When to worry about palpitations with hypoglycaemia

When blood glucose falls, the body releases stress hormones to restore energy availability. These hormones can make the heart beat faster or feel as though it is pounding, fluttering, or skipping. Shaking, sweating, hunger, dizziness, irritability, and difficulty concentrating may occur at the same time. Palpitations can settle as the low glucose is corrected, but a different heart rhythm or another illness can feel similar.

Stop what you are doing and sit somewhere safe. If you can swallow normally and have been given a personal plan, take the recommended fast-acting carbohydrate and recheck your glucose according to that plan. Do not drive while symptoms continue. If you use glucose-lowering medicine, record the reading, timing, food, activity, and medicines so a clinician can look for a pattern. Never give food or drink to someone who is drowsy or unable to swallow.

Call emergency services for palpitations with chest pressure, severe breathlessness, collapse, a new irregular heartbeat, seizure, or confusion that does not improve. Arrange same-day medical advice if episodes keep returning, occur without a low glucose reading, last after glucose has recovered, or follow a change in diabetes medicine. A clinician may need to review treatment, meals, alcohol, exercise, and heart rhythm.

Ask what glucose level should prompt action, how to adjust your personal treatment plan, and whether your medicines or meal timing could be contributing. Ask whether an ECG or other assessment is appropriate when palpitations continue after glucose correction.