For people living with diabetes treated with insulin, hypoglycemia can be an ongoing concern

What is hypoglycemia (low blood sugar)?

The medical definition of "low blood sugar" is when your blood sugar level goes below 4 mmol/L.1 When this occurs, you might start to feel a variety of things, which can include, but are not limited to:1,2

It is important to note that not everyone who experiences low blood sugar will experience the same symptoms, or the same severity of symptoms.2 You might feel hungry, but someone else could begin to have blurred vision—be sure to record any symptoms you might feel you are experiencing, and talk with your healthcare provider about them.



Has your blood glucose level ever dropped below 4 mmol/L in the past 3 months?

Have you experienced shaking, sweating, dizziness, tiredness, or headaches?

Have you experienced low blood sugar during the night?

Have you experienced nighttime low blood sugar that caused symptoms, such as nightmares and sweating, which woke you up during the night?

Are you frequently snacking to prevent or treat low blood sugar?

Is the possibility of experiencing low blood sugar often on your or your family’s mind?

Speak with your healthcare provider. There are ways to help manage your risk of hypoglycemia. It is safer and more effective to prevent low blood sugar than to treat it.3

Keep watching for symptoms of low blood sugar. Regular blood sugar monitoring can help you know if you are at a healthy sugar level, and help prevent a silent state of hypoglycemia.2,3

Show this questionnaire to your healthcare provider and discuss ways to prevent hypoglycemia.

Why does low blood sugar occur?

A) When blood sugar levels are high (like after a meal), insulin is released, allowing cells to absorb sugar and, in turn, allowing your body to work properly. Extra glucose gets stored in the liver, where it is readily available to be used if needed.4

B) When blood sugar levels are low (like between meals or after exercise), another hormone released from the pancreas instructs the liver to release stored sugar.4

Below are a few reasons that could cause you to have low blood sugar:2

EXERCISE – Trying a new, more intense activity, exercising more than usual, or exercising longer than usual.

ALCOHOL – Drinking alcohol, especially without eating, prevents the stored sugar from being released from your liver.

MEDICATION – Taking either the wrong type of medication, the wrong dosage of medication prescribed by your healthcare provider, or taking too much medication in relation to your other activities and food intake.

PHYSIOLOGY – A chronic illness of the kidney or liver, or a hormone deficiency could also lead to low sugar levels.

Getting the balance right

The key to managing diabetes is getting the right balance
between food, medication, and physical activity.

Low blood sugar can occur in anyone with diabetes,
regardless of their A1C.5

Who does low blood sugar occur in?

Low blood sugar can happen to anyone with diabetes. While people with type 1 diabetes may be more likely to experience a low blood sugar event, it is not unusual for people with type 2 diabetes to also experience low blood sugar.5*

Many people with diabetes taking insulin do not report low
blood sugar to their physicians.5 However, it is important that
healthcare providers know about low blood sugar because they
can suggest ways to minimize the risk of future events.

Did you know that low blood sugar events are experienced…5*

* The Canadian cohort of a non-interventional, multicentre, 6-month retrospective and 4-week prospective study, using self-assessment questionnaires and patient diaries, included 498 patients, aged ≥18 years with type 1 diabetes (n=183) or type 2 diabetes (n=315), treated with insulin for >12 months. The primary endpoint was the proportion of patients experiencing at least one hypoglycemic event during the observational period. In the 4-week prospective period, 64.2% of people with type 2 diabetes and 95.2% of people with type 1 diabetes confirmed having experienced a low blood sugar episode.

Remember, you are not alone—there are many people who are
affected by low blood sugar. With many resources available and
a supportive diabetes healthcare team, it is possible to reduce,
prevent, and manage hypoglycemia.

What can you do about low blood sugar?

If you realize you are experiencing low blood sugar, it can be treated. Consuming 15 g of carbohydrates will relieve symptoms associated with hypoglycemia in most people.1

Examples of 15 g of carbohydrates:

  • 15 g of glucose in the form of glucose tablets (preferred choice)

  • 15 mL or 3 packets of table sugar dissolved in water

  • 150 mL of juice or regular soft drink

  • 6 LifeSavers®

  • 15 mL of honey (do not use for children less than 1 year old)

Wait 15 minutes, and then check your blood glucose again. If it is still low:

  • Treat again; wait 15 minutes, check your blood sugar. Continue these steps until your blood sugar is above 4 mmol/L

When your blood sugar is above 4 mmol/L:

  • If your next meal is more than one hour away, or you are going to be active, eat a snack with 15 g of carbohydrates and a protein source

  • Wait 40 minutes after treating low blood sugar before driving

Think about why your blood glucose went low and make the necessary changes to avoid
low blood glucose again.

Many people with diabetes taking insulin do not report low
blood sugar to their physicians.5 However, it is important that
healthcare providers know about low blood sugar because they
can suggest ways to minimize the risk of future events.

Before your next appointment, note down the following information:

When you have low
blood glucose

What signs and
symptoms you

What you think could
have led to your low
blood sugar episode

LifeSavers® is a trademark of the Wm. Wrigley Jr. Company.