Hypoglycemia in Pregnancy

What is it, How Can You Prevent it and Treat it?

Woman with gestational diabetes checking blood sugar
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Hypoglycemia occurs when blood sugar levels drop too low (below 70 mg/dL) and there is not enough glucose in the system to provide for your body's energy needs. It occurs most frequently in those persons who take insulin or other oral diabetes medications that cause the pancreas to make more insulin. Hypoglycemia can become an emergency situation if not treated promptly. People at greatest risk of hypoglycemia are children, pregnant women, elderly and anyone with hypoglycemia unawareness.


Pregnant women with preexisting type 2 diabetes or gestational diabetes are at risk for hypoglycemia if they use insulin. Other pregnancy problems, such as morning sickness, digestion problems and vulnerability to colds and the flu, can also increase risk.

This time can be especially tricky for women who are asked to maintain tight blood sugar control. Many women are asked to have their HbA1c level below 6%. Tight blood sugar goals and insulin use increase the risk for hypoglycemia.

Why Must My Blood Sugars Be So Tightly Controlled? 

Blood sugar levels need to be in good control in order to decrease the risk for complications and to increase the chance for a successful pregnancy. Elevated blood sugars in pregnancy have been associated with large babies and babies who are born with low blood sugars. When sugars are elevated, the babies body needs to produce more insulin, therefore when they are born their blood sugar can be dangerously low.


What Are The Signs and Symptoms of Hypoglycemia? 

Signs and symptoms of hypoglycemia vary from person to person, but typically include: 

  • Increased heart beat
  • Shakiness
  • Sweating
  • Nervous feeling (confusion)
  • Dizziness 
  • Hunger 

What Can I Do To Avoid Hypoglycemia? 

There are strategies for avoiding hypoglycemia and prevention is key.

Make sure you receive diabetes self management education so that you can be properly educated on healthy eating during pregnancy and appropriate amount of carbohydrates that need to be ingested to avoid low blood sugar. Typically, women with diabetes need a bedtime snack that contains both carbohydrate and protein to obtain good morning sugars. Meeting with a registered dietitian who is also a certified diabetes educator can help you meal plan so that your are optimizing nutrition for your baby, in addition to achieving good blood sugar control. 

It's also important to be diligent about checking your blood sugar regularly, especially before and after activity and driving. Follow your prescribed diet and do not skip meals or snacks. Do not leave too much time between meals and always keep fast-acting carbs and glucose pills or gel with you at all times, especially when driving.

If My Blood Sugar Does Go Low - What Do I Do? 

In the event that your blood sugar does go too low, you'll want to treat it right away.

Carry your meter with you wherever you go so that you can check your blood sugar. If your feel "different", check your sugar, if it is low,  <70mg/dL, treat it with 15 g of fast acting carbohydrates (such as 4 oz of juice) and re-check in 15 minutes. For more information: How to Treat Your Blood Sugar Quickly and Safely


Hypoglycemia. National Diabetes Clearinghouse. Accessed: September 7, 2015. http://www.niddk.nih.gov/health-information/health-topics/Diabetes/hypoglycemia/Pages/index.aspx

Living with Diabetes. American Diabetes Association. Accessed: September 5, 2015. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html​

American Diabetes Association. Standards of Medical Care in Diabetes - 2015. Diabetes Care. 2015. Jan; 38 (Suppl 1): S1-90. 

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