Skip to content
sayer date
Order on WhatsApp
November 20, 2022

Symptoms Of Hypoglycemia And Fruit Juice: NHS Advice

Please treat this page as general information and not medical advice. People with diabetes should follow the treatment plan agreed with their diabetes care team, and people without diabetes who get symptoms of low blood sugar should see a GP or their own doctor.

The one place fruit appears on the NHS page about low blood sugar (hypoglycaemia) is in its treatment advice, where a small glass of fruit juice is one way to raise blood sugar quickly. This article starts with that advice, then covers the rest of the NHS page, what the NHS says about juice and dates in daily eating, and two date studies on blood sugar.

Fruit juice in the NHS treatment steps

If you have diabetes and have symptoms, or your blood sugar is below 4mmol/L, the NHS advice is:

  1. Eat or drink something that will raise your blood sugar quickly, "such as a small glass of fruit juice or sugary fizzy drink, 5 glucose or dextrose tablets, 4 large jelly babies, or 2 tubes of glucose gel".
  2. Check your blood sugar after 10 to 15 minutes.
  3. If it is still below 4mmol/L, have another sugary drink or snack and check again after 10 minutes.
  4. Once your symptoms have improved and your blood sugar is above 4mmol/L, eat something that will keep it up for longer, "such as some biscuits, a sandwich, or your next meal if it's due".

So fruit juice is one choice among several in the first step, with a sugary fizzy drink, glucose or dextrose tablets, jelly babies and glucose gel. The page does not name a particular fruit and does not mention dates or date juice.

The NHS limit on juice

Outside a hypo, the NHS 5 A Day portion sizes page caps juice. Your combined total of fruit juice, vegetable juice and smoothies shouldn't be more than 150ml a day, which is a small glass. When fruit is blended or juiced it releases the sugars, which increases the risk of tooth decay, while whole fruits are less likely to cause tooth decay "because the sugars are contained within the structure of the fruit".

Signs of a hypo

The NHS lists these as possible symptoms of low blood sugar:

  • feeling hungry
  • feeling dizzy
  • feeling anxious or irritable
  • sweating
  • shaking
  • tingling lips
  • heart palpitations
  • feeling tired or weak
  • changes in your vision such as blurred vision
  • feeling confused

With severe low blood sugar you may have a seizure or fit, or become unconscious. The NHS says people with diabetes who get any of these symptoms should check their blood sugar if they can.

Severe hypos and emergency help

If a person with a severe hypo is unconscious, the NHS says not to give them any food or drink, because they will not be able to swallow safely. Put them in the recovery position and give a glucagon injection straight away, if one is available and you know how to use it. If they start to recover within 10 minutes of the injection and can swallow safely, give them food or drink that will raise their blood sugar, and stay with them until they have fully recovered.

The NHS says to call for emergency help if you think someone has very low blood sugar and they are not responding normally or are unconscious, and any one of these applies: a glucagon injection is not available or you do not know how to use it, you have given one and they have not recovered within 10 minutes, or they have been drinking alcohol.

Causes of low blood sugar

The NHS describes a hypo as usually being where blood sugar (glucose) is below 4mmol/L. It needs to be treated quickly to stop it getting worse, but you can usually treat it yourself. Low blood sugar usually affects people with diabetes who take insulin or some other diabetes medicines, and it is rare in people without diabetes.

Diabetes medicines lower blood sugar and can sometimes make it go too low. The NHS says this is common with insulin and can also happen with some other diabetes medicines, such as gliclazide and glimepiride. If you have diabetes, a hypo is more likely if you:

  • take too much insulin
  • have problems with the way you inject insulin, such as injecting in the same place too often
  • miss or delay meals, or do not eat enough carbohydrate
  • do a lot of exercise without eating more carbohydrate or reducing your insulin dose
  • drink a lot of alcohol, particularly without eating

Sometimes it is not clear why it happens. In people without diabetes, the NHS says low blood sugar can sometimes be caused by conditions including malnutrition, Addison's disease and a growth (tumour) in the pancreas.

Lowering the risk

For people who take diabetes medicine, the page lists three things to avoid: skipping or delaying meals; drinking too much alcohol (no more than 14 units of alcohol a week, spread over 3 days or more); and drinking alcohol without eating. One of its tips is to carry something that will raise your blood sugar quickly, "such as sugary drinks, sweets or glucose tablets".

The NHS says to see a GP in three situations: you have diabetes and get hypos often, have had severe hypos, or have had hypos at night; you have diabetes and do not always recognise the symptoms; or you do not have diabetes and get symptoms such as shaking, sweating, a fast heartbeat and feeling confused. People with diabetes can also speak to their diabetes care team for advice.

Dates in NHS advice and in two studies

The NHS 5 A Day: what counts? page names dates directly: "a 30g portion of dried fruit, such as currants, dates, sultanas and figs, counts as 1 of your 5 A Day". It adds that dried fruit should be eaten at mealtimes, not as a snack between meals, to reduce the impact on teeth, and that 30g of dried fruit is equivalent to around 80g of fresh fruit.

Per 100 g of Medjool dates, the USDA FoodData Central record lists 277 kcal, 75.0 g of carbohydrate, 66.5 g of total sugars, 6.7 g of fibre and 696 mg of potassium.

In a randomised trial, 79 patients with type 2 diabetes were given either 60 g of dates or 60 g of raisins a day for 12 weeks, split into a mid-morning and a mid-afternoon snack. 61 of them completed the study. There was no difference between or within groups for HbA1c or fasting glucose. The authors saw no improvement in glycemic indices with either food, "though neither had a deleterious effect on glycemic control over a 12-week period".

A study at Qassim University in Saudi Arabia measured the glycemic index of 17 date varieties at the tamer stage in healthy subjects (ten males and nine females). Each person had 50 g of glucose on three separate occasions and a portion of each variety giving 50 g of available carbohydrate once. The mean glycemic index was 55.2, ranging from 42.8 to 74.6. The authors found no significant difference in glycemic index between the varieties, but the glycemic load differed significantly, from 8.5 to 24. They note that tamer-stage results may not be translatable to all types of dates.

Neither study tested dates or date juice as a way to treat a hypo. The Qassim study measured blood sugar response in healthy people after single portions, and the trial measured blood sugar control over 12 weeks of daily eating in people with type 2 diabetes.

More about this site is on the About Us page and the contact page.

References