What Causes Lows in Type 2 Diabetes
Reviewed by CDE Mehandi Sharma · Updated
Low blood sugar is not a risk for everyone with Type 2 diabetes. It depends almost entirely on your treatment.
The medicines that cause it are insulin, sulfonylureas and meglitinides. Sulfonylureas are widely used in India, so this affects a lot of people. Metformin, DPP-4 inhibitors, SGLT2 inhibitors and GLP-1 receptor agonists do not usually cause lows on their own.
If you are on one of the medicines that can, these are the usual triggers:
- Not eating enough carbohydrate, or skipping or badly delaying a meal.
- Fasting while continuing to take your medicine.
- More physical activity than usual, including during and for hours afterwards.
- Alcohol, particularly on an empty stomach.
- Being unwell.
Reduced kidney function also matters, because some medicines clear from the body more slowly, so a dose that was right before can become too strong. This is one reason your kidney function is checked periodically.
The practical response is not to eat constantly. It is to keep meals reasonably regular, tell your doctor if lows are happening, and carry something to treat one. Repeated lows are a signal that your treatment needs adjusting, not something to manage privately with extra snacks.