Why low blood sugar is common in people with chronic kidney disease

Any unexpected drop in blood sugar should be discussed with a healthcare professional to identify the cause

Do you have low blood sugar? (Photo: Freepik)

3 min readNew DelhiJun 18, 2026 09:30 AM IST First published on: Jun 18, 2026 at 09:30 AM IST

Chronic kidney disease (CKD) can disrupt blood sugar control in several ways. While healthy kidneys help maintain glucose balance by breaking down insulin and producing glucose when needed, a decline in kidney function contributes to prolonged insulin in the bloodstream, which can lower blood sugar levels more than expected. “This is especially important for people with diabetes who are on insulin or certain glucose-lowering drugs,” said Dr Sumiran Mahajan, consultant nephrologist, interventional nephrology and transplant services, KIMS Hospitals, Thane.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

Is low blood sugar common in people with kidney disease?

It can happen, particularly in the later stages of kidney disease, continued Dr Mahajan. “Reduced appetite, dietary restrictions, nausea, and unintentional weight loss are common issues for many CKD patients and can lead to lower blood sugar levels. Sometimes, patients continue taking the same doses of diabetes medications even when their body’s insulin needs change, increasing the risk of hypoglycemia,” said Dr Mahajan.

What should you know about kidney health? (Photo: Getty Images/Thinkstock)

Symptoms to watch out for

Low blood sugar can cause sweating, shakiness, dizziness, weakness, hunger, headache, confusion, blurred vision, or trouble concentrating. “In severe cases, it may result in loss of consciousness if not treated quickly. Since some symptoms can be mild, regular monitoring is especially important for people dealing with both diabetes and kidney disease,” said Dr Mahajan.

Does a drop in blood sugar mean kidney disease is improving?

Not necessarily, clarified Dr Mahajan. “A decrease in blood sugar levels should not be seen as a good sign. Often, it indicates changes in how the body processes insulin and medications as kidney function worsens. Any unexpected drop in blood sugar should be discussed with a healthcare professional to identify the cause,” said Dr Mahajan.

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How can CKD patients reduce the risk of low blood sugar episodes?

Dr Mahajan advised regular blood sugar monitoring, timely meals, reviewing medications, and routine check-ups. “Patients should never change their diabetes medications without consulting a doctor. As kidney disease advances, treatment plans often need adjustments to keep blood sugar in a safe range. Early recognition of symptoms and active management can help prevent complications and enhance overall quality of life,” said Dr Mahajan.