Hypoglycemia is a condition in which your blood sugar (glucose) level is lower than normal. Glucose is your body's main energy source. Hypoglycemia is often related to diabetes treatment. But other drugs and a variety of conditions — many rare — can cause low blood sugar in people who don't have diabetes. Hypoglycemia needs immediate treatment when blood sugar levels are low. For many people, a fasting blood sugar of 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L), or below should serve as an alert for hypoglycemia. But your numbers might be different. Ask your doctor. Treatment involves quickly getting your blood sugar back to normal either with high-sugar foods or drinks or with medications. Long-term treatment requires identifying and treating the cause of hypoglycemia. Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this can happen; the most common is a side effect of drugs used to treat diabetes. When you eat, your body breaks down carbohydrates from foods — such as bread, rice, pasta, vegetables, fruit and milk products — into various sugar molecules, including glucose. Glucose, the main energy source for your body, enters the cells of most of your tissues with the help of insulin — a hormone secreted by your pancreas. Insulin enables the glucose to enter the cells and provide the fuel your cells need. Extra glucose is stored in your liver and muscles in the form of glycogen. If you haven't eaten for several hours and your blood sugar level drops, another hormone from your pancreas signals your liver to break down the stored glycogen and release glucose into your bloodstream. This keeps your blood sugar within a normal range until you eat again. Your body also has the ability to make glucose. This process occurs mainly in your liver, but also in your kidneys. If you have diabetes, you might not make enough insulin (type 1 diabetes) or you might be less responsive to it (type 2 diabetes). As a result, glucose tends to build up in the bloodstream and can reach dangerously high levels. To correct this problem, you might take insulin or other drugs to lower blood sugar levels.

But too much insulin or other diabetes medications may cause your blood sugar level to drop too low, causing hypoglycemia. Hypoglycemia can also occur if you eat less than usual after taking diabetes medication, or if you exercise more than you normally do. Over time, repeated episodes of hypoglycemia can lead to hypoglycemia unawareness. The body and brain no longer produce signs and symptoms that warn of a low blood sugar, such as shakiness or irregular heartbeats. When this happens, the risk of severe, life-threatening hypoglycemia increases. If you have diabetes, recurring episodes of hypoglycemia and hypoglycemia unawareness, your doctor might modify your treatment, raise your blood sugar level goals and recommend blood glucose awareness training. If you have diabetes, episodes of low blood sugar are uncomfortable and can be frightening. Fear of hypoglycemia can cause you to take less insulin to ensure that your blood sugar level doesn't go too low. This can lead to uncontrolled diabetes. Talk to your doctor about your fear, and don't change your diabetes medication dose without your doctor's okay. A continuous glucose monitor (CGM) is an option for some people, particularly those with hypoglycemia unawareness. A CGM has a tiny wire that's inserted under the skin that can send blood glucose readings to a receiver. If blood sugar levels are dropping too low, some models of CGM will alert you with an alarm. Some insulin pumps are now integrated with CGMs and can shut off insulin delivery when blood sugar levels are dropping too quickly to help prevent hypoglycemia. Be sure to always have a fast-acting carbohydrate with you, such as juice or glucose tablets so that you can treat a falling blood sugar level before it dips dangerously low.

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