Can GLP-1 medications cause dangerously low blood sugar?

GLP-1 medications alone rarely cause hypoglycemia (low blood sugar) because they stimulate insulin release in a glucose-dependent manner - they only increase insulin when blood sugar is elevated. However, when combined with insulin or sulfonylureas (like glipizide or glyburide), the risk of hypoglycemia increases significantly. Symptoms include: shakiness, sweating, rapid heartbeat, confusion, irritability, dizziness, hunger, and in severe cases, loss of consciousness or seizures. Prevent hypoglycemia by: working with your provider to reduce insulin or sulfonylurea doses when starting GLP-1s (typically 20-30% reduction in basal insulin), monitoring blood sugar more frequently when making medication changes, always carrying fast-acting glucose (glucose tablets, juice), wearing medical identification, and educating family about glucagon use for severe episodes. If you experience hypoglycemia on GLP-1 therapy, contact your provider promptly for medication adjustment. Never adjust diabetes medications without medical guidance.