Feeling Shaky? Why Blood Sugar Crashes & Medically Approved Next Steps

Feeling shaky, sweaty, dizzy, or suddenly anxious can be alarming—especially if it seems to come out of nowhere. One common cause of these symptoms is hypoglycemia, also known as low blood sugar.

Hypoglycemia happens when the level of glucose (sugar) in your blood drops below normal. Glucose is your body's main energy source, especially for your brain. When levels fall too low, your body reacts quickly—and sometimes dramatically.

Here's what you need to know about why blood sugar crashes happen, how to recognize them, and what medically approved steps to take next.

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What Is Hypoglycemia?

Hypoglycemia is typically defined as a blood glucose level below 70 mg/dL (3.9 mmol/L). It most commonly affects people with diabetes, but it can also occur in people without diabetes under certain conditions.

Your body carefully balances blood sugar using hormones like insulin and glucagon. When that balance is disrupted—by medication, missed meals, illness, or other factors—blood sugar can drop too low.

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Common Symptoms of Hypoglycemia

Symptoms can range from mild to severe. Early recognition is important.

Early (Mild to Moderate) Symptoms:

• Shakiness or trembling
• Sweating
• Fast heartbeat
• Hunger
• Anxiety or irritability
• Dizziness or lightheadedness
• Headache
• Pale skin

More Serious Symptoms:

• Confusion
• Slurred speech
• Blurred vision
• Clumsiness
• Extreme fatigue
• Seizures
• Loss of consciousness

The brain depends heavily on glucose. When levels drop too low, mental symptoms often appear quickly.

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Why Does Blood Sugar Crash?

1. Diabetes Medication

The most common cause of hypoglycemia is diabetes treatment, especially:

• Insulin
• Sulfonylureas (a type of oral diabetes medication)

Too much medication, skipped meals, or unexpected exercise can all lower blood sugar more than intended.

2. Skipping or Delaying Meals

If you don't eat for an extended period, especially after taking insulin or certain medications, your blood sugar can drop.

3. Intense or Prolonged Exercise

Physical activity uses glucose for energy. Without proper fueling before and after workouts, blood sugar may fall too low—sometimes even hours later.

4. Alcohol Consumption

Drinking alcohol—especially on an empty stomach—can interfere with the liver's ability to release stored glucose, increasing the risk of hypoglycemia.

5. Reactive Hypoglycemia

Some people without diabetes experience low blood sugar a few hours after eating, particularly after high-carbohydrate meals. This is called reactive hypoglycemia. It may be linked to excessive insulin release.

6. Rare Medical Causes

Though uncommon, hypoglycemia can be caused by:

• Hormonal deficiencies (such as adrenal insufficiency)
• Severe liver disease
• Insulin-producing tumors (insulinomas)
• Severe infections
• Advanced kidney disease

If episodes are frequent or unexplained, medical evaluation is essential.

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What To Do If You Feel Shaky Right Now

If you suspect hypoglycemia, act promptly.

Follow the "15-15 Rule" (Medically Recommended First Aid)

1. Consume 15 grams of fast-acting carbohydrates, such as:

   • 4 glucose tablets
   • 4 ounces (½ cup) of fruit juice
   • 4 ounces of regular (non-diet) soda
   • 1 tablespoon of sugar or honey

2. Wait 15 minutes, then recheck blood sugar if possible.

3. If still below 70 mg/dL, repeat.

Once levels return to normal, eat a small snack containing protein and complex carbohydrates (like peanut butter and whole-grain crackers) to prevent another drop.

If someone is unconscious or unable to swallow:

• Do NOT give food or drink.
• Use glucagon if available.
• Call emergency services immediately.

Severe hypoglycemia is a medical emergency.

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When Should You See a Doctor?

Occasional mild hypoglycemia may happen, especially if you have diabetes. But you should speak to a doctor if:

• You experience frequent low blood sugar episodes
• Symptoms occur without clear cause
• You do not have diabetes but suspect hypoglycemia
• Episodes are severe or involve confusion or fainting
• Your medication may need adjustment

Recurrent hypoglycemia is not something to ignore. It can increase the risk of accidents, falls, and serious complications.

If you're experiencing any of these symptoms and want to better understand what might be happening, Ubie offers a free AI-powered symptom checker for Hypoglycemia that takes just a few minutes to complete and can help you prepare important information before your doctor's appointment.

However, online tools do not replace medical care. Always speak to a doctor about symptoms that could be serious or life-threatening.

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How Doctors Diagnose Hypoglycemia

Diagnosis usually involves:

• Reviewing your symptoms
• Measuring blood glucose levels
• Evaluating medication use
• Checking for underlying medical conditions

Doctors often look for what's known as Whipple's triad:

• Symptoms of hypoglycemia
• Low measured blood glucose
• Relief of symptoms after glucose is raised

If you don't have diabetes, your doctor may order additional blood tests to rule out rare but important causes.

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Preventing Future Blood Sugar Crashes

Prevention depends on the cause, but these general strategies help:

If You Have Diabetes:

• Monitor blood glucose regularly
• Take medications exactly as prescribed
• Eat consistent meals
• Adjust insulin before exercise (with medical guidance)
• Limit alcohol or consume it with food
• Carry fast-acting carbohydrates at all times

If You Do Not Have Diabetes:

• Eat balanced meals with protein, fiber, and healthy fats
• Avoid large amounts of simple sugars on an empty stomach
• Don't skip meals
• Discuss persistent symptoms with a doctor

Small, regular meals may help prevent reactive hypoglycemia.

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Why You Shouldn't Ignore Repeated Episodes

Even mild hypoglycemia can become dangerous if it happens often. Over time, your body may stop giving early warning signs—a condition called hypoglycemia unawareness. This increases the risk of sudden severe episodes.

In severe cases, untreated hypoglycemia can lead to:

• Seizures
• Injury from falls
• Loss of consciousness
• In rare cases, death

This is not meant to alarm you—but to emphasize that persistent symptoms deserve medical attention.

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The Bottom Line

Feeling shaky, sweaty, or suddenly confused could be a sign of hypoglycemia, especially if symptoms improve after eating or drinking something sugary.

Blood sugar crashes happen for many reasons:

• Diabetes medications
• Skipped meals
• Alcohol
• Exercise
• Rare medical conditions

Most mild episodes can be treated quickly with fast-acting carbohydrates. However, frequent, severe, or unexplained hypoglycemia should always be evaluated by a healthcare professional.

If you're unsure whether your symptoms match Hypoglycemia, using a free AI symptom checker can help you identify patterns and gather useful information before your medical appointment.

Most importantly: Speak to a doctor promptly if your symptoms are severe, recurring, or potentially life-threatening. Early evaluation can prevent complications and give you peace of mind.

Your body sends signals for a reason. Paying attention—and taking appropriate next steps—can help you stay safe and well.