Hypoglycaemia can be diagnosed clinically and/or biochemically (based on blood glucose levels). Common symptoms of hypoglycaemia include:1,2,3

Autonomic Neuroglycopenic Nonspecific
  • Trembling
  • Pounding heart
  • Sweating
  • Anxiety
  • Hunger
  • Difficulty concentrating
  • Confusion
  • Weakness
  • Drowsiness, dizziness
  • Vision changes
  • Difficulty speaking
  • Nausea
  • Headache

The IHSG defines blood glucose < 3.0 mmol/L (54 mg/dL) as “serious biochemical hypoglycaemia” and
3.5 to 3.9 mmol/L (63 to 70 mmol/L), in the absence of symptoms, as an “alert range”

[see Definition section]. People with blood glucose > 3.9 mmol/L occasionally report hypoglycaemia symptoms, a presentation that has been described as “pseudohypoglycaemia.”1


  1. Edelman SV, Blose JS. the impact of nocturnal hypoglycemia on clinical and cost-related issues in patients with type 1 and type 2 diabetes. Diabetes Educ 2014;40:269.
  2. Graveling AJ, Frier BM. Impaired awareness of hypoglycaemia: a review. Diabetes & Metabolism2010;36: S64.
  3. McAulay V et al. Symptoms of hypoglycemia in people with diabetes. Diabet Med 2001;18:690.