Low blood sugar (hypoglycemia) is common in people with diabetes who are taking insulin or other medicines to control their diabetes.
All of the following can cause blood sugar (glucose) level to drop:
Getting too much activity
Intentionally or unintentionally overdosing on the medicines used to treat diabetes
Even when diabetes is managed very carefully, the medicines used to treat diabetes can result in drug-induced low blood sugar. The condition may also occur when someone without diabetes takes a medicine used to treat diabetes. In rare cases, non-diabetes-related medicines can cause low blood sugar.
Medicines that can cause drug-induced low blood sugar include:
Bactrim (an antibiotic)
Metformin when used with sulfonylureas
SGLT2 inhibitors (such as dapagliflozin and empagliflozin)
Thiazolidinediones (such as Actos and Avandia)
Cryer PE. Glycemic goals in diabetes: trade-off between glycemic control and iatrogenic hypoglycemia. Diabetes. 2014;63(7):2188-2195. PMID: 24962915 www.ncbi.nlm.nih.gov/pubmed/24962915.
Davis SN, Lamos EM, Younk LM. Hypoglycemia and hypoglycemic syndromes. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 47.
Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.