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Hypoglycemia Symptoms
Why a Short List Is Not Enough

by Celia Kirkman, RN, CDE

Headache. Having a headache often signals that you had hypoglycemia earlier in the day or have had it for some time. For example, if you wake up with a headache or leave a movie theater with a headache, you may have been hypoglycemic for some time. If the headache is severe enough, you may have nausea. You should treat yourself with carbohydrate and plan to monitor more frequently for the rest of the day. If the hypoglycemia has lasted a long time, the body’s stored sugar may have been used up, and you are more prone to repeat episodes of hypoglycemia that day.

Impaired vision. Double vision and tunnel vision are two types of visual disturbances that may occur with hypoglycemia. Like headache, impaired vision also often signals that your blood glucose has been low for quite some time. Your brain routinely takes two pictures from two eyes and formulates the pictures into a single image. When your brain does not have enough glucose, the brain loses the ability to coordinate vision. You may see fine with one eye closed, but quick action is needed to prevent the confused state that will follow if you don’t raise your blood glucose level.

Enlarged pupils can also be a symptom of hypoglycemia, but you are unlikely to notice them unless you’re looking in a mirror or someone else takes a close look at your eyes. If you are becoming hypoglycemic while reading, you may notice that you cannot find the correct line or that you see fewer words with each glance.

Difficulty communicating. Difficulties with communication can range from not being able to remember a word, to speaking in a monotone, to only responding in simple words such as “yes” or “no.” Some people describe feeling that the words they want to use are just out of their reach.

Difficulty absorbing new information. Without adequate glucose, your brain has trouble taking in new information. If you find yourself reading the same paragraph over and over or listening to someone speak then realizing you missed what was said, perhaps because you were daydreaming, you may have hypoglycemia.

Dizziness. Dizziness is another symptom that occurs after a person has been hypoglycemic for some time. You may have trouble walking a straight line or changing body positions. This is one of many symptoms of hypoglycemia that may be misinterpreted as drunkenness. If strangers or the police find you swerving while walking, medical identification in the form of a bracelet, necklace, or wallet card may save you from a misunderstanding and get you the treatment needed to stave off severe hypoglycemia.

Numbness or tingling. Numbness or tingling in the face or hands may be symptoms of hypoglycemia. Sometimes the numbness is first noticed in one spot, such as the upper lip, then it spreads across the face.

Unusual behavior. Anxious, giddy, confused, and irritable behaviors are important symptoms for friends, coworkers, and family members to learn about. These symptoms may occur when you can no longer judge that you are in danger. Your blood glucose may be so low that you no longer recognize family members or authority figures such as the police. You may argue, cry, yell, or fight.

It can be difficult to help a person who has reached this stage. Often, a person in this stage of hypoglycemia wants to perform a particular task and finds that a “stranger” (the person trying to help) is keeping him from performing that task by trying to get him to consume some carbohydrate.

It may help to talk over the possibility of this happening with your friends, coworkers, and family members before it happens and to brief them on what to do if it does. You might ask your potential helpers to remain calm, to refrain from raising their voices (which can feel threatening), and to place a container of juice or some glucose tablets in your hand or on the table or desk in front of you. Remind them that you may not recognize them when you’re in an agitated or confused state and that you may say potentially hurtful things you don’t mean.

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