There are many stories circulating online about how embarrassing low blood sugar can be, such as kneeling in a store to beg for food, snatching candy from a kid, or fainting from hunger while waiting for a meal and scaring the boss...

Isn't this a bit of an exaggeration? Can't you really wait even half a minute to eat?

True low blood sugar is indeed an emergency that requires immediate treatment. However, many of the descriptions circulating online are likely not actually cases of low blood sugar, and the treatment methods mentioned are also inappropriate.

Let's take a look at some common misunderstandings about low blood sugar, such as the belief that all low blood sugar is caused by hunger, that it's embarrassing but not life-threatening, that feeling dizzy when standing up is low blood sugar, that fainting on the subway in the morning is low blood sugar, and that you should feed people with low blood sugar chocolate and drinks.

If you have low blood sugar, will you definitely feel extremely hungry first?

Many of the embarrassing descriptions of low blood sugar focus on the urgent need to eat, and most people who experience low blood sugar also feel extremely hungry.

However, when low blood sugar first starts, the initial symptoms may not be hunger but rather these: dizziness, weakness, trembling hands, sweating, nausea, palpitations, anxiety, and pale complexion.

Because the feeling of hunger is not obvious, some people may mistake these symptoms for general weakness or high stress. They only realize it's low blood sugar after accidentally finding that eating makes them feel better. If you frequently experience the symptoms mentioned above and they are related to eating, you can check your blood sugar when you feel uncomfortable and consult a doctor.

Of course, conversely, feeling extremely hungry doesn't necessarily mean you have low blood sugar. To be considered a low blood sugar reaction, you need to have symptoms such as hunger, dizziness, and fatigue, along with a blood sugar level below normal or an improvement in symptoms after eating.

Low blood sugar is embarrassing but not life-threatening?

When low blood sugar first occurs, the above symptoms may appear due to sympathetic nerve excitement. These discomforts themselves are not fatal, but they may lead to accidents such as falls.

If not treated in time and it develops into severe long-term low blood sugar, the brain may also "shut down" due to lack of sugar, resulting in blurred vision, abnormal behavior, coma, epileptic seizures, permanent brain damage, and even death.

Among these, abnormal behavior is easily misunderstood. In fact, some patients with low blood sugar have been mistakenly sent to psychiatric hospitals. For diabetic patients, if they suddenly exhibit behavior different from their usual selves, such as talking nonsense or shouting, it's necessary to check their blood sugar in a timely manner, as their blood sugar may have dropped to a dangerous level.

If your blood sugar level is measured as low, does it mean you have low blood sugar?

Strictly speaking, the term "low blood sugar" simply refers to an abnormally low blood sugar value. For people without diabetes, a blood sugar level < 2.8 mmol/L is considered low blood sugar. For diabetic patients receiving drug treatment, a blood sugar level < 3.9 mmol/L can be diagnosed as low blood sugar.

What we usually call "having an episode of low blood sugar" that makes people feel uncomfortable is medically known as "hypoglycemia," which means not only a low blood sugar level but also the presence of discomforts related to low blood sugar.

A low blood sugar reaction is not entirely the same as hypoglycemia. Generally, the lower the blood sugar level and the faster the decline, the more obvious the symptoms. In rare cases, people who meet the criteria for low blood sugar may not feel any discomfort (which is even more dangerous). Conversely, symptoms may also occur when the blood sugar value is higher than this standard, especially in diabetic patients.

I often hear people say they've had an episode of low blood sugar. Is it very common?

Among diabetic patients, hypoglycemia is indeed relatively common. Patients with type 1 diabetes experience hypoglycemia about twice a week on average, and have 1 - 1.7 serious hypoglycemic events per year that require assistance from others. The incidence is lower in patients with type 2 diabetes, but the risk significantly increases in the later stages.

However, for people without diabetes, hypoglycemia is not common. Its exact incidence is difficult to统计. Some studies show that the incidence among hospitalized patients is 0.36%. Some of the descriptions of low blood sugar episodes circulating online are likely not actually cases of true hypoglycemia but rather manifestations of other problems.

If you feel dizzy when you stand up, it must be low blood sugar, right?

Many netizens describe their "low blood sugar" by saying that they feel dizzy and see stars for a few seconds, or even faint directly, when suddenly standing up from a squatting, sitting, or lying position.

Low blood sugar can cause dizziness, but the discomfort of low blood sugar usually appears and worsens gradually. It's less likely to cause an immediate faint and is often accompanied by other symptoms such as hunger, sweating, and trembling hands. The symptoms last for a relatively long time and usually improve after consuming sugar.

If the discomfort occurs every time you suddenly stand up, and you experience dizziness, blackouts, or fainting within a few seconds of standing up and feel better within a few seconds of sitting down, it's more likely that you have orthostatic hypotension.

This is usually due to a disorder in the autonomic nerve regulation function. When you stand up, blood pools in your legs, reducing the amount of blood returning to the heart, causing a temporary drop in blood pressure and insufficient blood supply to the brain. Anemia, certain medications, and dehydration are also related to orthostatic hypotension.

Fainting on the subway on the way to work in the morning, is it an episode of low blood sugar?

Many people have had this experience: the subway is stuffy and crowded during the morning commute. After standing for a long time, they feel dizzy, nauseous, break out in a cold sweat, have blurred vision, and some may even faint. Thinking they skipped breakfast, they wonder if it's an episode of low blood sugar.

This situation could be low blood sugar, or it could be neurally mediated syncope, which is caused by abnormal neural regulation leading to temporary insufficient blood supply to the brain. Fainting when seeing a needle, blood, in pain, or when extremely nervous is also likely neurally mediated syncope.

Another cause of fainting is cardiogenic syncope, which is more common in the elderly and is caused by a decrease in the heart's pumping volume due to arrhythmia or cardiovascular disease.

If you've fainted several times and don't know the cause, it's recommended to go to the hospital to rule out serious diseases.

Are all cases of hypoglycemia caused by hunger?

For people without diabetes, hypoglycemia may occur when they've been hungry for too long, or it may occur after eating, especially 2 - 4 hours after consuming a large amount of carbohydrates that can quickly raise blood sugar or after heavy drinking. This special phenomenon is also known as reactive hypoglycemia. Its cause is mostly a mismatch between insulin secretion levels and blood sugar, and it is usually a clinical manifestation in the early stages of type 2 diabetes, so it should be taken more seriously.

Other triggers for hypoglycemia include fasting or long - term exercise, certain medications, post - gastric surgery, tumors such as insulinomas, glycogen storage diseases, severe liver and kidney diseases, and infections.

Diabetic patients are more prone to hypoglycemia, and the triggers include improper coordination between medications, diet, and exercise, vomiting and diarrhea, drinking alcohol, and significant weight loss.

Is chocolate the most effective thing to eat when you have an episode of low blood sugar?

If a person with low blood sugar is conscious and can swallow, they can first eat or drink something on their own to correct the low blood sugar. At this time, try to choose foods that can quickly raise blood sugar, that is, fast - absorbing sugars, preferably without fat and protein.

The most ideal choice is to eat glucose tablets. If not available, you can choose regular sugar or sugary drinks (don't choose "sugar - free," "zero - calorie," or "no - calorie" options). A less ideal choice is high - sugar fruits or high - carbohydrate foods such as biscuits and steamed buns. Chocolate has a relatively high fat content and is not the fastest food to raise blood sugar.

It's important to note that when a person with low blood sugar can't eat on their own, you should immediately call the emergency number. Don't force - feed them food or water, as this may cause choking or suffocation.

How much should you eat or drink to improve low blood sugar?

You can first eat or drink an amount equivalent to 15 - 20 grams of glucose. How much is 15 grams of glucose? It's approximately 2 sugar cubes, 150 milliliters of cola, or 150 - 300 milliliters of other sugary drinks.

For mild cases of low blood sugar, the symptoms usually improve within 15 - 20 minutes after eating or drinking. After the symptoms improve, you can continue to eat some snacks or have a meal to prevent another episode. If there is no improvement after eating, you should be sent to the hospital as soon as possible.

After a diabetic patient experiences low blood sugar, they should check their blood sugar 15 minutes after eating. If necessary, they should supplement food again until their blood sugar returns to normal. If the low blood sugar is related to hypoglycemic medications, they may need to eat more food or have a meal according to the duration of the drug's effect and check their blood sugar until it reaches the normal value.

Can eating well prevent low blood sugar?

If you don't have diabetes and there are no other diseases or medications that cause low blood sugar, eating small, frequent meals, having snacks between main meals, avoiding fasting exercise, avoiding a large intake of high - sugar foods at once, and avoiding heavy drinking can help prevent episodes of low blood sugar.

Diabetic patients taking hypoglycemic medications need to consult their doctor on how to prevent low blood sugar. They may also need to adjust their drug treatment plan and loosen their blood sugar control targets.

Can't low blood sugar occur while you're asleep?

Low blood sugar can also occur during sleep at night, usually in diabetic patients, and is related to eating less in the evening, excessive exercise, drinking alcohol, and medications.

A nocturnal episode of low blood sugar may not wake a person up immediately. It may only manifest as sweating a lot, having a headache, feeling weak, and having nightmares when waking up in the morning.

If you suspect that you have episodes of low blood sugar during sleep, consult your doctor to see if you need to be tested and adjust your treatment plan.

Hypoglycemia is not rare, and it doesn't mean it won't occur just because you eat well. It can not only be embarrassing but also potentially life - threatening.

Learning a little more about low blood sugar may help you reduce uncomfortable episodes, detect potential diseases, and provide help to those around you at a critical moment. A piece of candy or an emergency call could save someone from falling into the abyss.