Diabetes is increasing in prevalence worldwide, and unfortunately, more people are becoming familiar with this chronic disease.
Diabetes affects the pancreas and its ability to produce the hormone insulin. When the insulin-producing cells of the pancreas are destroyed, or when the body doesn’t respond to insulin as well as it should, blood glucose (sugar) levels rise, and diabetes develops.
Having diabetes means that your pancreas can’t automatically keep your blood sugar levels where they should be. People without diabetes may never appreciate how efficient the pancreas is at releasing insulin when it should and the liver releasing sugar to prevent low blood sugar.
When you have diabetes, one of the main goals is to keep blood sugar levels from going too high and too low. It can seem like a balancing act sometimes since many factors can influence blood sugar levels. Despite the best diabetes management plan and healthy habits, there may still be a time when someone with diabetes experiences low blood sugar.
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Low blood sugar is called hypoglycemia and occurs when blood sugar levels fall below 70 mg/dL. Low blood sugar can become life-threatening if it becomes severe, so it’s essential that people with diabetes and those caring for them know which foods to eat when low blood sugar occurs.
Suppose someone has repeated incidents of low blood sugar. In that case, they may develop hypoglycemia unawareness, which is when they don’t notice low blood sugar symptoms as quickly as they once could. Hypoglycemia unawareness increases the risk of severe hypoglycemia, so treating and preventing hypoglycemia is very important for the health and safety of people with diabetes.
What causes low blood sugar?
There are different causes of hypoglycemia, such as:
Too much insulin: Injecting insulin lowers blood sugar more quickly than any other diabetes medication. The risk of low blood sugar is highest with short- and rapid-acting insulins. Fast-acting insulin is usually taken around meals because eating raises blood sugar, so it works quickly to counteract the rise in blood sugar. Taking short- and rapid-acting insulins without eating may result in a hypo.
Long-acting or basal insulin works the slowest out of all of the types of insulin. It is usually injected once or twice a day. Long-acting insulin mimics the body’s natural ability to constantly release a small amount of insulin throughout the day and night.
Intermediate-acting insulin works more slowly than fast-acting but is faster than basal insulin. They are often injected twice per day.
Insulin doses can overlap, which increases the risk of hypoglycemia. For example, taking a morning dose of intermediate-acting insulin as well as a dose of rapid-acting insulin before lunch can cause a “stacking up” of insulin levels in the body and increase the risk of a hypo.
- Not enough food, especially carbohydrates. Foods that contain carbohydrates, such as bread, milk, fruit, and starchy vegetables, turn into sugar when digested. If someone isn’t eating very many carbohydrates, especially if they’re also taking insulin or other diabetes medications, hypoglycemia can occur.
- Exercise and weight loss. Physical activity stimulates the body to take up more glucose for energy, which can cause low blood sugar if food or drink containing carbohydrates aren’t taken in regular amounts while exercising for long periods of time.
The liver stores sugar in the form of glycogen. Glycogen helps provide our bodies with sugar when we are fasting and exercising, which reduces hypoglycemia risk. During prolonged periods of exercise or fasting, glycogen stores can become used up. Severe weight loss can also use up glycogen stores due to being in a fasting state. Without adequate glycogen stores, hypoglycemia can occur.
- Gastroparesis. Gastroparesis is the slowing of stomach emptying, which can occur as a complication of diabetes. When food isn’t emptied from the stomach very quickly, it isn’t available to be digested and converted into sugar in the bloodstream. Hypoglycemia risk increases in people with gastroparesis who also take insulin.
10 Foods to Raise Blood Sugar
- Fruit juice. One of the best things to have on hand to treat low blood sugar levels is fruit juice. Juice boxes are especially convenient because they don’t have to be refrigerated so that they can be kept in the car, by the bedside, and in other places that would be convenient to have nearby.
- In order to treat low blood sugar, 15 grams of carbohydrates should be consumed. Sugary drinks like juice are preferred as they are rapidly absorbed into the bloodstream. It doesn’t take much juice to get to 15 grams of carbohydrates; about one-half cup is enough. Blood sugar should be re-tested within 15 minutes, and the treatment repeated until blood sugar is above 70 mg/dL. Any type of juice will suffice to treat low blood sugar, such as orange, apple, or grape.
- Candy. Another convenient option because of its ease to transport, hard candy is a popular option. Many people like to store candies in their purse or near their desk to have in case of a low blood sugar. How much candy is required to treat a low blood sugar level will depend on the type of candy. It likely won’t take too much candy in order to get 15 grams of carbohydrates, so it’s important to not overcorrect a low blood sugar by eating a lot of candy. It’s also best to choose candy that can easily be chewed versus harder candies like jawbreakers or others that might not dissolve quickly. Jelly beans, M&Ms, and licorice are all examples of candy that would be easy to eat quickly to treat low blood sugar.
- Raisins. Raisins are another great portable option to treat low blood sugar. Having them in individual serving boxes is even more convenient. One small box of raisins (1.5 ounces) contains 34 grams of carbohydrates, so you’d technically only need half of that box to treat the low blood sugar. For a more severe low blood sugar, it would be wise to consume the whole box.
- Honey. Honey is rapidly absorbed into the bloodstream, making it a good option to treat low blood sugar. One tablespoon of honey contains around 15 grams of carbohydrates, which is exactly how much is recommended to treat hypoglycemia. If someone is experiencing low blood sugar and is groggy or confused, honey can be easier for them to take since they don’t need to swallow much to get 15 grams of carbohydrates. A caregiver could even help spoon-feed the honey to the person experiencing low blood sugar if needed.
- Fruit. Fruit is rich in natural sugars, making it a food people might turn to treat low blood sugar. The important thing to note about fruit is that it can contain higher amounts of fiber, which is a healthy carbohydrate but doesn’t raise blood sugar. Fiber also slows down digestion, which means it might delay how quickly the sugar is absorbed into the bloodstream. To quickly treat a low blood sugar, opt for softer fruits like bananas, grapes, or canned fruit instead of fiber-rich fruit like apples and berries.
- Granola. Granola is usually high in sugar, making it a food not usually recommended for people with diabetes to consume large amounts regularly. One serving of standard granola (Quaker Simply Granola with almonds and raisins) contains 51 grams of carbohydrates, which is more than enough to treat low blood sugar. It also contains 7 grams of fiber and 7 grams of protein, which may slow down the sugar release into the bloodstream. In the case of more severe hypoglycemia, granola might not be the most effective choice.
- Glucose tablets. Glucose tablets are made out of pure glucose, which means the body doesn’t have to break them down to get them into usable sugar in the bloodstream. Most sugars we eat are made of fructose and sucrose, which have to be broken down before they turn into blood sugar. Glucose tablets are a popular low blood sugar treatment because they’re easy to have on hand in all different types of situations. They dissolve quickly, and each tablet contains 4 grams of carbohydrates, so in the case of low blood sugar, 3-4 tablets should be used. A common brand of glucose tablet is Dex4, but other brands make similar products. They are available over the counter without a prescription and can be used in cases of severe hypoglycemia when someone may not be able to chew or swallow well.
- Fruit leather. Unlike fruit snacks which contain added sugar, fruit leather is made with fruit purees and juices. It’s a convenient option to treat low blood sugar and is easy to eat quickly. It’s a good choice for those who want to avoid candies and other added sugar but want to raise blood sugar effectively. One strip of fruit leather contains 12 grams of carbohydrates, so a little over one piece should be adequate to raise blood sugars.
- Crackers. Crackers contain carbohydrates from wheat and other grains. For example, five Ritz crackers contain 10 grams of carbohydrates; to treat low blood sugar, you’d need to start with about 7-8 crackers to reach 15 grams of carbohydrates.
- Bread. One slice of bread usually contains enough carbohydrates to provide the 15 grams needed to raise blood sugar. Whole-grain breads contain more fiber and protein, so it would be better for low blood sugar treatment to choose lower-fiber options such as white bread.
When to seek help
If someone is experiencing low blood sugar several times in the course of one or two weeks, or often enough that it’s interfering with their quality of life and safety, they should seek medical attention. People with moderate hypoglycemia (blood sugar below 54 mg/dL) may also need to seek medical attention if the blood sugar can’t be raised promptly.
For severe hypoglycemia (blood sugar level below 40 mg/dL and/or the person is unable to function), emergency medical care should be sought. If a person suspected of having a low blood sugar ever becomes unconscious, call 911 immediately.
To raise a low blood sugar lev at least 15 grams of carbohydrates should be consumed to help bring blood sugar levels up to 70 mg/dL or higher. There are many food options that raise blood sugar levels, including juice, candy, dried fruit, and glucose tablets.