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Category: Diabetes Education
Hypoglycemia (low blood sugar) symptoms: how to feel safer and prevent lows
When James woke up, he didn’t notice the usual signs of low glucose—just a heavy fatigue. Then, his FreeStyle Libre 3 system alarm* went off. “I was able to take immediate corrective action and avoid a tragic outcome,” James said1.
If you’ve experienced a worrisome hypoglycemia episode, you’re not alone2. “Hypos” can feel uncomfortable and embarrassing3, impacting work, sleep, relationships, and confidence in daily life4,5.
Fear of hypoglycemia can even lead some people with diabetes to run their glucose levels a bit high, just to avoid the risk of going low6—despite the health risks of high glucose7.
Continuous glucose monitoring (CGM) can help. With Libre systems, spend less time in low glucose (<70 mg/dL), both during the day and at night†8–9, and be notified the minute your glucose is too low*.
What is hypoglycemia—and what causes it?
Hypoglycemia is when your glucose levels drop below your target range—usually below 70 mg/dL (3.9 mmol/L)10. It’s important to pay attention to early symptoms, though not everyone feels them at this level10.
Glucose levels below 54 mg/dL (3.0 mmol/L) can be dangerous10. Be sure to talk to your healthcare provider about your appropriate target range11.
Here are some reasons lows can happen—even when you’re doing your best:
- Skipping or delaying meals12
- Eating less than usual or cutting back on carbs without reducing insulin treatment13
- Physical activity, if you don’t have enough fuel. Lows can happen during activity or even hours later14,15
Recognizing the symptoms of hypoglycemia
Spotting early signs can help you catch lows and prevent them from becoming more serious.
Potential hypoglycemia symptoms include16:
- Sweating, chills, or clamminess
- Irritability or confusion
- Hunger or nausea
- Feeling sleepy, weak, or losing energy
- Tingling or numbness in the lips, tongue, or cheeks
- Shakiness or dizziness
The following signs and symptoms could indicate more severe hypoglycemia17:
- Confusion or unusual behavior
- Poor coordination
- Slurred speech
- Blurred vision
- Seizures
- Loss of consciousness
Over time, repeated lows can lead to a risky condition called hypoglycemia unawareness, where you no longer feel the signs and symptoms of low glucose17.
CGMs such as Libre systems can help, as they track your glucose in real time, all day long‡ and offer optional alarms* that help you know when to take action.
Understanding overnight lows
Have you ever woken up drenched in sweat, felt groggy, or disoriented?
It could be nocturnal hypoglycemia—the low glucose episodes that happen while you’re asleep18.
Symptoms of nocturnal hypoglycemia include18:
- Nightmares
- Trembling or shaking
- Changes in breathing
- Racing heartbeat
A few reasons your glucose might drop overnight18:
- Skipped meals
- Exercise before bedtime
- Alcohol before bedtime
- Infections
With optional low-glucose alarms*, Libre systems help you take action early, even when you’re sleeping19,20.
How to prevent hypoglycemia: proactive ideas
Every hypo is an opportunity to learn how your body responds. And that knowledge? That’s progress.
Before making any changes to your routine, always consult your healthcare provider.
Get to know your low signs.
When you know how a low feels for you, it could be easier to catch it early next time13. But you can’t rely on your physical symptoms alone to detect lows17.
Libre systems offer real-time glucose alarms* that let you know when to take action19,20.
Check in at the moments that matter13.
Frequent glucose checks can mean a lower risk of low glucose13.
Libre systems offer minute-by-minute readings of glucose levels, with trend arrows that show where your glucose is heading19,20.
Good times to check your glucose13:
- Before meals and a couple of hours after eating21
- Before and after being active
- Before bed
- Overnight—especially after a busy or active day
- If you have had alcohol22
See your personalized trends and patterns.
With Libre systems, easily see patterns in your readings to learn how food, activity, and insulin impact your glucose§23.
Stay steady with meals.
Eating on a regular basis helps ensure your body has enough glucose12. Try pairing carbs with protein or fat to keep your glucose levels steadier14,21.
Snacks have your back.
A little juice, candy, or a glucose tab can help if your glucose drops. Keep some stashed in your bag, desk, or nightstand—just in case12.
Proactive hypoglycemia self-care isn’t about perfection. It’s about knowing your patterns, using your tools, and feeling ready to respond.
With Libre systems, you don’t have to navigate hypos alone.
Choose the #1 prescribed CGM in the US||—FreeStyle Libre systems.
Learn more about Libre systems today.
CGM = continuous glucose monitor(ing)
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Try Libre Assist¶—a new feature only in the Libre app#.
Make in-the-moment food choices.
The FreeStyle Libre 3 Plus sensor, along with Libre Assist¶, can help you predict the impact of food on your glucose**.
Predict.
Libre Assist¶ predicts how your food can impact glucose**.
Know.
Get personalized food suggestions†† to help lower glucose impact.
Want to try Libre systems and see how it works for yourself?
Request a free♢ sensor now.
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The views expressed should not be used for medical diagnosis or treatment or as a substitute for professional medical advice. Individual symptoms, situations and circumstances may vary.
The FreeStyle Libre 3 system includes the Libre 3 Plus sensor, Libre 3 sensor, Libre 3 app, Libre app, and the Libre 3 reader.
The FreeStyle Libre 2 system includes the Libre 2 Plus sensor, Libre 2 sensor, Libre 2 app, Libre app, and the Libre 2 reader.
FreeStyle Libre 3 system is cleared to be used by children 4 years and older with Libre 3 sensor and 2 years and older with Libre 3 Plus sensor.
FreeStyle Libre 2 system is cleared to be used by children 4 years and older with Libre 2 sensor and 2 years and older with Libre 2 Plus sensor.
Medicare and other payor criteria may apply.
* Alarm notifications will only be received when alarm settings are enabled and turned on and sensor is within 20 feet (FreeStyle Libre 2) or 33 feet (FreeStyle Libre 3) unobstructed of the reading device.
† Study was performed with the outside US version of the FreeStyle Libre 14 day system. Data is applicable to FreeStyle Libre 2 and FreeStyle Libre 3 systems, as feature sets are similar as FreeStyle Libre 14 day system, excluding alarms.
‡ 60-minute warm-up required when applying the sensor.
§ Study was performed with the US version of the FreeStyle Libre 14 day system. Data is applicable to FreeStyle Libre 2 and FreeStyle Libre 3 systems, as feature sets are similar as FreeStyle Libre 14 day system, excluding alarms.
|| Based on retail and durable medical equipment sales data for patient’s last-filled prescription, by manufacturer.
¶ Libre Assist is a feature within Libre app that uses generative artificial intelligence to provide information on how foods could impact your glucose levels. Generative artificial intelligence may not always be accurate, and it should not be used to make treatment decisions.
# The FreeStyle Libre systems apps are only compatible with certain mobile devices and operating systems. Please check the Support section of our website for more information about device compatibility before using the apps. Use of the FreeStyle Libre systems apps may require registration with LibreView.
** Predicted glucose impact is based on user-provided food data and may differ from actual impact, which depends on sensor readings and factors like activity, stress, medication, and alcohol. For personalized advice, consult your healthcare provider.
†† Personalized food suggestions are based on food preference information inputted by the user.
♢ Eligible patients will receive one (1) FreeStyle Libre 3 Plus sensor for users with a compatible mobile phone operating system at $0 copay. The expiration date of the voucher is 60 days from the issue date. This program is available for patients with Type 1 diabetes or Type 2 diabetes or gestational diabetes. Patients ages 18 and older are eligible to sign up and receive an offer for the (1) FreeStyle Libre 3 Plus sensor. Patients ages 2–17 are eligible to receive an offer for the (1) FreeStyle Libre 3 Plus sensor through their parent or guardian. This offer is void where prohibited by law. Abbott may modify or rescind this offer at any time without notice. The discounts are not available to beneficiaries of Kaiser Permanente, Medicaid, TRICARE, Veteran Affairs or other state healthcare programs, residents of Massachusetts, or US territories (other than Puerto Rico). The free (1) FreeStyle Libre 3 Plus sensor is provided as a sample and is limited to one sample per eligible person per product identification number. The FreeStyle Libre 3 Plus sensor cannot be re-sold, traded nor submitted to any third-party payer for reimbursement and is not provided as any inducement for future purchases. The free sample card is not health insurance
References: 1. Abbott FreeStyle Libre. User Generated Content. 2. American Diabetes Association. “Severe Hypoglycemia (Severe Low Blood Glucose).” Accessed March 23, 2026. https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/severe. 3. Polonsky, William H., Susan J. Guzman, and Lawrence Fisher. “The Hypoglycemic Fear Syndrome: Understanding and Addressing This Common Clinical Problem in Adults with Diabetes.” Clinical Diabetes 41, no. 4 (2023): 502–509. https://doi.org/10.2337/cd22-0131. 4. Chatwin, Hannah, et al. “‘Never Again Will I Be Carefree’: A Qualitative Study of the Impact of Hypoglycemia on Quality of Life Among Adults With Type 1 Diabetes.” BMJ Open Diabetes Research & Care 9 (2021): e002322. https://drc.bmj.com/content/9/1/e002322. 5. Wu, Chao, et al. “The Influence of Hypoglycemia on the Specific Quality of Life in Type 2 Diabetes Mellitus: A Comparative Cross-Sectional Study of Diabetics With and Without Hypoglycemia in Xi’an, China.” Health and Quality of Life Outcomes 19 (2021): 151. https://doi.org/10.1186/s12955-021-01790-0. 6. Przezak, Agnieszka, Weronika Bielka, Piotr Molęda. “Fear of Hypoglycemia—An Underestimated Problem.” Brain and Behavior 12, no. 7 (2022): e2633. https://doi.org/10.1002/brb3.2633. 7. Cleveland Clinic. “Hyperglycemia (High Blood Sugar).” Accessed March 23, 2026. https://my.clevelandclinic.org/health/diseases/9815-hyperglycemia-high-blood-sugar. 8. Haak, Thomas, et al. “Flash Glucose-Sensing Technology as a Replacement for Blood Glucose Monitoring for the Management of Insulin-Treated Type 2 Diabetes: A Multicenter, Open-Label Randomized Controlled Trial.” Diabetes Therapy 8 (2017): 55–73. https://doi.org/10.1007/s13300-016-0223-6. 9. Bolinder, Jan, et al. “Novel Glucose-Sensing Technology and Hypoglycaemia in Type 1 Diabetes: A Multicentre, Non-Masked, Randomised Controlled Trial.” The Lancet 388, no. 10057 (2016): 2254–2263. https://doi.org/10.1016/S0140-6736(16)31535-5. 10. American Diabetes Association Professional Practice Committee for Diabetes. “6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes—2026.” Diabetes Care 49, suppl. 1 (2026): S132–S149. https://doi.org/10.2337/dc26-S006. 11. Battelino, Tadej, et al. “Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range.” Diabetes Care 42, no. 8 (2019): 1593–1603. https://doi.org/10.2337/dci19-0028. 12. Johns Hopkins Medicine. “Hypoglycemia (Low Blood Sugar).” Accessed March 23, 2026. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/hypoglycemia-low-blood-sugar. 13. American Diabetes Association. “Causes and How to Prevent Hypoglycemia (Low Blood Glucose).” Accessed March 23, 2026. https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/causes-prevention. 14. Nakhleh, Afif, and Naim Shehadeh. “Hypoglycemia in Diabetes: An Update on Pathophysiology, Treatment, and Prevention.” World Journal of Diabetes 12, no. 12 (2021): 2036–2049. https://doi.org/10.4239/wjd.v12.i12.2036. 15. American Diabetes Association. “Blood Glucose and Exercise.” Accessed March 23, 2026. https://diabetes.org/health-wellness/fitness/blood-glucose-and-exercise. 16. American Diabetes Association. “Signs, Symptoms, and Treatment for Hypoglycemia (Low Blood Glucose).” Accessed March 23, 2026. https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/symptoms-treatment. 17. Mayo Clinic Staff. “Hypoglycemia.” Mayo Clinic. Accessed March 23, 2026. https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685. 18. Johns Hopkins Medicine. “Hypoglycemia: Nocturnal.” Accessed March 23, 2026. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/hypoglycemia-nocturnal. 19. FreeStyle Libre 2 User’s Manual. 20. FreeStyle Libre 3 User’s Manual. 21. American Diabetes Association. “Good to Know: Continuous Glucose Monitoring and Nutrition.” Clinical Diabetes 42, no. 3 (2024): 463. https://doi.org/10.2337/cd24-pe03. 22. American Diabetes Association. “Alcohol and Diabetes.” Accessed March 23, 2026. https://diabetes.org/health-wellness/alcohol-and-diabetes. 23. Unger, Jeff, Paul Kushner, and John E. Anderson. “Practical Guidance for Using the FreeStyle Libre Flash Continuous Glucose Monitoring in Primary Care.” Postgraduate Medicine 132, no. 4 (2020): 305–313. https://doi.org/10.1080/00325481.2020.1744393.
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