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Understanding Hyperglycemia vs. Hypoglycemia and How to Recognize the Differences

Madison Holt, MS, RDN, LD

Published in Health & Wellness

6 min read

September 27, 2021
trio of people and a glucose monitor
trio of people and a glucose monitor

When monitoring your blood sugar, think of “Goldilocks and the Three Bears.”

Blood sugar, or glucose, levels that are too high could lead to “hyperglycemia,” blood sugar levels dipping too low could lead to “hypoglycemia.”

The key to avoiding both is to find the Goldilocks balance, otherwise, it could lead to many problems. Understanding the differences between hyperglycemia and hypoglycemia as well as how they work should not only encourage a healthier lifestyle but also create a better mood.

Online discussions about the two sugar levels have created misconceptions and confusion about the differences and what causes them. 

This topic isn’t isolated to people with diabetes. Anyone can experience hypoglycemia and hyperglycemia, and this is where non-diabetic glucose monitoring can come in handy to help you identify when these spikes and dips occur.

To understand why blood sugar fluctuations are important to be aware of, let's discuss what they are and the differences between the two.

a glucose monitor in the middle of the picture, veggies an fruits on the left and cookies and candies n the right

What is Hypoglycemia?

Hypoglycemia, or low blood sugar, occurs when glucose levels drop below healthy levels in the bloodstream.  This can be especially troubling for those with diabetes and can prevent their bodies from getting the glucose they need.

According to the Centers for Disease Control and Prevention, glucose is necessary to supply the body’s red blood cells with energy and reduce the chances of long-term risks of experiencing severe health problems, such as heart disease, vision loss, and kidney disease

So how do you avoid those unwanted side effects? The answer is maintaining a healthy glucose level, but that level can vary depending on your situation.

Common Signs and Symptoms of Hypoglycemia

For those with diabetes, glucose levels falling below 70 are considered low. For those without diabetes, glucose levels below 55 with hypoglycemic symptoms are considered dangerous. Symptoms to monitor for include:

  • Hunger
  • Irritability
  • Blurred vision
  • Pale skin
  • Weakness
  • Shakiness
  • Excess sweating
  • Lightheadedness/dizziness
  • Anxiety
  • Confusion
  • Difficulty speaking
  • Headaches

Why Hypoglycemia Occurs in People without Diabetes

Yes, people without diabetes can experience hypoglycemia in two different instances.

The first is reactive hypoglycemia, which occurs when blood sugar levels drop in the hours following a meal and can be an early sign of diabetes.

The second is fasting hypoglycemia. This occurs when you are refraining from eating or when you’re sleeping. Several factors can cause this, including some medications like Beta-blockers or some antibiotics, excess alcohol, hypocortisolism, hypothyroidism, pregnancy, menopause, pancreatic tumors, and anorexia.

Those who suffer from obesity, those who are prediabetic, have a family history of diabetes, or have a genetic predisposition for diabetes are at risk for non-diabetic hypoglycemia. Using a CGM without diabetes can help you determine what lifestyle habits may contribute to hypoglycemia so that you can make educated choices about your well-being.

Why Hypoglycemia Occurs in People with Diabetes

Hypoglycemia commonly occurs in people with diabetes if they take too much insulin.  This is especially common in Type 1 diabetes. However, anything that reduces the bodily intake of sugar can cause hypoglycemia.

According to the CDC, this includes not eating enough carbohydrates, drinking alcohol, or excessive physical activity without adjusting medications.

Ways to Prevent Hypoglycemia 

There’s a lot you can do to stave off the effects of hypoglycemia.

Understand Your Current Medication's Impact On Your Blood Sugar Levels

As mentioned previously, certain medications can reduce blood sugar levels. If you’re using insulin, Beta-blockers, or ACE/inhibitors, talk to your doctor about these medications. 

Compensate for Increases in Physical Activity / Working Out

Physical activity is crucial in maintaining a healthy body, and the more you do it, the more energy you burn. That means less glucose for your body. However, the catch-22 is less exercise means more available glucose. So if you are planning on exercising more, be sure to increase the number of meals or food you eat, as well.

Regularly Monitor Your Blood Glucose Levels

Of course, none of this is effective unless you’re keeping an eye on your glucose levels. Using a CGM, you can directly see which foods have the greatest impact on you and which ones you could cut out. In recent years continuous glucose monitoring technology has improved significantly. Plus, they’re pretty easy to use. Read more about the four best CGMs at Nutrisense.  

Avoid Refined Carbohydrates

Reactive hypoglycemia can occur when people eat too much sugar or starch, such as candy, chips, or bread, and their pancreas overcompensates by pumping out too much insulin, which plummets their blood sugar below healthy levels and causes the symptoms of low blood sugar. Choosing balanced meals instead, such as those containing protein, fat, and complex carbohydrates, can help lead to an even glucose response. 

a graph showing declining sugar consumption

What is Hyperglycemia?

Hyperglycemia, otherwise known as high blood glucose, occurs when too much sugar is in the bloodstream. Insulin is the body’s janitor for sweeping up and disposing of glucose from the bloodstream. Hyperglycemia occurs most commonly when there is a lazy janitor problem and the janitor is around but not doing their job or doing it poorly. 

Common Signs and Symptoms of Hyperglycemia

Hyperglycemia can lead to severe long-term health problems. Here are some of the most common signs and symptoms are according to the CDC:

  • Thirst
  • Frequent urination
  • Blurry vision
  • Headaches and brain fog
  • Increased cravings for carbs and sweets
  • “Hanger”
  • Poor energy levels or midday crashes
  • Fatigue
  • Unintentional weight loss
  • Slow-healing cuts

Why Hyperglycemia Occurs in People without Diabetes

Just like with hypoglycemia, anybody can experience hyperglycemia, not just diabetics.

Blood sugar measuring higher than 200 mg/dl is considered too much glucose in the bloodstream. It’s not uncommon for people to experience high blood sugar levels at some point during the day.

Researchers found that 93% of individuals reached dangerous glucose levels, with 10% of that sample spending two hours a day at that level.

A glucose spike can happen for any number of reasons, including high-intensity exercise and stress. Foods like artificial sweeteners and coffee could play a role, as well.   

Why Hyperglycemia Occurs in People with Diabetes

As mentioned before, different foods and high-intensity exercise can trigger hyperglycemia in a person with diabetes. In the case of type 1 diabetics, the body can’t increase its insulin level during a glucose spike.

How to Prevent Hyperglycemia

Exercising Regularly

Maintaining a healthy amount of exercise can help keep hyperglycemia at bay. Regular exercise encourages your body to burn more energy than usual, and therefore consume more glucose.

Improve Your Diet to be Glucose-Friendly

Improving your diet to be more glucose-friendly can be a great way to keep your blood sugar balanced. One way to do that is to avoid processed foods. While food impacts will vary from person to person, research indicates processed foods high in sugar and fat can increase blood glucose. Also, the frequency at which you eat could have an impact. A 2013 study found that eating two large meals per day compared to six small meals did more to reduce blood glucose.

Maintain a Healthy Weight

Maintaining a healthy weight is crucial. One cause of hyperglycemia can also be unintentional, rapid weight loss. According to the American Diabetes Association, if you’re aiming to lose weight, be sure to establish a routine that you can stick to. That way, your body can lose weight without any unintended stress.

Take Your Medications Regularly

Be aware of what medications you’re putting in your body. Some medications can disrupt insulin’s effectiveness. Medications like steroids and beta-blockers are the usual suspects. Second-generation antipsychotics and certain antibiotics can also be high-blood-sugar inducing culprits. 

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Engage with Your Blood Glucose Levels with Nutrisense

Your blood sugar levels can significantly impact how your body feels and functions. That’s why stable blood glucose levels can be an important factor in supporting overall wellbeing.

With Nutrisense, you’ll be able to track your blood glucose levels over time using a CGM, so you can make lifestyle choices that support healthy living.

When you join the Nutrisense CGM program, our team of credentialed dietitians and nutritionists are available for additional support and guidance to help you reach your goals.

Ready to take the first step? Start with our quiz to see how Nutrisense can support your health.

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Kara Collier, RDN, LDN, CNSC

Reviewed by: Kara Collier, RDN, LDN, CNSC

Kara Collier is the co-founder and VP of Health at Nutrisense, one of America’s fastest-growing wellness-tech startups, where she leads the health team. She is a Forbes 30 under 30 recipient, frequent podcast guest & conference speaker.

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