Understanding Hypoglycemia, Hypothermia & Their Link
Quick Overview
This page explains what hypoglycemia and hypothermia are, how they can occur together, and what to do if you or someone you know is experiencing these symptoms.
Hypoglycemia (Low Blood Sugar)
What It Is
Hypoglycemia occurs when blood glucose (sugar) drops below a safe level, typically below 70 mg/dL (3.9 mmol/L) in most clinical guidelines. The brain and body rely on glucose for energy; when levels fall too low, normal functions can be impaired.
Common Causes
- Taking too much insulin or diabetes medication
- Skipping or delaying a meal
- Intense physical activity without eating
- Alcohol consumption
- Certain medications or medical conditions
Typical Symptoms
Mild to Moderate
- Shakiness, tremor
- Sweating
- Anxiety, nervousness
- Hunger
- Tingling lips
- Heart palpitations
- Difficulty concentrating
- Irritability
Severe
- Loss of consciousness
- Seizures
- Difficulty speaking
- Combativeness or behavioral changes
- Coma (if untreated)
Symptoms vary by individual and can escalate rapidly. If blood glucose is measured and confirmed below 70 mg/dL, treatment is needed.
Hypothermia (Low Body Temperature)
What It Is
Hypothermia occurs when core body temperature drops below 35°C (95°F). The body loses heat faster than it can generate it, affecting normal organ function and consciousness.
Common Causes
- Prolonged exposure to cold environments
- Wet clothing
- Exhaustion or exertion in cold weather
- Immersion in cold water
- Severe illness or infection
- Certain medications or medical conditions (including severe hypoglycemia)
Typical Symptoms (by severity)
| Mild (32–35°C) | Moderate (28–32°C) | Severe (<28°C) |
|---|---|---|
|
|
|
Severe hypothermia is a medical emergency. Core temperature is best measured with a low-reading thermometer (essential thermometer).
When Hypoglycemia & Hypothermia Occur Together
The Phenomenon
Clinical and research evidence shows that hypothermia can develop during severe hypoglycemia, even in warm environments. This co-occurrence is more common than many clinicians realize, especially in acute, severe episodes and in newborns.
Why Does This Happen?
The central nervous system (brain) relies heavily on glucose. When glucose levels drop severely, the brain struggles to maintain normal functions—including thermoregulation (the body's temperature control). Additionally, altered consciousness or inability to move may prevent the person from generating or conserving heat. The result: the person develops hypothermia while hypoglycemic.
This is particularly pronounced in:
- Severe, prolonged hypoglycemia
- Neonates (newborns), who have less fat for insulation and less developed heat-production mechanisms
- Elderly individuals
- People in cold or resource-limited environments
- Alcohol-intoxicated individuals
Clinical Evidence
A 2012 emergency medicine study found that hypothermia was documented in approximately 23% of patients presenting with severe hypoglycemia (PubMed PMID: 22559928). A 2018 case review described hypothermia as a 'forgotten sign' of prolonged severe hypoglycemia, often overlooked until explicitly measured (PMC6119383).
Neonatal research shows strong associations between low blood glucose and low body temperature; management often addresses both simultaneously (Frontiers in Endocrinology, 2022).
These studies underscore why a unified term—Hypoglycothermia—improves communication and clinical awareness.
When to Seek Emergency Care
MEDICAL EMERGENCY
If you or someone nearby is experiencing:
- Loss of consciousness or difficulty waking
- Seizures
- Severe confusion or inability to follow commands
- Severely low body temperature (below 32°C / 90°F)
- Slow, weak, or absent pulse
- Difficulty breathing
CALL EMERGENCY SERVICES (911 in the USA) IMMEDIATELY.
Do not wait. Do not attempt treatment at home.
Severe hypoglycemia and hypothermia are both time-sensitive emergencies. Once stabilized, patients may also benefit from recognition that both conditions were present—improving future monitoring and care.
Prevention & Risk Reduction
If You Have Diabetes or Are at Risk
- Monitor blood glucose regularly (check before activities, especially outdoors).
- Carry a fast-acting carbohydrate (glucose tablets, juice, candy) at all times.
- Inform friends, family, and colleagues about hypoglycemia symptoms and how to help.
- Avoid alcohol or use carefully (it impairs glucose awareness).
- Dress warmly in cold weather; monitor your environment.
- Educate yourself and others about the link between hypoglycemia and hypothermia, especially if you live in a cold climate or engage in outdoor activities.
- Wear medical alert identification (bracelet, pendant).
In Cold Environments
- Limit time in cold without adequate clothing.
- Carry extra food and a blanket.
- Never underestimate hypothermia risk; measure core temperature if symptoms develop.
- Be extra vigilant if you have diabetes or another condition that impairs temperature regulation.