Can Low Blood Sugar Cause Nausea?

Hypoglycemia, or low blood sugar, can cause nausea.

Blood sugar levels can vary throughout the day and low blood sugar can happen in people with and without diabetes. High blood sugar levels (hyperglycemia) can also cause nausea, so it’s important to measure your blood glucose to find out which is causing the queasiness. 

This article will explore whether nausea could be a symptom of low blood sugar, the potential causes of both, and treatment options for nausea.

What Is Low Blood Sugar?

Whether people have diabetes or not, when they have mild low blood sugar, they may feel both extremely hungry and nauseated. This symptom combination is the first sign of low blood sugar and is caused by the release of the stress hormone epinephrine, also known as adrenaline.

When your blood sugar drops, it triggers the fight-or-flight response, causing a surge of adrenaline. This flood of adrenaline functions as a helper, moving stored glucose into the bloodstream quickly. However, this surge isn’t without effects. Other symptoms like sweating, shakiness, and anxiousness can also be caused by this process.

That said, people with diabetes shouldn’t assume their nausea is always related to low blood sugar. The only way to know for certain is to measure your blood sugar. If your levels are within the normal range, other factors may be contributing to your nausea.

Is Nausea a Symptom of Low Blood Sugar?

You will notice certain symptoms when your blood sugar begins to drop. These symptoms arise in stages, ranging from mild to moderate to severe. Each stage is characterized by a specific set of symptoms.

Nausea is one of the symptoms that occur in the mild stage, but it can also be present in later stages. Many organizations like the National Institute of Diabetes and Digestive and Kidney Diseases combine the mild and moderate stages into one.

Other Symptoms of Low Blood Sugar

In addition to nausea, other symptoms of mild to moderate low blood sugar include:

• Blurred vision
• Confusion or cognitive changes
• Coordination issues
• Concentration issues
• Changed behavior or personality
• Dizziness or lightheadedness
• Extreme hunger
• Fast or irregular heartbeat
• Headache
• Irritability or mood swings
• Paleness or pallor
• Shaking
• Sleepiness
• Sweating
• Muscle weakness

Signs of severe low blood sugar include:

• Inability to eat or drink
• Seizures or convulsions (jerky movements)
• Unconsciousness (coma)

Symptoms of hypoglycemia during sleep include:

• Crying out or having nightmares
• Sweating enough to make your pajamas or sheets damp
• Feeling tired, irritable, or confused after waking up

Connections Between Low Blood Sugar and Nausea

People with diabetes can experience nausea for several different reasons. This is why it’s always important to check your blood sugar level before deciding on the appropriate course of action.

Medication

Metformin is used to lower blood sugar in people with type 2 diabetes, and nausea is both a potential side effect and a sign of metformin overdose. If you experience nausea while taking metformin, you should let your healthcare provider know immediately. 

Nausea is also listed as one of the most common side effects in injectable medications such as Ozempic (semaglutide) and Mounjaro (tirzepatide). If you feel nauseated while taking any of these injectables or if your nausea worsens with a dosage increase, it is important to tell your healthcare provider right away. They may decide to switch you to a different medication.

Gastroparesis

People with diabetes are at increased risk of having gastroparesis, also known as diabetic stomach, because diabetes can damage the nerve cells (including the vagus nerve) within the stomach wall.

Damage to the vagus nerve decreases your stomach's and small intestine’s ability to move food through the digestive tract, which slows the emptying of your stomach and leads to a buildup of contents.

Medications for diabetes that delay gastric emptying, such as GLP-1 agonists like Ozempic and Mounjaro, can make symptoms of gastroparesis worse.

Symptoms of gastroparesis include:

• Feeling full soon after starting a meal
• Feeling full for a long time after eating a meal
• Nausea
• Vomiting
• Excessive bloating
• Excessive belching
• Upper abdominal pain
• Heartburn
• Poor appetite

Pancreatitis

People with diabetes also have a higher risk of developing pancreatitis. Pancreatitis refers to sudden and temporary (acute) or chronic inflammation of the pancreas. Your pancreas is responsible for releasing digestive enzymes and making insulin, both of which help regulate your body’s use of glucose.

Symptoms of pancreatitis include nausea and pain in your upper abdomen that may spread to your back. Pancreatitis requires immediate medical attention. 

Other symptoms of pancreatitis may include:

• Fever
• Rapid heartbeat
• Swollen, distended, and tender abdomen
• Vomiting
• Poor appetite

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a life-threatening condition that occurs when there is a lack of insulin, which leads your body to burn fat for energy. It is characterized by very high blood sugar levels and ketones in your urine, which can be checked with an at-home testing kit.

If you have symptoms of DKA, which include feelings of severe nausea, contact your healthcare provider or seek emergency medical care right away.

Other symptoms of DKA include:

• Fruity breath
• Confusion
• Deep or rapid breathing
• Extreme fatigue
• Fainting
• Feelings of malaise
• Increased urination
• Increased (unquenchable) thirst

Treatment of Low Blood Sugar and Nausea 

Blood sugar is considered low if blood glucose is less than 70 mg/dL. Immediate treatment of hypoglycemia requires consuming 15 grams (g) of carbohydrates and assessing whether your symptoms are improving. What happens next depends on whether you have been diagnosed with diabetes. 

People With Diabetes

The American Diabetes Association suggests that people with diabetes experiencing hypoglycemia follow the 15-15 rule, which is as follows:

• Consume 15 g of carbohydrates to raise your blood sugar.
• Check your blood sugar after 15 minutes.
• If it’s still below 70 mg/dL, have another 15 g of carbohydrates.
• Repeat these steps until your blood sugar is at least 70 mg/dL.
• Once your blood sugar is back to normal, eat a meal or a snack to make sure it doesn’t lower again.

Examples of servings of 15 g of carbohydrates include:

• Glucose tablets (read package instructions)
• Gel tube, such as Glucogel (which is typically 10 g, so you will need two tubes)
• 4 ounces (1/2 cup) of juice or regular soda (not diet or sugar-free)
• 1 tablespoon of sugar, honey, or corn syrup
• Hard candies, jelly beans, or gumdrops (see food label for how many to consume)

Food items that contain only carbohydrates (no protein or fat) are the best things to eat when your blood sugar is low because they will raise blood glucose the fastest.

Everyone with diabetes on medications that can cause low blood sugar should have a glucagon emergency kit. In an emergency, it would not be safe for a family member, friend, or bystander to try to pour orange juice into your mouth because it could go into your lungs. A glucagon injection can be used instead to safely raise blood glucose.

Parents of Children With Diabetes

If your child has diabetes and shows symptoms of hypoglycemia, it's important to check their blood glucose level with a glucometer. If this is not possible, treat them as if they have hypoglycemia by giving them carbohydrates to prevent symptoms from getting worse.

Your child should have a safety plan in place for when they are not in your care, such as when they are at school, friends’ homes, or daycare. The plan should include a person they should talk to if they are not feeling well.

People Without Diabetes

When people without diabetes experience low blood sugar, it is called non-diabetic hypoglycemia. This is a rare occurrence and is categorized as either reactive hypoglycemia (which happens within a few hours of eating) or fasting hypoglycemia (which may be related to a disease). Consuming 15 g of carbohydrates in these cases should help with symptoms.

Relieving Nausea

Because nausea is a symptom rather than a condition, treatment depends on the underlying cause. 

Oftentimes, you can stop nausea from low blood sugar by getting your blood glucose back into the normal range.

Other short-term treatments for nausea may include:

• Getting fresh air
  
• Staying hydrated by sipping cold drinks
• Drinking ginger or peppermint tea
• Eating small, frequent meals
• Eating foods that contain ginger
• Avoiding spicy, strong-smelling, or greasy foods

When to Call a Healthcare Provider

If you are experiencing blood glucose highs and lows regularly or more frequently than usual, talk to your healthcare provider. They can help determine the cause and a plan of action to keep your blood sugar levels within the normal range. 

If you cannot raise your blood sugar with the 15-15 rule, call your healthcare provider or seek medical care immediately.

If reactive hypoglycemia or fasting hypoglycemia occurs, you should see your healthcare provider for an assessment of your symptoms, a physical exam, a review of your risk for diabetes, and a check of your blood glucose to determine the cause and treatment.

Summary

In people with and without diabetes, nausea can be a sign of low blood sugar. Checking your blood sugar is the only way to know for sure if low blood sugar is the cause of your nausea. If your blood sugar is within the normal range, nausea may be the result of medications that need adjustment or severe health conditions like pancreatitis and diabetic ketoacidosis.

Treatment may be as simple as consuming carbohydrates, but this isn't always the case. Treatment may depend on the underlying cause. Low blood sugar that cannot be elevated to normal ranges can quickly become a medical emergency.

Let your healthcare provider know if you experience nausea, so you can understand the cause and get the appropriate treatment.