How do you know you are having a low blood sugar event?

How can you tell? At what level does it typically happen, for a type 2? Can it happen up in the “normal” ACE or ADA range? Will it wake you up up? For a type 2 what happens if you just do nothing until normal breakfast in the morning?

For certain, if/when you are unconsciousand did nothing to achieve that result (ie alcohol, doing a triathalon, etc., etc.) is a pretty good indicator something went very, very wrong.

The standard approach would be BG testing. Readings below 60 was the gold standard. Any reading below that number means you are “low”, if only technically. You can be far lower, and have no apparent symptoms, be completely normal. Some people cannot stand, others have no visable problems to speak of whatever their number might be.

Symptoms vary a great deal among experienced diabetics, and beginners alike. That is why there is a long list of possible signs. Lows can happen at any time, awake or asleep.

Unless you’ve had a massive overdose of insulin pills/injection, it is extremely likely you WILL wake up just fine. Your sugar will spike like a NASA rocket afterwards mind you, and you can thank your liver for dumping sugar into your bloodstream and keeping you alive… but very, very likely you will survive quite easily.

If you discover any low, you DO NOT WAIT and pretend nothing is happening. You do not wait for breakfast in a couple hours, or even 30 minutes out. You treat then and there, and have more food afterward, if, if you are still hungry. But treat the low conservatively, test, and figure out what you want for breakfast in a couple minutes.

“Lows” do not suffer being ignored happily, or in a friendly way at all.


I am on Amaryl which stimulates beta cell production so i do occasionally go low, but never too low and only during very strenuous exercise (usually it takes a 1 mile swim to get me low). My lowest is then is 50 and i can can feel it coming on because my heart start racing and between laps my hands get a little shaky. I rest 10 minutes and it comes back up to the 70’s without requiring any action. if i plan on continuing with my swim, i might eat a couple glucose tabs and an energy bar to give me some short and long term glucose.

Usually you get shaky, and weak… takes you a long time to wake up, and you’ll usually be easily irritable (just my dog scratching himself can make me mad when my bg is low). If you usually run really high, when you drop down into normal ranges it can make you feel low, but after you run in the normal range for a few days your body will get used to it, and it should only happen when you’re low.

There’s no real “limit” for feeling low. Everyone is different. Some might feel low if they’re 150. Others might be fine until they’re in the low 40s. Usually if you’re under 60mg/dl it’s considered low, and should be treated with 15 carbs (a glass of milk can take care of that). If you wake up due to being low, you should take care of it right away and not wait, as you might drop lower and end up in trouble.

Well I had this happen two times now, where at around 2 AM I awaken from a vivid dream, have cold sweats and horrible indegestion and acid reflux, feel nauseous and a little like seasickness.

So in my class they said whenever you feel funny, check your sugar. Both times my sugar was below 110 - I had a 102 and a 101. Now thats not considered low for a fasting blood sugar I know, but, I am guessing its probably the lowest my blood sugar has been in many years.

But since it was right in the OK range, I figured it was not a low and I just sat up for 30 minutes or so, and then went back to bed. Should I have done something? Did I dodge a bullet?

I am on 2000 mg of Metformin, and 1.2 mg of Victoza. I am not even sure if you can get a low from that regime.

I just don’t know how worried I should be.

Jeff, mine can happen at anytime after 60…I can tell because I get feeling light headed, thristy, nauseated, tired, and in a trance like state. I used to have those hit at night, and then it felt like the flu, sweaty, nauseated, and just the need to get something in my stomach…I did wake up thankfully, and if I do nothing, I am sure an EMT will be looking after me day or night.
Best not to wait and play with trouble. Have some candy in a bedstand beside you…or eat something protein or low carb before bed…that helps a lot, I’ll have yogurt and string cheese for a snack and the 'cured" the night lows.

Victoza (like Amaryl (Glimepiride)) increases insulin production so it is possible for you to go low. if you BG is usually much higher than the 101, then its possible you got a phantom low which can occur as your BG starts coming down into normal range.

Its not likely you will actually go low, because of the Victoza increases insulin production, be prepared for a low and like Cathy said, keep some glucose tabs or hard candies with you so you can treat if you do go low. but test first and i wouldn’t treat if you are above 70. test again 15-30 minutes later and see what direction you are going. if you continue to drop, then treat. if its a false low, your body will adjust in a couple days.

I am told that low BG is below 70. For myself, I don’t usually have the low symptoms - clammy, light-headed, slow, “fuzzy” thinking, until around the 50 range. I have emergency glucogen on hand at home & at work, but have never needed it. I can usually treat with 15g of carbs & test again in 15 minutes & tell that it’s moving back into the normal range.

If your body is accustomed to high BG readings, you may have low symptoms. You should always check, treat with 15g fast-acting carbs if necessary, test again in 15 minutes, & repeat if necessary.

Unless you are hypo-unaware, you will feel it, even if you are asleep.

I heard, (I don’t know if its true) that if I want to know what direction I am going, I should measure my blood sugar at a finger and also on same forearm. The forearm measurement is where the blood sugar was a little while ago while the finger is where the blood sugar is now, so if the finger is higher its going up.

Is there anything to that?

It can very by person, but my experaince is that the finger is most accuate at the time it the test is taken. Alternate sites, like the forearm, can be somewhat delayed, but… If you rub the forearm, or run it under hot water, the heat brings blood to the surface making the result more accurate. I personally had similar results.

As far as determining direction, i think that would all very based on where you are in your curve. IMO, i wouldn’t leave it to chance. i bought a cheap meter and anytime i try a new food, i test every 15 minutes to see a) how much my BG went up and b) how long it took me to peak. I’ll do this a few time for each new food to make sure its consistent then i know know going forward, when i need to test when i have that meal and what i should expect.

I shake and feel nauseous and dizzy.

Many Type 2’s get what is called “false lows”. Your body may be use to much higher numbers. So numbers in the low 100’s give you “low symptoms” I would wait 15 minutes or so and test again on my fingers to see which direction bg is going. If it is going down I would eat something like a glucose tablet. The other thing that could be going on is our body tend to produce all sorts of hormones in the early morning hours, adrenaline, growth hormone, cortisol. Many of these hormones will wake you up with a jolt. Sometimes they cause your liver to add extra glucose to deal with these hormones. Most Type 2’s when they start to fall below 70, our pancreas produces glucagon which then signals liver to turn glycogen into glucose , thus raising our bgs.

I have been having these “false” hypos, or fantom lows, more frequently than before. Seems like once or twice a week in the middle of the night. Nausea, shaky, cold sweat, disorientation, combined with real bad indigestion. I check my blood on these occations and its above betwen 100 and 120. Thats not low, but it is low for me.

Makes sense that it might be because my body was not used to that low a blood sugar. But lately, as I have gotten better control, I have on occation had my blood sugar that low during the day, especially after my walk, with no side effects or problems.

So I don’t know. Maybe its not the number, but a precipitious drop during the night, that doesn’t go below 100 but I react to the rapid drop.???

I mentoned it to my doctor who didn’t think it was anything. And did not recommend I do anything.

I don’t do anything about it except measure and sit and feel horrible for an hour.

Should I be doing something?? I have tried a snack before bed, but it hasn’t helped yet. I have not tried a glass of milk during the event.

Is it perhaps an indication of something entirely different??? Very high triceritops because my bituen is low and the dingle arm on the encabulator needs re-framming? (Thats what some of the experts sometimes sound like to a newbie like me.)

I tell because my CGMS beeps like a posessed little girl and starts spitting pea soup everywhere…Naaa, but it does beep like crazy. Then i test and its usually dropping so fast the sensor cant keep up. Last night mine read 75 and I was 55. And that was after very light exercise. Other than a bit or irritability, I had no other major symptoms. 28 yr T1 vet here, so lows dont phase me that much.

If I don’t treat a low blood sugar, I’ll just wake up in the morning with Dawn Phenomenon. (But I actually, on occasion, do get some low blood sugars. Most Type 2’s who are not on medicines or insulin, do not get these.)

Symptoms can be felt when we haven’t been within normal range for a long, long time, because our bodies had gotten used to the really high blood sugars… it had considered the really high blood sugars to be its new ‘normal,’ and thus, when you fall either below or above that, it will react.

For me, I start feeling like total crap anytime I’m above 150 or 160 or so, because that’s my new high… I will feel hungover, really bad. Headache, moodiness… sleepiness.

When I’m low, I’ll feel like I’m drunk, and very uncoordinated, hungry. The body will start getting used to the lower numbers, with time… So I don’t overdo treating those symptoms, if at all. I may have a 4 oz serving of milk, or a slice of low carb bread, or a Wasa cracker with hummus, and leave it at that. \

For the highs, I just drink a lot of water… and go out for a mild walk. If you’re higher than 250 or so, though, do not exercise. Just have a lot of water, and rest. It’s dangerous to exercise with really high blood sugar. It just makes you dehydrated, further increasing high blood sugar, and maybe even dropping ketones in the urine.

I guess it makes sense, because I don’t have a car… and I walk across town, everywhere… more in one day, than some people do in a month, sometimes… and I was still diagnosed with really very high blood sugar. lol No wonder I’d get home from all that walking, and feel like utter crap. lol

You could of had a real low and you woke up after the adreneline kick for a while i woke up with low feeling but normal range. I did a test one night and tested every hour. I saw a steady drop every hour down to the 70 mark. so i figure i was going in the lows cause i woke up with the low symptom.

I have been hoping for the “take two oreos and call me in the morning” reccommendation.

Oh wait, I gave away all my oreos. :slight_smile:

hahaha oh dear…Oreos would not treat a hypo at all. I can still call you in the morning though:P

JeffD, you might need to look at your overall control. If 100-120 is low for you, and your normal range is much higher, you might continue to have these “phantom lows” until you get things more under control. For a lot of folks, anytime the BG goes below the norm, the body reacts with low symptoms even if the BG is actually a “low”

Having a snack in the evening before you go to bed may help with that symptom, but the result will be higher BG on a regular basis. Your doc probably didn’t think much of it because technically your not a dangerous range and he doesn’t want to tweak anything that is going to result in increased BG levels.

Feel free to ignore the question but if 120 is low for you, what is your average (fasting and/or postprandial). Also, are you on any specific diet to get your BG down?

120 is low for me these days. My average for the week is 158. And thats averaging in numbers from both before and after a meal.

I am on a diet, devised by the folks at the diabetes center at the hospital. I follow it mostly. If I follow it exactly my sugar goes up a bit. The diet is designed for me to lose a pound a week. A hundred pounds in two years. (Which after seven weeks I am on track for).

The big thing is to rule out something else, food poisening, allergic reaction to one of the drugs, coincedental condition, like an ulcer from worrying about all this stuff.