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Using GLP-1s

Hypoglycemia

Low blood sugar — a GLP-1 on its own rarely causes it, but combining one with insulin or a sulfonylurea meaningfully raises the risk.

By the glp1.how editorial teamReviewed

Hypoglycemia is blood sugar that falls below the normal range — commonly defined as under 70 mg/dL. Early symptoms include shakiness, sweating, a racing heart, hunger, and irritability; if it drops further, confusion, blurred vision, and loss of consciousness can follow. It is treated by taking fast-acting carbohydrate (glucose tablets, juice) and rechecking.

GLP-1 medications trigger insulin release only when blood sugar is high, so on their own they rarely cause hypoglycemia. The risk rises substantially when a GLP-1 is combined with insulin or a sulfonylurea, both of which lower blood sugar regardless of what it already is. Prescribers often reduce those doses when a GLP-1 is started. See GLP-1s with insulin or sulfonylureas: understanding hypoglycemia risk. Source: NIDDK (external link).

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Revision history

Updated 2 times since Sep 2, 2026 · show changes
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Related terms

  • Sulfonylurea · A class of oral type 2 diabetes medications (e.g. glipizide, glimepiride, glyburide) that stimulate the pancreas to release insulin regardless of blood sugar level.
  • GLP-1 · A gut hormone (glucagon-like peptide-1) that stimulates insulin release, slows digestion, and reduces appetite; the target of drugs like semaglutide and liraglutide.

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