You get shaky when hungry because your blood sugar (glucose) drops too low, triggering your body to release adrenaline to raise it, causing symptoms like tremors, sweating, and a fast heart rate, while your brain also signals intense hunger as it's deprived of its main energy source. This is a normal response, especially if you haven't eaten in a while, but it can also signal hypoglycemia (low blood sugar).
In healthy individuals, fasting blood sugar usually stays between 70 and 99 milligrams per deciliter (mg/dL). However, you can experience symptoms of hypoglycemia if your blood sugar dips below 70 mg/dL. Typical symptoms include hunger, sweating, nervousness, and shakiness.
In rare cases, it's possible for a person who doesn't have diabetes to experience hypoglycaemia. It can be triggered by malnutrition, binge drinking or certain conditions, such as Addison's disease.
If you suddenly feel weak, shaky, or lightheaded—or if you even faint—you could be experiencing hypoglycemia, per the Mayo Clinic. A headache that comes on quickly, weakness or tremor in your arms or legs, and a slight trembling of your body are also signs your blood sugar is too low.
If you have diabetes, you may experience hyperphagia, an excessive hunger that can occur even after eating a meal. This can lead to hunger pangs and cravings that can be both a discomfort and a distraction. Due to insulin dysfunction, this kind of hunger isn't uncommon in people with diabetes.
Ten key warning signs of diabetes include increased thirst and urination, extreme hunger, fatigue, blurred vision, slow-healing sores, unexplained weight loss, tingling/numbness in hands or feet, frequent infections, and sometimes dark skin patches (acanthosis nigricans), all indicating high blood sugar levels needing medical attention.
Symptoms of hyperglycaemia
Fasting blood glucose test
This is a blood test that measures blood sugar levels after fasting. If your fasting blood sugar level is between 100 mg/dL and 125 mg/dL, it's an indication that you're prediabetic.
Common signs and symptoms of low blood glucose
Eat regular meals every 3-4 hours to prevent dramatic blood sugar drops. Include fiber-rich foods like vegetables, legumes, and whole grains, which help stabilize blood sugar levels.
Dehydration, salt deficiency, and heat exhaustion can mimic hypoglycemia symptoms. It is important for people to consider environmental factors and electrolyte balance. The most reliable way to know if a person's symptoms are due to hypoglycemia is to measure their blood sugar levels.
Avoid sugary foods and processed simple carbohydrates, such as white bread or white pasta, especially on an empty stomach. When drinking alcohol, eat food with it. Eat several small meals and snacks about three hours apart throughout the day.
Hypoglycemia, although rare, is likely due to cortisol deficiency that interferes with counterregulatory response during times of stress (76). Addison's disease should be considered in a hypoglycemic individual with hyperpigmentation, hyponatremia, hyperkalemia and acidosis (75).
Hypoglycemia is frequently observed in patients with diabetes mellitus but is uncommon in patients without diabetes. Hypoglycemia in patients without diabetes may be due to a variety of causes. Therefore, it is important to take a thorough clinical history and examination.
At some time, most people with diabetes experience the sweating and shakiness that occurs when blood glucose levels fall below 70 mg/dl — a condition known as hypoglycemia. The average person with type 1 diabetes may experience symptoms of low blood glucose up to two times a week.
What is low blood sugar (hypoglycemia) in people who don't have diabetes? You may have briefly felt the effects of low blood sugar when you've gotten really hungry or exercised hard without eating enough. This happens to nearly everyone from time to time. It's easy to correct and usually is nothing to worry about.
If blood sugar levels become too low, hypoglycemia signs and symptoms can include:
If the patient is a known diabetic, consider IM glucagon (0.5 mg if <25kg and 1mg if >25kg) to assist with hypoglycemia. You can use the memory aid of the “rule of 50” or the “5/2/1 rule” – the concentration of dextrose and the volume per kilogram should equal 50.
Five early signs of diabetes include frequent urination, increased thirst and hunger, fatigue, blurry vision, and slow-healing sores or frequent infections, stemming from high blood sugar levels that affect the body's ability to use glucose for energy, leading to these common symptoms.
The same factors that may increase the risk of a person getting type 2 diabetes also may increase the risk of prediabetes, including: Age 35 or older. Excess weight in the abdomen. Family history of diabetes.
Over time, diabetes may cause nerve damage, also called diabetic neuropathy, that can cause tingling and pain, and can make you lose feeling in your feet. When you lose feeling in your feet, you may not feel a pebble inside your sock or a blister on your foot, which can lead to cuts and sores.
Prediabetes or Borderline diabetes is a condition in which you have higher than normal blood sugars, but not to a level high enough to be Diabetic. It is a condition that needs monitoring and lifestyle changes.
Feeling very thirsty. Feeling very hungry—even though you are eating. Extreme fatigue. Blurry vision.
Many conditions that mimic diabetes, such as PCOS, hypothyroidism, and Cushing's syndrome, share insulin resistance as a defining feature. The most common cause of insulin resistance is obesity.