Hypoglycemia refers to an abnormally low level of glucose (sugar) in the blood, typically defined as a blood glucose level below 70 mg/dL. Glucose is the body’s primary energy source, especially for the brain, so low levels can cause a wide range of symptoms and may become dangerous if not treated promptly.

Symptoms can vary in intensity and may include:

• Early signs: shakiness, sweating, dizziness, hunger, irritability, fast heartbeat
• Later signs: confusion, blurred vision, weakness, seizure, or loss of consciousness

The most common cause of hypoglycemia is diabetes treatment, particularly in patients taking insulin or sulfonylureas. However, hypoglycemia can also occur in non-diabetic individuals due to:

• Fasting or missed meals
• Excessive alcohol consumption
• Intense physical activity without proper nutrition
• Hormonal imbalances (e.g., adrenal insufficiency, hypopituitarism)
• Insulinoma (a rare insulin-producing tumor)
• Reactive hypoglycemia, where blood sugar drops after eating, often linked to insulin over-response

Hypoglycemia is diagnosed with Whipple’s triad:

• Symptoms consistent with hypoglycemia
• A low measured blood glucose level
• Relief of symptoms after raising blood glucose

Additional tests may include fasting studies, insulin and C-peptide levels, and imaging if an insulinoma is suspected.

Immediate treatment includes eating 15–20 grams of fast-acting carbohydrates (e.g., glucose tablets, juice). Severe cases may require emergency glucagon injection or IV glucose. Long-term management involves:

• Adjusting diabetes medications
• Reviewing diet and meal timing
• Treating underlying hormonal or pancreatic disorders

In-depth hormonal evaluations and metabolic assessments

Medication adjustment and monitoring

Dietary counseling and lifestyle coaching

Education on glucose monitoring and prevention strategies

Coordination of care for insulin pump users or those needing continuous glucose monitors (CGMs)