Since proper management of diabetes involves keeping an eye on blood sugar levels, most diabetics are at least aware of the need to keep their blood sugar from being too high or too low.
Many different problems can come about when blood sugar is either too low or high, and while many diabetics may know some of those problems, others – like seizures – may not be as well known. Here is how hypoglycemia can cause seizures and the best ways to detect and prevent this problem.
What is Hypoglycemia?
Hypoglycemia is also known as low blood sugar. [1] Your blood sugar is the amount of glucose in your blood. Glucose in the blood is what gives you energy and keeps various organs functioning. If you have too little glucose in your blood, you won’t be able to do various tasks as well as you can when your blood glucose is at a normal level. [2]
What is considered a low blood sugar level can vary from person to person. For most people, blood glucose levels at or lower than 70 milligrams per deciliter (mg/dL) or 3.9 millimoles per liter (mmol/L) are considered to be hypoglycemic levels. But low readings may be different in your case, and it’s important to ask your doctor what readings are considered too low for you. [3]
Can Hypoglycemia Cause Seizures?
Hypoglycemia can cause a variety of physical symptoms. Most of those symptoms are not particularly serious, like dizziness or fatigue. But if you don’t treat low blood sugar and let your blood glucose level continue to drop, more serious symptoms can result, such as seizures. [4] One study found that 25 percent of diabetics had had a seizure at some point in their lives and that they were even more common in those who had experienced diabetic ketoacidosis. [5]
Seizures from low blood sugar have been noted ever since insulin was first administered to diabetics. (Once dextrose, a type of sugar, was administered, the seizures usually stopped.) For a time in the 40s to the 60s, hypoglycemic seizures were even deliberately induced in the belief that seizures could treat psychiatric conditions. [6]
Not all seizures in diabetics should be considered a result of low blood sugar; epilepsy occurs in diabetic populations as often as in non-diabetic ones. But if a diabetic person has a seizure and there appears to be no obvious cause, hypoglycemia should be considered as one possible reason.
What to do If I have Hypo with Diabetes?
Even someone with the best and most careful handling of their diabetes can still suffer from hypoglycemia. If the diabetic is on a continuous blood glucose monitoring system (CGM), they can set the system up so it alerts them when their blood glucose goes below whatever level their doctor considers to be safe. [7]
If the person in question does not have a CGM, they can still monitor their blood sugar by periodic finger prick tests to see if it has dipped below the safe level.
Since finger prick tests only show blood sugar at that moment, it is also important to know the signs of low blood sugar. These include:
- Sweating
- Skin paleness
- Hunger
- Blurred or impaired vision
- Headache
- Dizziness
- Increased pulse
- Fatigue
- Trouble concentrating [8]
If a diabetic is experiencing any of these symptoms, they should test their blood sugar right away. If it is low, they should immediately treat it. This is usually done by eating or drinking a fast-acting carbohydrate. Some of the best sources for this are glucose tablets or gels, a piece of hard candy, or a small amount of fruit juice.
This will raise blood sugar, but only for a short period of time. After about fifteen minutes or so, it is best to eat a slower-acting carbohydrate, like a sandwich or a piece of fruit. Including a source of protein with this will keep blood sugar up for a longer period of time. [9]
What should you do if you’re with a diabetic that has a seizure due to hypoglycemia? First, make sure there is nothing they can hurt themselves on, and then put them in the recovery position (on their side, legs apart, one arm used to support the head). [10] If they have a glucose injection kit, give an injection of glucose if you know how to use it. Finally, call an ambulance and stay with the person until help arrives. [11]
Can Seizures Cause Low Blood Sugar?
If low blood sugar can trigger a seizure, is the opposite true? Can a seizure by itself cause someone to have low blood sugar?
Seizures themselves can result from a variety of causes. All of those causes disrupt the nerve cells in the brain, called neurons. Those cells enable the brain to communicate through various electrical signals. When those signals are disrupted, it can lead to a seizure. Seizures can be focal (involving only part of the brain), affecting the body while the person remains conscious, or general (involving the whole brain), which causes the person to lose consciousness. [12]
One of the things seizures seem to do to the body is to alter the way the body processes things like glucose. These are called disturbances in metabolism.
To see how those disturbances related to seizures, people conducted a survey and found that it is extremely difficult to control or stop a seizure with drugs if blood glucose levels are at abnormal levels. [13] So while there needs to be more research done on the subject, it does appear that seizures themselves can have an effect on blood sugar levels.
FAQ
Can Diabetes Cause Seizures?
While diabetes does not directly cause seizures, it can cause instances of hypoglycemia (low blood sugar) which may lead to someone having a seizure.
Can High Blood Sugar Cause a Seizure?
While hypoglycemia is responsible for most seizures caused by blood sugar, it’s also possible to have a seizure from high blood sugar. In some cases, high blood sugar causes the neurons in the brain to act abnormally, triggering a seizure. [14] In cases of diabetic ketoacidosis, seizures are one complication that may result. [15]
How do I Know if I have Low Blood Sugar?
If you are on a CGM system, you can set it to alert you whenever your blood sugar goes below an acceptable level. Finger stick tests can also tell you when your blood sugar is low. Those who are not on a CGM should take care to memorize the symptoms of a low blood sugar level so that if it happens to them, they can work quickly to counteract it.
Final Thoughts
Low blood sugar or hypoglycemia is one of the more common problems that diabetics may have. If it is treated before it becomes too low, it will not result in any serious problems, but if it is left for too long, symptoms such as seizures and unconsciousness may result.
This is why it is important for all diabetics to know the signs of hypoglycemia and how to treat them before those problems result. Knowing these signs will also give the diabetic a better feeling of control over their condition, which is also worth it.
References
- Diabetes UK. (2017). What is a hypo? Diabetes UK. https://www.diabetes.org.uk/guide-to-diabetes/complications/hypos
- Mayo Clinic. (2018). Diabetic hypoglycemia – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525
- Mayo Clinic. (2018). Diabetic hypoglycemia – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525
- National Health Service. (2020, September 24). Low blood sugar (hypoglycaemia). NHS. https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/
- Yun, C., & Xuefeng, W. (2013). Association Between Seizures and Diabetes Mellitus: A Comprehensive Review of Literature. Current Diabetes Reviews, 9(4), 350–354. https://doi.org/10.2174/15733998113099990060
- Brennan, M. R., & Whitehouse, F. W. (2012). Case Study: Seizures and Hypoglycemia. Clinical Diabetes, 30(1), 23–24. https://doi.org/10.2337/diaclin.30.1.23
- Diabetes UK. (n.d.). Diabetes and Checking Your Blood Sugars. Diabetes UK. https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/testing
- Diabetes UK. (2017). What is a hypo? Diabetes UK. https://www.diabetes.org.uk/guide-to-diabetes/complications/hypos
- Having a hypo. (2022). Diabetes UK. https://www.diabetes.org.uk/guide-to-diabetes/complications/hypos/having-a-hypo
- National Health Service. (2017, October 24). First aid – Recovery position. Nhs.uk. https://www.nhs.uk/conditions/first-aid/recovery-position/
- National Health Service. (2020, September 24). Low blood sugar (hypoglycaemia). NHS. https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/
- Mayo Clinic. (2021, February 24). Seizures – Symptoms and causes. Mayo Clinic; Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711
- Schauwecker, P. E. (2012). The effects of glycemic control on seizures and seizure-induced excitotoxic cell death. BMC Neuroscience, 13, 94. https://doi.org/10.1186/1471-2202-13-94
- Stafstrom, C. E. (2003). Hyperglycemia Lowers Seizure Threshold. Epilepsy Currents, 3(4), 148–149. https://doi.org/10.1046/j.1535-7597.2003.03415.x
- Yun, C., & Xuefeng, W. (2013). Association Between Seizures and Diabetes Mellitus: A Comprehensive Review of Literature. Current Diabetes Reviews, 9(4), 350–354. https://doi.org/10.2174/15733998113099990060/
