptoms. Simple Hacks To Regulate Blood Sugar After A Meal Postprandial

Common Symptoms of Hypoglycemia:

  • Shakiness or trembling
  • Sweating
  • Dizziness or lightheadedness
  • Confusion or difficulty concentrating
  • Irritability or anxiety
  • Rapid heartbeat
  • Blurred vision
  • Hunger
  • Weakness
  • Headache

These symptoms arise because your brain and other organs are not receiving enough fuel to function properly. The 5 Minute Habit To Help Regulate Your Blood Sugar

What Causes Hypoglycemia?

The causes of hypoglycemia can vary depending on whether you have diabetes.

  • In People with Diabetes: The most common cause is related to diabetes management. This includes:
    • Taking too much insulin.
    • Skipping meals or eating too little.
    • Exercising more than usual without adjusting insulin or food intake.
    • Drinking alcohol, especially on an empty stomach.
  • In People Without Diabetes: This is less common, but potential causes include:
    • Certain medications, such as some used to treat malaria or pneumonia.
    • Excessive alcohol consumption.
    • Hormone deficiencies, such as adrenal insufficiency.
    • Severe liver or kidney disease.
    • Rarely, a tumor in the pancreas that produces excess insulin (insulinoma).
    • Reactive hypoglycemia, which occurs a few hours after eating, often due to an exaggerated insulin response to a carbohydrate-rich meal.

Understanding Severe Hypoglycemia

Severe hypoglycemia takes the situation a step further. It's a more critical state where your blood sugar is so low that you become unable to treat yourself. In other words, you need assistance from another person. This usually means you're unconscious or experiencing seizures and can't take oral glucose or other corrective measures.

Defining Characteristics of Severe Hypoglycemia:

  • Loss of consciousness: You are unable to respond to your surroundings.
  • Seizures: Involuntary muscle contractions due to brain malfunction.
  • Inability to self-treat: You need help from another person to raise your blood sugar.

Comparing Hypoglycemia and Severe Hypoglycemia: A Detailed Look

The table below highlights the key differences between regular hypoglycemia and severe hypoglycemia, focusing on symptoms, treatment, and potential long-term impacts.

Feature Hypoglycemia (Mild to Moderate) Severe Hypoglycemia
Symptoms Shakiness, sweating, dizziness, confusion, hunger, irritability. You are conscious and able to respond. Loss of consciousness, seizures, inability to swallow. You are unable to treat yourself.
Treatment Consume 15-20 grams of fast-acting carbohydrates (e.g., glucose tablets, juice, regular soda). Recheck blood sugar after 15 minutes and repeat if still low. Requires assistance from another person. Glucagon injection is usually administered. Call for emergency medical assistance immediately.
Severity Usually self-treatable; generally not life-threatening if treated promptly. Potentially life-threatening if not treated promptly. Requires immediate medical attention.
Long-Term Impact May cause anxiety about future episodes. Requires careful monitoring and adjustments to medication or diet. Can lead to brain damage if prolonged. May increase the risk of future episodes.

How to Treat Hypoglycemia

Knowing how to treat both hypoglycemia and preparing for the possibility of severe hypoglycemia is vital.

Treating Mild to Moderate Hypoglycemia:

  1. Check Your Blood Sugar: Confirm that your blood sugar is low.
  2. Consume Fast-Acting Carbohydrates: Eat or drink 15-20 grams of quick carbohydrates such as:
    • 3-4 glucose tablets
    • ½ cup (4 ounces) of juice or regular soda (not diet)
    • 1 tablespoon of honey or sugar
  3. Wait 15 Minutes: After consuming carbohydrates, wait 15 minutes before checking your blood sugar again.
  4. Recheck and Repeat: If your blood sugar is still below 70 mg/dL, repeat steps 2 and 3.
  5. Eat a Meal or Snack: Once your blood sugar is back to normal, eat a meal or snack to prevent another drop. Choose something with protein and complex carbohydrates, such as whole-grain crackers with peanut butter or cheese.

Responding to Severe Hypoglycemia:

Severe hypoglycemia requires immediate assistance from another person because the affected individual cannot help themselves.

  1. Administer Glucagon: If a glucagon emergency kit is available, and you have been trained how to administer it, follow the instructions to give a glucagon injection. Glucagon is a hormone that raises blood sugar levels.
  2. Call for Emergency Medical Assistance: Immediately call emergency services (911 in the US) to ensure prompt medical attention.
  3. Do Not Give Food or Drink: Do not attempt to give food or drink to someone who is unconscious, as they could choke.
  4. Turn the Person on Their Side: If the person is breathing, turn them onto their side in the recovery position to prevent choking in case of vomiting.
  5. Stay with the Person: Remain with the person until emergency services arrive and provide them with any relevant medical information.

Preventing Hypoglycemia

Prevention is always better than cure. Here are some strategies for preventing hypoglycemia, especially if you have diabetes:

  • Regular Monitoring: Regularly check your blood sugar levels, especially before meals, after exercise, and before bedtime.
  • Medication Management: Work closely with your healthcare provider to ensure your diabetes medications are properly adjusted to your lifestyle. Never skip or change dosages without professional guidance.
  • Meal Planning: Eat regular meals and snacks, and avoid skipping meals. Balance your carbohydrate intake with protein and fat.
  • Exercise Planning: If you exercise, monitor your blood sugar and adjust your insulin or food intake accordingly. Carry a source of fast-acting carbohydrates with you in case you experience low blood sugar during exercise.
  • Alcohol Consumption: Limit alcohol consumption, especially on an empty stomach. Alcohol can interfere with your liver's ability to release glucose.
  • Wear a Medical Alert ID: Wear a medical alert bracelet or necklace that indicates you have diabetes and what to do in case of hypoglycemia.

When to Seek Medical Attention

It is crucial to know when to seek professional medical help.

  • Frequent Hypoglycemic Episodes: If you experience frequent episodes of hypoglycemia, consult your doctor to adjust your medication or develop a better management plan.
  • Unexplained Hypoglycemia: If you experience hypoglycemia and you do not have diabetes, consult your doctor to identify the underlying cause.
  • Severe Hypoglycemia: After an episode of severe hypoglycemia, follow up with your healthcare provider to determine the cause and prevent future episodes.
  • Concerns about Glucagon Administration: If you or a loved one is prescribed glucagon, make sure you understand how to administer it correctly and when to use it. Ask your healthcare provider for a demonstration and practice administering the injection.

Living Well with Diabetes and Minimizing Hypoglycemia Risk

Living with diabetes requires diligent management, but it is entirely possible to live a full and active life while minimizing the risk of hypoglycemia. Here are some additional tips:

  • Educate Yourself: Learn as much as you can about diabetes, hypoglycemia, and hyperglycemia. Knowledge is power.
  • Work with a Diabetes Educator: A certified diabetes educator can provide valuable support, education, and guidance.
  • Join a Support Group: Connecting with others who have diabetes can provide emotional support and practical tips.
  • Stress Management: Practice stress-reduction techniques such as meditation, yoga, or deep breathing exercises. Stress can affect blood sugar levels.
  • Healthy Lifestyle: Maintain a healthy lifestyle by eating a balanced diet, exercising regularly, and getting enough sleep.

Conclusion

Understanding the difference between hypoglycemia and severe hypoglycemia is a cornerstone of managing blood sugar effectively, especially for individuals with diabetes. By recognizing the symptoms, understanding the causes, knowing how to treat both conditions, and implementing preventative measures, you can maintain stable blood sugar levels and minimize the risk of complications. Remember, prompt action is crucial in cases of severe hypoglycemia, so make sure that you, your family, and your close friends are educated on the signs and treatment. Regular communication with your healthcare team is essential for personalized management and ensuring your ongoing health and well-being. Feeling shaky can be alarming, but with the right knowledge and proactive approach, you can take control and live a healthy, balanced life. Daily Habits For Better Diabetes Management And Stable Bg Levels

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