If you’re a type 1 diabetic, you’ve likely been in one, if not all, of these situations before. You’re taking a college entrance exam, only to feel your blood sugar dropping. But there’s no food allowed in testing centers. You’re giving a presentation at work, when your Continuous Glucose Monitor (CGM) low alert goes off. People would look at you funny if you left or started eating a snack, right? You’re sitting on a plane when suddenly your blood sugar is low. You forgot your snacks are in the overhead bin, and you’re not allowed to get out of your seat. 

Having low blood sugar as a type 1 diabetic is not just inconvenient, it can be downright terrifying. 

Why? Because if left untreated, low blood sugar can lead to serious consequences such as seizures, unconsciousness, or even death. 

Due to the constant, daily management of our blood sugars, most type 1 diabetics will often experience several low blood sugar episodes a week. As type 1 diabetics, we give ourselves insulin based on the food we eat and our blood sugar readings. Due to many factors, we can often end up with too much insulin in our system, leading to low blood sugar. In most non-diabetics, their pancreas can easily adjust the amount of insulin in their bloodstream without overdoing it.

If you’re someone who knows or loves a type 1 diabetic but aren’t diabetic yourself, you may be thinking, “But when my diabetic loved one goes low, they just grab a juice box or packet of fruit snacks, and they’re A-OK.”

If you’re thinking this, you’re right… and you’re wrong. Most diabetics only need about 15 grams of carbohydrates (give or take) to raise their blood sugar if it’s low, which is why a juice box or packet of fruit snacks brings them back up to a normal level. If the low blood sugar is severe enough, a type 1 may need a lot more sugar, or even require a glucagon injection. 

But what a lot of people don’t understand or think about is the mental toll that going low can have, especially when it’s happening multiple times per day. Having a low blood sugar means interrupting whatever you were doing to treat it while feeling hunger, brain fog, weakness, irritability, and anxiety.

What is Low Blood Sugar?

Simply put, low blood sugar is when your glucose level drops below 70. A normal range for blood sugars is 70-120mg/dL or 3.9-6.7mmol/L. (While the US uses mg/dL, some other countries use mmol/L). Low blood sugar occurs in type 1 diabetics for a number of reasons, including:

1. Too much insulin was taken for the amount of carbohydrates that were consumed

2. Exercise or movement

3. Stress

4. Alcohol

5. Hormone fluctuations, especially for those with a menstrual cycle

6. Certain medications

And there are so many more. With low blood sugar, the body stops functioning as it should. It’s essentially “running on fumes” because the cells become starved for energy without glucose.

What Does Low Blood Sugar Feel Like?

Low blood sugar can feel different for everyone, but there are a few common symptoms that most diabetics experience:

1. Feeling extremely shaky and/or weak

2. Sweating or feeling hot

3. Blurred vision

4. Mental confusion 

I’ve experienced all of these symptoms before, but most often I get shaky, weak, and my vision blurs. It feels like I’m walking through water with bricks on my feet, and I usually have to sit or lay down until my levels are back to normal. 

Thankfully, I’ve only had two instances in my 18 years of living with type 1 where my low left me so confused I had to ask for help — and thankfully, both times were with my mom.  

It’s important to note that some diabetics become desensitized to their low symptoms, which is where life-saving technology like CGMs or therapy dogs come in to help. 

Why is Low Blood Sugar So Serious?

As I previously mentioned, untreated or severe low blood sugar in diabetics can lead to death. 

Why? Because the body has been deprived of glucose, which it needs in order to run all bodily functions effectively. 

The funny (ok, it’s not funny) part about being a diabetic is that we often experience lows multiple times a week. And we literally make life-saving decisions for ourselves multiple times a day. Imagine knowing that if you didn’t drink that juice box or pop glucose tablets in your mouth, you wouldn’t be here anymore. It’s really that dramatic, and it’s why, for so many diabetics, having low blood sugar really messes with your brain. 

In fact, many diabetics purposely keep their blood sugars high (which can have very serious long-term effects) because they are that afraid of going low.

How Do You Treat Low Blood Sugar?    

The most common way to treat low blood sugar is with glucose. Like I mentioned before, a normal low can be treated with about 15 grams of carbs and can take about 15-20 minutes to go back to normal. If after 15 minutes, the blood sugar hasn’t gone up, more sugar is required until it goes back to normal. Diabetics commonly treat their lows with juice, glucose tabs, fruit, or anything sugary that can be easily.

Another way to treat more serious lows (for example, if the diabetic is unconscious or too confused to help themselves) is with a glucagon injection, which looks is similar to an EpiPen and is injected directly into the muscle. There is also a nasal powder version, called Baqsimi, which you spray directly into one nostril. 

There’s only been one time I had to use this emergency hormone, and my blood sugar (which had been in the 40s for over 30 minutes!) shot right back up to normal within 5 minutes. 

Low blood sugars are no fun, and because they’re so serious, it’s always important that someone with type 1 informs their family, friends, work colleagues, or teachers that they’re diabetic and know what to do in case a low blood sugar turns into an emergency situation.