December 27, 2021

Low Blood Sugar and Diabetes

Note: this article has been updated in June 2023.

Low blood sugar, also known as hypoglycemia

Low blood sugar, also known as hypoglycemia, is a condition where the glucose levels in your bloodstream fall below normal. It can have serious health effects and cause symptoms such as mood swings, fatigue, sweating, and dizziness. Learn more about the causes and consequences of low blood sugar here.

Various causes and how better to manage your blood sugar levels for a healthier life.

Hypoglycemia can have various causes, ranging from certain medications and diets to certain medical conditions such as diabetes and liver disease. Learning more about these causes can provide clues to better managing your blood sugar levels. Making lifestyle changes regarding diet, exercise, and medication play an essential role in preventing low blood sugar levels. It's important to talk to your doctor if you have hypoglycemia episodes so they can help you find the proper treatment regime. With the right support and management, living with low blood sugar doesn't have to be a burden.

What is Low Blood Sugar?

Low blood sugar, also known as hypoglycemia, is a condition in which your body doesn't have enough glucose or sugar in the bloodstream to fuel your body's functions. Blood sugar levels that are lower than average may lead to feelings of lightheadedness, dizziness, and fatigue. In more severe cases, hypoglycemia can confuse shaking, sweating, and even loss of consciousness. Understanding the causes, symptoms, and treatments for low blood sugar is essential if you suspect you may be at risk for this condition.


Low blood sugar can cause various symptoms, from mood swings to sweating. These include shaking, feeling anxious or irritable, hunger, difficulty speaking and understanding, weak, or experiencing fatigue. Other common signs of low blood sugar are confusion, hallucinations, impaired judgment and coordination, coma, and even death. If you experience any of these symptoms, it is essential to test your blood sugar levels immediately and take steps to raise your glucose level.

Risk Factors 

Certain factors increase your risk of developing low blood sugar. These include consuming too little food (especially carbohydrates) before or during physical activity, skipping meals, consuming alcohol on an empty stomach, and taking certain medications for diabetes, such as insulin. Additionally, people with Type 1 diabetes are more prone to developing low blood sugar than those with Type 2 diabetes because their bodies cannot produce enough insulin to regulate their blood sugar levels.

Diagnosis and Treatment

Low blood sugar, or hypoglycemia, can often be mistaken for other conditions such as anxiety or the flu. If you suspect you have low blood sugar, speak with your doctor, who might recommend a complete physical exam and a glucose tolerance test to check your blood sugar levels over time. In some cases, doctors will prescribe medications for treatment. Eating more frequent meals and snacks throughout the day can help prevent future episodes of low blood sugar by avoiding sudden drops in your blood glucose level.

Can You Have Low Blood Sugar and Type 2 Diabetes?

When people think of type 2 diabetes, they think of abnormally high blood sugar levels, and this is only natural, as is the belief that type 1 diabetes puts you at risk for dangerously low glucose levels. Most people with type 2 diabetes tend to have problems with high blood sugar levels, so it is understandable to equate hyperglycemia (high blood glucose levels) with type 2 diabetes and discount hypoglycemia (low blood glucose levels) as a possible symptom. For a detailed discussion of hypoglycemia and low blood sugar, see Medical New Today.

However, hypoglycemia, low blood sugar, can occur in patients with type 2 diabetes. So, the answer is yes, there are certain instances where low blood sugar levels (hypoglycemia) can happen in type 2 diabetic patients, and these occurrences have to do with medication and lifestyle actions.

Before we look at exactly how low blood sugar is possible with type 2 diabetes, let us see if we can get a clear definition of this disease.

Defining Type 2 Diabetes

"Type 2 diabetes is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel."

That is the definition that comes to us from the Mayo Clinic. As you can see, this globally respected health authority makes no mention of high or low glucose levels. They simply note that there is a problem with the way your body processes, uses and stores glucose.

However, here's the definition from the American Diabetes Association.

"Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most common form of  diabetes."

Here you see the noted diabetes organization referring directly to abnormally elevated levels of blood glucose. And truth be told, that is the way that insulin resistance, which happens with type 2 diabetes, is most diagnosed and perceived.

You may make plenty of insulin, but your body does not respond to it correctly. This leads to insulin resistance, sugar gets trapped in your bloodstream rather than absorbed into your cells for use as fuel, and you receive a type 2 diabetes diagnoses.

The Hypoglycemic Type 2 Diabetes Exceptions

Hypo means low, and hyper means high, at least in medical terms. If you have been diagnosed with insulin resistance and type 2 diabetes, it is still possible to have low blood sugar levels or hypoglycemia. Low blood sugar  happen for one of a couple of reasons.

1 – Medication Side-Effect

2 – Consistent Physical Exertion Without Nutrition

Glucose is the fuel your body uses to supply its energy needs. Glucose energy is utilized by your body to do many things. Even if you sit perfectly still and engage in zero physical activity, glucose fuels your brainpower and internal functions such as digestion. So, glucose, or blood sugar, should not be looked at simplistically as being an evil thing.

When a type 2 diabetes patient has low blood sugar levels, this is sometimes a reaction to the medication. If you are prescribed sulfonylurea drugs like Glipizide or Glyburide, your doctor uses those drugs to stimulate insulin production.

However, maintaining an ideal blood sugar ratio when insulin resistant-can be a balancing act. These insulinotropic agents can sometimes cause a severe drop in your blood glucose level; not all diabetes medication causes this problem.

Diabetes specialists will always recommend regular exercise accompanied by smart nutrition to treat diabetes, and in some cases, the exercise/nutrition combo can even reverse a type 2 diabetes prognosis. However, if you perform strenuous physical activities for long periods and do not give your body enough healthy carbohydrates, your blood sugar level could also plummet.

These two scenarios can compound each other, also. For this reason, diabetics must be aware of their body’s responses to both exercise and their medication, and ensure they diligently follow prescribed advice regarding the timing of their medication.

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