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Hypoglycemia Symptoms
Why a Short List Is Not Enough

by Celia Kirkman, RN, CDE

Common symptoms explained
Given the potential consequences of severe hypoglycemia, it’s worth doing your best to avert it by treating mild hypoglycemia as quickly as possible. In addition, the earlier you treat mild hypoglycemia, the faster your symptoms will go away. The following are some common signs and symptoms of hypoglycemia. Just because they’re common, however, doesn’t mean that everyone experiences them. You may have your own, unique indicators of hypoglycemia that don’t appear on this list. In addition, your experience of a common symptom may be somewhat different from someone else’s, or it may be different from what you might have expected. That’s why it’s important to pay attention to any feeling, sensation, emotion, or behavior that might be attributable to hypoglycemia.

Shaking. A common early symptom of hypoglycemia, shaking does not refer to the full-body shakes of someone having a seizure but instead to a more subtle trembling that may initially be sensed by the person experiencing it without being visible to an observer. It may progress to fine tremors of the fingers so that if you are trying to perform fine motor tasks with your hands, such as writing or threading a needle, you may notice that the task is more difficult. If you are not using your hands, however, you may not notice any trembling.

Sweating. Another common symptom of the early stages of hypoglycemia, sweating typically occurs all over the body — not just in the armpits — and can progress from mild to drenching. Many people notice the sweating on their face first. You may also feel warmer than usual at first but have chills later. While in some situations you may be keenly aware that your sweating is unusual, there are others in which you may not realize you’re sweating because of hypoglycemia. For example, you would expect to sweat during exercise or while outside on a hot day. If sweating occurred while swimming, taking a shower, or sleeping, you might not even realize you were sweating.

For some people who take beta-blockers, a type of blood pressure medicine, sweating may be the only early symptom of hypoglycemia, because beta-blockers can prevent the body from shaking or having other hypoglycemia symptoms such as a fast heartbeat.

Fast heartbeat. Many things in addition to hypoglycemia can cause a fast heartbeat, including excitement, stress, exercise, or ketones associated with high blood glucose. This can make it harder to notice fast heartbeat as a potential sign of hypoglycemia, but if you are having a fast heartbeat when there is no apparent reason for this to occur, you should check your blood glucose level.

Looking pale. You or those around you may notice that you are paler than usual during hypoglycemia.

Hunger. Hunger is a useful symptom of hypoglycemia since it usually leads a person to eat and consequently raise his blood glucose level. However, you may be in the habit of ignoring the initial symptoms of hunger at work or school if you’re in a meeting, engrossed in studying, or attending a lecture. This is a dangerous habit to have, because the longer you ignore hunger, the hungrier you get and the more likely you are to overeat when you finally eat. In addition, if you wait until you have moderate hypoglycemia, your judgment may be affected such that you eat the first thing you find, whether or not it will quickly raise your blood glucose level.

Weakness and fatigue. These symptoms are directly related to your body not having enough energy (glucose) for both physical and mental needs. It may be tempting to take a nap when you feel weak and tired, but it’s important to monitor your blood glucose level if you feel this way at a time of day when you are not usually tired. If hypoglycemia is causing your feeling of fatigue, your blood glucose level may go even lower during your nap, and you are unlikely to be able to detect other symptoms of hypoglycemia while asleep.

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