Severe Hypoglycemia: Causes, Risks, and What to Do When Blood Sugar Drops Dangerously Low

When your blood sugar drops too low—below 54 mg/dL—it’s not just feeling shaky or dizzy. Severe hypoglycemia, a life-threatening drop in blood glucose that impairs brain function and requires outside help to treat. Also known as insulin reaction, it can lead to seizures, loss of consciousness, or even death if not treated fast. This isn’t just a problem for people with type 1 diabetes. People with type 2 on insulin or certain pills can also hit this point, especially if they skip meals, over-exercise, or take too much medication.

Insulin, a hormone that moves glucose from the blood into cells for energy is the main culprit when things go wrong. Too much insulin, or not enough food to balance it, causes glucose levels to crash. Glucagon, a hormone that signals the liver to release stored sugar is the body’s natural fix—but in severe cases, your body can’t produce enough, or you’re too confused to eat or drink. That’s when someone else has to step in with a glucagon injection or emergency glucose gel. Many people with diabetes carry glucagon kits for this exact reason.

Severe hypoglycemia doesn’t always come with warning signs. Some people develop hypoglycemia unawareness, where their body stops sending the usual signals like sweating, trembling, or hunger. This is dangerous because they don’t realize they’re in trouble until it’s too late. It’s more common in people who’ve had diabetes for years or who frequently experience low blood sugar. Monitoring with a continuous glucose monitor (CGM) can help catch drops before they become emergencies.

It’s not just about medication. Alcohol, especially on an empty stomach, can block the liver from releasing glucose. Certain heart meds like atenolol, a beta-blocker that masks symptoms of low blood sugar, make it harder to tell when your glucose is dropping. Even skipping a meal after taking diabetes meds can trigger a crash. And if you’re sick, your body’s glucose needs change—yet many people keep taking the same dose.

What you’ll find in the posts below are real, practical stories and guides from people who’ve dealt with this. You’ll learn how to spot the early signs before it turns critical, how to help someone who’s passed out from low blood sugar, why some meds make it worse, and how to prevent repeat episodes. There’s no fluff—just clear advice on what works, what doesn’t, and what to keep on hand in your medicine cabinet or purse. Whether you live with diabetes, care for someone who does, or just want to understand what happens when blood sugar crashes, this collection gives you the tools to act fast—and stay safe.