Why does hypoglycaemia cause tremor?

As glucose falls, the body releases hormones that signal an urgent need for fuel. Adrenaline can make the hands feel shaky, the body tremble, and the heart beat more noticeably. Tremor is a common presentation of Hypoglycaemia and can occur alongside sweating, hunger, tingling, dizziness or anxiety. The intensity can vary; some people have only a fine hand tremor while others feel generally shaky. Tremor also has other causes, including caffeine, stress, medicines, thyroid problems and neurological conditions. A glucose reading during symptoms can be useful, particularly for people using insulin or glucose-lowering medication.

Sit down to reduce the risk of falling or dropping objects. Check your glucose if you have a monitor, then use the treatment steps in your personal low-glucose plan if you are awake and able to swallow. Do not rely on the tremor alone to decide the cause. Delay driving, climbing, cooking over a flame or operating machinery until symptoms have resolved and you have followed your plan. Make a note of the circumstances, including a missed meal, exercise, alcohol, illness or a medication dose, for discussion at your next review.

Get urgent medical help if shaking is accompanied by confusion, severe weakness, loss of consciousness, a seizure, inability to swallow, chest pain or breathing difficulty. Seek prompt advice for repeated low-glucose symptoms, tremor that continues when glucose is not low, or episodes that you cannot safely manage. Someone who is drowsy or unable to swallow should not be given food or drink by mouth. Their emergency plan or emergency services should be used instead.

Ask whether your treatment schedule fits your meals, work pattern and activity. Discuss the warning symptoms you usually notice, when a support person should help, and whether you need a written plan for travel, exercise, illness or fasting.