Recognising and Treating a Low
Reviewed by CDE Mehandi Sharma · Updated
Hypoglycemia means blood sugar too low, generally below 70 mg/dL. On metformin alone it is unlikely. Once a sulfonylurea or insulin is part of your treatment, it becomes something to be ready for.
Early symptoms are your body's warning system: shakiness, sweating, a pounding heart, sudden hunger, anxiety, irritability, tingling around the lips. If it drops further you may become confused, slur your words, have blurred vision, or feel very weak.
Fifteen grams of fast-acting carbohydrate is about three or four glucose tablets, three teaspoons of sugar or glucose powder in water, half a cup of fruit juice or regular soft drink, or a tablespoon of honey.
What does not work well: chocolate, biscuits, laddoo or anything with a lot of fat, because fat slows absorption. Save those for afterwards, not for the low itself.
The most common mistake is overtreating — eating everything within reach because the feeling is unpleasant — which sends you high afterwards. Measured amount, then wait.
If someone with LADA becomes unconscious or cannot swallow safely, do not put food or liquid in their mouth. Turn them on their side and get emergency help immediately.
Every low is worth noting: what you had eaten, what you had taken, and what you were doing. Repeated lows mean your doses need review.