If I have low blood sugar now, will I become diabetic later?

Dear Shaky Sharon,

While there may be a relationship between hypoglycemia (low blood sugar) and the development of diabetes, the connection is more likely due to the treatment of diabetes in folks that already have the condition (type 1 or type 2). In other words, hypoglycemia is usually a result of the medication taken by individuals with diabetes, rather than a cause of developing diabetes in the first place. Those prone to severe hypoglycemic episodes may take something when they can’t get to food or juice, but treating the root cause and incorporating some healthy lifestyle behaviors (for both individuals with and without diabetes) may help to prevent bouts of low blood sugar in the first place.

Symptoms of hypoglycemia, including anxiety, irritability, or hunger, aren’t very specific and may be related to a number of causes. However, if your symptoms are due to hypoglycemia (usually classified as blood sugar levels below 70 milligrams/deciliter) in the absence of diabetes some potential causes for this include:

• Taking certain medications, including specific types of antibiotics
• Excessive alcohol consumption
• Certain illnesses such as severe liver disease, disorders of the kidneys, and infection
• Insulin overproduction, which may be caused by a tumor on the pancreas or abnormal enlargement of the beta cells (the cells that produce insulin)
• Hormone deficiencies due to disorders of the adrenal and pituitary glands

When a spat of low blood sugar hits, replenishing blood sugar is key. This can be done by consuming foods that are quickly converted into sugar in the body (such as candy, regular soda, or fruit juice, as you mention). But, if you know that getting to food or juice might be a challenge, it may be helpful to think about keeping snacks handy, such as hard candy, in your purse or backpack. That way you can get to it quickly if you need it without any serious disruptions to your day.

Additionally, utilizing strategies, including (but not limited to) chowing down on small, frequent meals throughout the day and making sure those meals are balanced (including proteins, fats, fiber, etc.), can help to keep your blood sugar steady and may curb your low blood sugar issues in general. Since you mention this is an issue you’ve experienced a number of times, it may also be time to see whether there is another condition contributing to the low blood sugar. Repeated episodes of hypoglycemia may lead to a health condition called hypoglycemia unawareness, which occurs when your body and brain no longer produce the symptoms that alert you to your low blood sugar. This increases your risk of life-threatening complications from hypoglycemia, including seizures and coma. Partnering up with a medical professional to investigate and treat a possible underlying cause can address the root of your blood sugar issues and hopefully prevent dips in the future. Depending upon the severity of your episodes, they may advise you to carry a glucagon kit with you, which is an injectable medication used to raise blood sugar in an emergency.

Lastly, because you broached the connection between diabetes and low blood sugar, it bears mentioning that different strategies may be utilized to handle hypoglycemia for those living with diabetes. The insulin taken by individuals with diabetes in order to maintain glucose levels can cause blood sugar levels to drop too low, especially if too much insulin is taken relative to the amount of blood glucose. As such, it's recommended that individuals with diabetes have carbohydrate-rich snacks or glucose tablets at the ready. Those undergoing insulin therapy are also advised to have a glucagon kit with them to replenish blood sugar levels in the event of an emergency. Changes in medication, diet, or physical activity can also cause hypoglycemia in individuals with diabetes. To that end, it’s crucial to find the optimum dosage of medication to fit with each person’s regular dietary and physical activity habits. The Centers for Disease Control and Prevention website, Living with Diabetes, has even more information and great resources about balanced eating for those living with diabetes to help keep blood sugar levels in check.

From your inquiry, it seems that you’d like to put a stop to your sugar lows. Speaking with a health care provider is likely the best way to help inform what actions to take to address individual episodes, determine what's behind your low blood sugar, and work to prevent those shakes once and for all.