Why does hypoglycaemia cause palpitations?

When glucose becomes low, the body tries to protect the brain by releasing counter-regulatory hormones. Adrenaline can increase heart rate and make each beat more noticeable, which may feel like pounding, fluttering or racing. Palpitations are a common presentation of Hypoglycaemia, and may come with tremor, sweating, hunger, tingling or difficulty concentrating. Palpitations themselves have many possible causes, including stress, caffeine, fever, dehydration and heart-rhythm problems. The timing of symptoms, a glucose reading, and your medicines help a clinician work out whether low glucose is involved.

Pause what you are doing and sit somewhere safe. If you use a glucose monitor, check your level when practical. If you are awake and can swallow, follow the action plan given by your diabetes team for low glucose, including the recommended fast-acting glucose treatment and follow-up check. Avoid driving until you have recovered and are following your plan. Note the episode's timing, recent food, activity, alcohol intake and medication dose. This information can reveal a pattern and help your clinician tailor prevention.

Call emergency services for chest pain, severe shortness of breath, fainting, a seizure, collapse, or confusion that is worsening. Seek urgent help if you cannot swallow safely or symptoms do not settle after the treatment directed in your plan. Arrange a prompt review for recurrent palpitations, episodes that wake you from sleep, or symptoms occurring when glucose is not low. A medical review may include checking your treatment plan and considering other causes of a changed heartbeat.

Ask how to distinguish your usual low-glucose warning signs from symptoms that need heart assessment. Discuss whether your glucose targets, meal timing, activity routine or medication schedule should change. If you have a monitor, ask which readings and event details are most useful to bring to an appointment.