Question 1

Why would my blood sugar be low if I am not diabetic?

Accepted Answer

Possible causes include reactive hypoglycemia after eating, prolonged fasting or inadequate nutrition, alcohol, medications, serious liver or kidney disease, hormone deficiencies and previous bariatric surgery. Rarely, excessive insulin production from an insulinoma or another disorder can cause recurrent hypoglycemia.((Endocrine Society. Hypoglycemia. January 24, 2022. https://www.endocrine.org/patient-engagement/endocrine-library/hypoglycemia))

Question 2

Can a healthy person have low blood sugar?

Accepted Answer

Yes, but clinically significant hypoglycemia is uncommon in otherwise healthy people who are not taking glucose-lowering medications. Repeated symptoms should be evaluated along with documented glucose levels rather than assuming that every episode of shakiness or dizziness is caused by low blood sugar.((Endocrine Society. Hypoglycemia. January 24, 2022. https://www.endocrine.org/patient-engagement/endocrine-library/hypoglycemia))

Question 3

Why does my blood sugar drop a few hours after eating?

Accepted Answer

Low blood sugar occurring within several hours after eating may be reactive or postprandial hypoglycemia. The cause is not always clear, although meal timing, food composition and previous gastric or bariatric surgery can play a role.((Mayo Clinic. Reactive Hypoglycemia: What Can I Do? https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/reactive-hypoglycemia/faq-20057778))

Question 4

Why does my blood sugar drop at night if I don't have diabetes?

Accepted Answer

True fasting hypoglycemia can occur overnight and may be associated with certain medications, alcohol, severe illness, hormone deficiencies or, rarely, excessive insulin production.((Endocrine Society. Hypoglycemia. January 24, 2022. https://www.endocrine.org/patient-engagement/endocrine-library/hypoglycemia))

An isolated low CGM reading does not necessarily prove hypoglycemia because continuous glucose monitors can be less accurate at very low glucose levels.((Merck Manual Professional Edition. Hypoglycemia. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-hypoglycemia/hypoglycemia))

Repeated or symptomatic nighttime lows should be discussed with a healthcare professional.

If your glucose is rising rather than falling overnight or toward morning, learn how the dawn phenomenon can affect early-morning blood sugar.

Question 5

Does low blood sugar mean I am developing diabetes?

Accepted Answer

Not necessarily. Diabetes is characterized primarily by blood glucose that is too high, not too low. Although some people with abnormal glucose regulation may experience post-meal symptoms, recurrent hypoglycemia without diabetes has several other possible causes and should be evaluated based on the individual pattern.

If you're trying to understand your longer-term glucose levels, our A1C Calculator shows how A1C relates to estimated average glucose.

Author: Ken Gri, Founder of DiabetesKnow

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