Shakes & Sweating With a Drop in Blood Sugar

Shakes and sweating with a drop in blood sugar is a sign of hypoglycemia. It is particularly important for people with diabetes to know the signs of low blood sugar.

Shaking and sweating can signal a number of health conditions, including low blood sugar, or hypoglycemia 12. Hypoglycemia is most common in people with diabetes, according to the Mayo Clinic 1. Here's what you need to know about low blood sugar — and how to manage it.

Symptoms of Low Blood Sugar

Blood sugar, also called glucose, is the body's main source of energy, per the Mayo Clinic 1. The body gets most of its glucose by metabolizing the carbohydrates in food. The hormone insulin helps move glucose out of the bloodstream and into the cells, thereby lowering blood sugar levels. But if blood sugar levels drop too far, hypoglycemia may result 1.

According to the American Diabetes Association (ADA), common symptoms of low blood sugar include 12:

  • Hunger
  • Irritability 
  • Feeling shaky
  • Sweating
  • Lightheadedness
  • Dizziness 
  • Nausea
  • Fatigue

Samar Hafida, MD, an endocrinologist at Harvard's Joslin Diabetes Center, spoke with about why the symptoms of hypoglycemia occur 1. "The brain needs glucose to function," she says. "If blood sugar levels are less than 60 to 70 milligrams per deciliter, the brain starts to panic. It sends many signals to many parts of the body in a fight-or-flight response. This [is called] sympathetic activity, which manifests as hunger, nausea, [feeling] shaky, sweating and weakness. All of these symptoms drive a person to go eat something" — thereby bringing blood sugar levels back up.

However, unless a person has a serious illness or is taking certain kinds of medications (namely, diabetes medications), says Hafida, they can feel the symptoms of hypoglycemia even when their blood sugar level is still within the normal range 12. This is because the body has a number of strong defense mechanisms in place to prevent serious hypoglycemia 1. Therefore, although the symptoms of low blood sugar can feel very unpleasant, most people don't need to worry when they experience them. For people with diabetes, however, the symptoms of hypoglycemia can be a cause for concern 1.

Read more: What Is Type 1 Diabetes?

Low Blood Sugar and Diabetes

People with diabetes have systems that either don't make enough insulin (type 1) or can't use insulin effectively (type 2). Without proper insulin action, excess glucose builds up in the blood, causing high blood sugar, or hyperglycemia, according to the National Institutes of Health 3. To manage this, many people with diabetes take blood sugar-lowering medications such as insulin injections. But taking too much medication (or not eating enough carbs) can cause hypoglycemia 1.

Physical activity can also cause low blood sugar, according to the Joslin Diabetes Center 4. Exercise lowers blood sugar, even for people without diabetes. But for people with diabetes who are taking insulin, the combination of insulin and exercise can lower blood sugar levels too far.

Read more: Advantages and Disadvantages of Exercise

The bottom line is that, in certain circumstances, blood sugar-lowering medications like insulin can remove too much glucose from the blood. If the body doesn't get more glucose (through food), the symptoms of hypoglycemia can become worse 1. According to the Mayo Clinic, signs of severe hypoglycemia include 1:

  • Blurred vision
  • Confusion
  • Slurred speech
  • Seizures
  • Loss of consciousness

In very severe cases, insulin-induced hypoglycemia can be fatal — which is why it's important to treat low blood sugar right away 12.

Treating Hypoglycemia

To treat hypoglycemia, you need to eat what are known as simple or "fast-acting" carbohydrates 1. These are high-sugar foods which will rapidly raise blood sugar levels. The ADA recommends following the "15/15" rule: Eat 15 grams of simple carbs, then wait 15 minutes. (It takes the body about 15 minutes to convert carbs into glucose, thereby raising blood sugars to normal levels.) While you're waiting for the 15 minutes to elapse, you may still experience the symptoms of low blood sugar. Avoid the temptation to rectify the situation by eating more carbs before the 15 minutes is up: By the time all the carbs are digested, your blood sugar levels may be too high.

Per the ADA, here are some of the best simple-carb foods to eat in order to treat low blood sugar:

  • Three or four glucose tablets
  • One glucose gel packet
  • Four ounces (half a cup) of fruit juice
  • One tablespoon of honey or syrup
  • A few hard candies, jellybeans or gumdrops

If your symptoms continue to worsen after repeating the 15/15 process a few times, seek medical attention.

In general, it's advised that people with diabetes who are taking blood sugar-lowering medications always carry a small high-carb snack or beverage with them in case their blood sugar levels get low.

If you have diabetes and regularly experience hypoglycemia, contact your diabetes care team 1. You may need to make adjustments to your diet, exercise routine and/or medication. Never change your medication without consulting your doctor.

Other Causes of Low Blood Sugar

In rare instances, hypoglycemia can be caused by medical conditions other than diabetes, according to 15. These include critical illnesses (particularly those affecting the liver, heart or kidneys), hormonal imbalances or a rare pancreatic tumor called an insulinoma. Excessive alcohol consumption, stomach surgery and certain medications (such as the sulfa class of antibiotics) can also cause low blood sugar.

The Wrap Up

If the body doesn't get more glucose (through food), the symptoms of hypoglycemia can become worse 1. To treat hypoglycemia, you need to eat what are known as simple or "fast-acting" carbohydrates 1. But taking too much medication (or not eating enough carbs) can cause hypoglycemia 1.