Hypoglycemia classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]


Hypoglycemia can be classified based on its severity into 5 categories, including severe hypoglycemia, symptomatic hypoglycemia, asymptomatic hypoglycemia, probable symptomatic hypoglycemia, and pseudo hypoglycemia. It also maybe classified based on severity into mild, moderate and severe subtypes.


Classification of hypoglycemia in diabetics according to the American Diabetes Association's (ADA) and the Endocrine Society Workgroup on Hypoglycemia is:[1][2][3][4]

Severe hypoglycemia

  • Severe event in which patient loses consciousness or becomes very dizzy. Patients usually require the assistance of another person to actively administer carbohydrate or glucagon.
  • Resolution of neuroglycopenic symptoms after administration of glucose

Symptomatic hypoglycemia

  • The symptoms of hypoglycemia are seen with plasma glucose concentration ≤70 mg/dL.

Asymptomatic hypoglycemia

  • Measured plasma glucose concentration of ≤70 mg/dl without typical symptoms of hypoglycemia.

Probable symptomatic hypoglycemia

  • When hypoglycemic symptoms do not correlate with low plasma glucose level (but likely due to plasma glucose concentration (70 mg/dL-3.9 mmol/liter).


  • Patients with poor glycemic control can experience symptoms of hypoglycemia at plasma glucose levels >70 mg/dL.

Other classification of hypoglycemia according to severity include:



  • It is characterized by the presence of neurological symptoms that can prevent the patient from taking oral glucose and most of the patients need help from an observer.



  1. Seaquist, Elizabeth R.; Anderson, John; Childs, Belinda; Cryer, Philip; Dagogo-Jack, Samuel; Fish, Lisa; Heller, Simon R.; Rodriguez, Henry; Rosenzweig, James; Vigersky, Robert (2013). "Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society". The Journal of Clinical Endocrinology & Metabolism. 98 (5): 1845–1859. doi:10.1210/jc.2012-4127. ISSN 0021-972X.
  2. Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER; et al. (2009). "Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline". J Clin Endocrinol Metab. 94 (3): 709–28. doi:10.1210/jc.2008-1410. PMID 19088155.
  3. Service FJ (1999). "Classification of hypoglycemic disorders". Endocrinol Metab Clin North Am. 28 (3): 501–17, vi. PMID 10500928.
  4. "Table 1, ADA/ENDO classification of hypoglycemia in diabetes (21,22). - Endotext - NCBI Bookshelf".