Hypoglycemia can be a dangerous condition for people with diabetes. It occurs when blood sugar levels fall too low, usually because of problems related to diabetes management. Other conditions, such as alcoholism or kidney disease, can increase the likelihood of experiencing hypoglycemia.

Low blood sugar symptoms can range from trembling, weakness, and sweating to seizures, coma, and death. Because of the seriousness of the condition, you need to work to prevent hypoglycemia — and not give it a chance to occur. This most often involves making sure you take your diabetic medications as prescribed and avoid conditions that could make hypoglycemia more likely.

Better Diabetes Management

Your diabetes management plan undoubtedly involves a very precise design to make sure that the dosage and the timing of your medication matches your individual lifestyle. If medication is mismatched to a person's food intake or daily activities, hypoglycemia can result.

The main types of medication that can cause hypoglycemia if taken incorrectly are:

  • Insulin. Insulin is a hormone created by the pancreas that helps the body use or store the blood glucose it receives from food. People with advanced diabetes must use insulin because their bodies either are not able to produce the hormone (type 1 diabetes) or have developed a high level of resistance to insulin (type 2 or gestational diabetes). It is taken as an injection, usually several times a day.
  • Sulfonylureas. These drugs stimulate the beta cells of the pancreas, spurring them to produce more insulin. Sulfonylureas include chlorpropamide (Diabinese), glipizide (Glucotrol and Glucotrol XL), glyburide (Micronase, Glynase, and Diabeta), and glimepiride (Amaryl). They usually are taken once or twice a day, before meals, and are helpful only to people with type 2 diabetes.
  • Meglitinides. These medications also work to stimulate the pancreas to release insulin. Repaglinide (Prandin) and nateglinide (Starlix) are two examples. These drugs are taken before each of three meals and also are only used to help people with type 2 diabetes.

All of these drugs can cause blood sugar levels to plummet if too large a dose is taken. If you’re on any of these drugs, you must take them strictly according to your doctor's instructions. Any change of the dosage or timing, especially if there are also delays in the timing of meals or if meals are skipped, could result in hypoglycemia.

Other Conditions Leading to Hypoglycemia

Over time, your lifestyle may change. When that happens, you may need to change your diabetes management plan as well.

Conditions or lifestyle changes that could result in the need to tweak the dosage or timing of your diabetes medications include:

  • Changes in meals. People with diabetes need to stick to a strict meal plan as part of their diabetes management. If you begin eating differently, you may need a different dosage of medication to keep hypoglycemia from occurring.
  • Changes in physical activity. If you begin working out more frequently or start playing a sport, you may need to either change the dosage or timing of your medication or plan to eat a snack to restore blood sugar levels.
  • Alcoholism. Alcohol can interact very dangerously with either insulin or medications that promote insulin production. An alcoholic may find it very difficult to control low blood sugar symptoms.
  • Kidney damage. Diabetes is the top cause of kidney disease the world over. As kidney disease progresses in a person with diabetes, it can severely alter the levels of diabetes medication in the body, making it more difficult to keep blood sugar stable. That's because the kidneys clear insulin as well as diabetic medications from the bloodstream, and as kidney function becomes impaired the need for insulin and medication decreases.
  • Liver damage. The liver stores glucose and releases it into the bloodstream when needed. If the liver is damaged or diseased, its ability to release stored glucose can be impaired. In this situation, you might need more or less insulin or medication to keep your blood sugar levels constant.

Preventing hypoglycemia is a tricky task, and people with diabetes will not be successful 100 percent of the time. But you need to strive for that goal, both to avoid the damaging effects of hypoglycemia and to head off the other systemic damage that can occur due to fluctuating blood sugar levels. Be vigilant regarding low blood sugar symptoms and consult with your doctor if these symptoms seem to be occurring more frequently.