Nutrition Articles

Understanding Hypoglycemia

Eating to Prevent Low Blood Sugar

546SHARES
Your body breaks down the food you eat into a type of sugar called glucose. After you eat a meal or snack, that glucose makes its way into the bloodstream, causing the level of sugar in your blood to increase. Your pancreas responds by releasing the hormone insulin, which allows glucose to leave the bloodstream and enter into body tissues (including the liver, for later use). When the sugar supplied by your last meal is more or less used up, insulin levels go back down to keep your blood sugar from falling further. In addition, stored sugar is released back into the bloodstream from the liver with the help of another hormone called glucogon. Normal levels of blood glucose levels vary depending on when levels are measured and can range from 70- 145 milligrams per deciliter. Most people’s systems are remarkably adept at maintaining a fairly steady blood sugar level.

However, for people with hypoglycemia, which technically means "low blood sugar," this process doesn't come as easily. While it is not considered a disease itself, hypoglycemia is a medical condition that has many uncomfortable symptoms. Frequent episodes of hypoglycemia can also be related to other medical diagnoses, most commonly diabetes. There are two types of hypoglycemia.

Fasting hypoglycemia occurs when you have not eaten for eight or more hours. It can be caused by certain conditions that disrupt your body’s ability to balance the levels of glucose in the blood: eating disorders, and diseases of the kidney, liver, pancreas, and pituitary or adrenal glands. Taking a high dose of aspirin may also lead to fasting hypoglycemia.

Non-fasting (reactive) hypoglycemia occurs after eating a high-carbohydrate meal or snack. If your body is unable to respond appropriately, it releases insulin too late and in excessive amounts. This causes your blood glucose levels to drop too low.

Hypoglycemia can also be caused by:
  • Diabetes. Taking too much medication, eating inappropriately, changing your exercise routine, or illness can cause low blood sugar levels in people with diabetes.
  • Drinking excessive amounts of alcohol
  • Prolonged exercise
  • Waiting too long between meals and snacks, especially during pregnancy.
  • Prolonged fasting
  • Eating large amounts or the wrong types of food after certain stomach surgeries, such as gastric bypass surgery
  • Diseases of the glands that produce hormones important in blood glucose control, such as the pancreas, pituitary gland, or adrenal glands. (These are rare and generally require the care of an endocrinologist.)
  • Kidney failure, severe liver disease, severe congestive heart failure or severe widespread infection
  • Medication interactions
Signs of hypoglycemia include weakness, nausea, hunger, headache, sweating, nervousness, mental confusion, anxiety, shakiness, drowsiness, dizziness, and trembling.

Because these symptoms are similar to many other problems, including panic attacks and stress, it's important to get appropriate testing and an accurate diagnosis from you physician.
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About The Author

Becky Hand Becky Hand
Becky is a registered and licensed dietitian with almost 20 years of experience. A certified health coach through the Cooper Institute with a master's degree in health education, she makes nutrition principles practical, easy-to-apply and fun. See all of Becky's articles.

Member Comments

  • I don't need to wait 8 hours between meals to begin feeling the effects of hypoglycemia. If I go more than four hours without eating I start feeling cranky. If I go much longer I turn into a monster. - 7/27/2014 5:48:10 PM
  • I did want to say, I do eat a lot of protein - egg with breakfast, my lunch has chicken as does my dinner... - 2/7/2014 3:13:06 PM
  • I am severely hypoglycemic. I am not diabetic. The doctors actually aren't sure what the cause of my hypoglycemia is, however my symptoms present as such (it comes on from fasting or waiting too long between meals)

    *Unfocused
    *Yawning (not tired, yawning)
    *Uncontrollable Crying
    or
    *Passing out

    I've managed to maintain my blood sugar by eating complex carbohydrates and lots of fruit. For instance, this morning I had oatmeal with flax, wheat germ, and chia with a banana and blueberries. My lunch includes brown rice and a lot of vegetables. For snack I have a small nonfat blueberry yogurt and 1/4C honey toasted pecans. For dinner I'm making sesame chicken with broccoli and bok choy.

    I absolutely cannot do a low carb diet or a sugar free diet or I'm unable to function. But I'm also not eating all the time. I eat breakfast around 8ish, lunch around 2:30pm, snack around 4pm (before work as my work is very active), and then dinner around 8pm. I have found if I do not eat before exercising, I not only lack any energy to put into my workout, but I have gotten off the elliptical and passed out before. So it's important for me to eat something with protein and some sugar some 30 minutes-hour before my work out (so yogurt and nuts, cheese and fruit) and it will carry me through without drops in blood sugar. If I'm unable to have a full meal, yogurt, protein powder and a Naked juice will stick with me and fill me up and keep me going. Everyone will be different though, and finding the right balance is difficult, especially if you have to eat carbs and sugars to remain healthy. But I feel so much better when I am actively controlling my blood sugar levels. - 2/7/2014 3:11:17 PM
  • Why can't I get spark points for any of these articles today? There is no visible button for me to click, and no I haven't reached 25 points for these articles yet today. And yes, I am reading until the final page. Anyone else having the same issue? Very odd. I've been a member since March and never experienced this. - 10/4/2013 10:53:15 AM
  • MUSKRATMOM
    Yes, this is crazy. Yes you can prevent hypoglycemia by eating all day every day but life can't revolve around our little meals. Most of us are doing well to get two or three meals worked in.Every time you eat carbs, you set yourself up for another crash.
    Most of us with reactive hypoglycemia have a phase one insulin secretion defect and are on the slippery slope to diabetes.
    A little used method of diabetes and hypoglycemia diagnosis is the gllucose challenge or glucose tolerance test Ask for a 3-4 hour test with fasting and glucose testing every hour or immediately if you have symptoms. A diagnosis of post prandial hyperglycemia is something your doctor will know how to treat- either with very short acting insulin or with drugs that increase incretin function.
    Otherwise I'd recommend eating very little carbohydrate, (no more than 15-30 grams total at a meal, and exercise before or after each meal. - 8/31/2013 10:04:41 AM
  • LAST20FORME
    I always thought I may have this but never tested. I have to have a protein every few hours or I feel weak and if I go several hours without eating I will see a little trembling in my hands when I hold them out. Since just 6 almonds cures my problem, why be tested. I agree with the other posters that each body is different and one has to find what works for them. - 5/12/2013 1:39:56 PM
  • I couldnt eat that meal plan without having a reaction no protein for breakfast and bagels are empty carbs :o
    - 4/9/2013 2:21:18 PM
  • NK1959
    I agree with most of the others here who suffer from post prandial hypo. This sample diet would have me in a faint by an hour after breakfast. Protein, protein, protein! I wonder sometimes what dieticians are taught. I am seeing one at my endocrinologist's office who knows what she is talking about re: post prandial hypo. My diet, 8 meals a day, 150 cal every 2 hrs. Each with protein, fat and 5 gms or less of complex carbs. An example would be an egg with cheese and spinach; a cracklebred with chopped bell pepper on it and cheese melted on top; stir fry; a slice of crustless quiche made with egg beaters, heavy cream, cheddar, ham and veggies. Listening to the dietician at the bariatric office who gave me the above type of diet just made me much sicker and had me gaining back 11 lbs in 6 wks. - 2/3/2013 12:23:51 PM
  • I was very interested in reading the comments of those who have or have had hypoglycemia. I think it is good input and should be taken under consideration when reading "fixes". I do agree that protein at breakfast and within an hour of waking is good for everyone! - 1/14/2013 2:18:46 PM
  • AWILLABLE
    A part of some of these comments sounds true but only to the writer. Everyone is different and must choose their own individual health plan. Just because it works for one doesn't mean it will work for everyone. I was shocked to discover that I have diabetes because I had been a vegetarian for sixteen years. Obviously I did not follow a balanced diet and now my doctor wants me to follow a diet loaded with processed foods. To me that's going backwards and I object. I will make my changes, meal after meal until I get there. Your comments are very interesting though and I like the enthusiasm I feel when I read some of them.
    P.S. I do believe that protein is a must in breakfast, within one hour of awaking. - 10/9/2012 7:11:37 PM
  • I have had reactive hypoglycemia for probably 20 or more years now. The breakfast that SparkPeople recommend here:

    1 medium banana
    1 cup bran flakes with 1 cup skim milk
    1 cup decaffeinated coffee

    is guaranteed to give me a blood sugar plunge because it's almost all carbs, no fat, and little protein. Within an hour or so of eating it, I would have all of the typical signs of hypoglycemia, and my blood sugar would be low (under 70) when I took it. The only way that I could eat what you listed is by including a couple of eggs, maybe with some shredded cheese on top. Skim milk and low-fat cheeses are not my friend, causing more blood sugar issues than they fix. If I followed up your recommended snack and lunch after the recommended breakfast, I would be in bad shape by early afternoon, having one blood sugar incident after another.

    For those with reactive hypoglycemia, like me, the best breakfast is high in protein, moderate in fats, and low in carbs (but not no-carb). I can usually eat more carbs later in the day, but not first thing in the morning. My research on this has shown me that I'm not alone in this.

    Rather than following a high-bread, high-carb diet like the one recommended in this article, a dietician told me to envision my plate divided in half. Fill one half with vegetables. Then divide the empty half of the plate in two, and fill one part with a lean meat and the other with whatever high-carb side you might want (bread, pasta, potato, ...). Following that recommendation has worked wonders for my blood sugar.

    The diet recommended here would pretty much have me with type 2 diabetes in a fairly short time. I would NOT recommend it to anyone in a situation similar to mine. - 10/1/2012 11:38:37 AM
  • ROTTENMONKEY
    I have been hypoglycemic for probably 30 years. I have a plethora of physicians and NOT one gives a whoot about it. I'm a disabled veteran, and so far I do not have diabetes. The lowest my blood sugar level I was aware of was 43.
    I have yet to find a doctor who understands this can kill me likely quicker then diabetes because physicians just don't care or are oblivious to this condition.
    Why is hypoglycemia ignored? - 9/10/2012 6:00:55 PM
  • I related to several of the posts. I was diagnosed hypoglycemic in my late 20's and followed a diet of equal amounts of carbs and protein w/ minimal fat for a couple of years and the doctor declared me normal again. Fast forward to my 50's and I have a diagnosis of diabetes. I too wish I still had my old written diet plan, but I don't and have been having troubles with the foods and eating plans for about 3 years. I never got back in check after I retired: my exercise went w/ my job. So now, I an using insulin and other drugs just to bring my sugars down. I am getting better w/ the food stuff and have finally turned the corner I hope. I am very happy to have found Spark. The tracking software is fabulous. Best on the internet so far as I can tell. And w/ me tracking my food intake is really major. I enjoy reading the comments. - 6/17/2012 9:26:55 AM
  • I was diagnosed with Hypoglycemia when pregnant with my daughter years ago. Now I am thinking it is reactive hypoglycemia as when I eat carbs, I can pass out for hours at a time. Potatoes, bread put me out. - 5/31/2012 10:49:53 PM
  • I've experienced Reactive Hypoglycemia for most, if not all of my life. Recently, I started getting headaches while exercising and can keep a headache for hours (or even a full day). I did NOT know that headaches can be caused by low blood sugar!!

    The one time I received a "Diet" for my hypoglycemia, you were only supposed to eat HALF of a banana at a time. Eating every three hours was highly recommended. I also remember that servings of lean meat were suppose to outnumber servings of "starch" (7 to 5 in my case). Protein was supposed to be present at EVERY meal and all three snacks. I wish I still had that Food Plan! - 5/24/2012 1:23:17 PM

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