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9. Slurred speech

You may not notice if your speech becomes slurred due to low blood sugar, which will make it even more annoying when someone asks if you’ve been drinking. If you find you can’t get your words out clearly, or other people accuse you of slurred or confused speech, it’s time to check the glucose meter.

10. Trouble Sleeping Or Disturbed Sleep

Blood sugar dips are, unfortunately, common among people with diabetes. They can cause nighttime sweating, nightmares, crying out in the night, and confusion upon waking. Oh, and obviously, very poor sleep quality. Some find it helpful to have a snack before bed to help keep blood sugar in range.

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11. Blurry vision

Double-vision or blurry vision can be caused by low blood sugar, so test your numbers, even if you have to get someone else to read the number.

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12. Rapid or irregular heartbeat

If your heartbeat seems fast, irregular, or too strong for the occasion, you may be low. If you have a fitness tracker that checks heartbeat, you can learn what’s normal for you at rest. If you don’t have a way of checking your heart rate automatically you can practice taking your pulse by laying two fingers on your neck just under the corner of your jawline. Count the number of beats in 10 seconds and then multiply by six to get the number of beats in a minute. Though, if you are experiencing a hypo, that can be a difficult task—better to just check your meter.

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13. Shaking/tremors

Low glucose levels throw off your central nervous system, prompting the release of catecholamines, a hormone that encourages glucose production but can also cause shaking. Catecholamines can also cause shaking in other stressful situations.

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14. Loss of consciousness

Finally, when low blood glucose levels become too severe, you can lose consciousness and slip into coma or seizure. At that point, someone should call 911 immediately. This is where a medical ID bracelet and friends who know what to do in case of an emergency can be a literal lifesaver!

Hypoglycemia unawareness

If your body gets used to hypoglycemic episodes, it may no longer display symptoms or it may display less severe symptoms. This is referred to as hypoglycemia unawareness. Hypoglycemia is still dangerous even if your body no longer responds to it, and without the warning signs of low blood sugar, the risk of insulin shock or serious repercussions increases. It’s not safe to assume your blood sugar levels are fine just because you feel fine—get into the habit of checking levels regularly to stay safe.

Talk to your doctor about how to be prepared in case of a low, and talk to friends and family about how to help when your blood sugar drops. If you suspect you’re experiencing a low, avoid driving or putting yourself in a potentially dangerous situation until your levels are in your target range.

Stay healthy, friends!