If you’re taking a GLP-1 agonist or considering one for weight loss or Type 2 diabetes management, it’s natural to wonder about side effects—especially low blood sugar. The good news is that GLP-1 agonists typically do not cause hypoglycemia on their own. However, when combined with other medications or taken incorrectly, the risk may increase.

At Genesis Lifestyle Medicine, we help individuals achieve sustainable health through science-backed solutions like GLP-1 agonists. In this article, we explore how these medications work, the risk of hypoglycemia, and how to use them safely under expert medical guidance.

What are GLP-1 agonists?

GLP-1 agonists, or glucagon-like peptide-1 receptor agonists, are medications originally developed to treat Type 2 diabetes. They mimic a natural hormone your intestines produce in response to food, which helps regulate your blood sugar levels. By binding to GLP-1 receptors in your body, these medications promote insulin secretion, suppress glucagon (a hormone that raises blood sugar), and slow down digestion.

What makes GLP-1 agonists unique is their ability to also support weight loss. They signal your brain to feel full faster and longer, reducing your appetite and calorie intake. As a result, many people taking GLP-1 medications—like semaglutide, liraglutide, or tirzepatide—experience noticeable, sustained weight loss. Because of this, the FDA has approved certain GLP-1 agonists specifically for treating obesity, even in patients without diabetes.

Do GLP-1 agonists cause hypoglycemia?

Hypoglycemia occurs when your blood sugar drops below 70 mg/dL, leading to symptoms like shaking, dizziness, sweating, confusion, weakness, and intense hunger. In severe cases, it can lead to fainting, seizures, or even death if not treated promptly.

GLP-1 agonists are very unlikely to cause hypoglycemia on their own. That’s because they help the body release insulin only when your blood sugar is elevated, not when it’s already low. This glucose-dependent action makes them safer than other diabetes medications, such as sulfonylureas or insulin, which lower blood sugar regardless of your current levels.

However, hypoglycemia can occur in the following cases:

• You’re taking a GLP-1 agonist with other glucose-lowering medications, such as insulin.
• You’re not eating enough or skipping meals.
• You have an underlying medical condition that affects your metabolism.

That’s why it’s essential to work with a healthcare provider—like the experts at Genesis Lifestyle Medicine—to create a treatment plan tailored to your needs. We monitor your progress closely and adjust your medications to minimize risks while maximizing results.

How to take GLP-1 agonists safely and effectively

Using GLP-1 agonists properly helps reduce the chance of hypoglycemia and supports your overall success. Here are some important tips to follow:

• Follow your provider’s dosing instructions: Always start with the dose prescribed by your provider. GLP-1 agonists are usually started at a low dose to reduce side effects like nausea, and then gradually increased. Don’t adjust your dose without medical guidance, as improper dosing can increase your risk of complications.
  
• Avoid combining GLP-1s with other glucose-lowering medications unless advised: If you’re already taking insulin or sulfonylureas, your provider may need to lower the dose of those medications when you start a GLP-1 agonist. This prevents your blood sugar from dropping too low. Never stop or adjust any of your medications without professional support.
  
• Don’t skip meals or drastically reduce calories: While appetite suppression is a benefit, it’s important to maintain a balanced intake of food. Skipping meals or not eating enough carbs can contribute to hypoglycemia—especially if you’re taking other medications. Focus on nutrient-rich, portion-controlled meals that support steady energy.
  
• Monitor your blood sugar regularly (if diabetic): If you have diabetes, monitor your glucose levels, especially in the first few weeks of treatment. Tracking helps you and your provider identify patterns, adjust your regimen if necessary, and catch any low readings early before they become dangerous.
  
• Stay hydrated and listen to your body: GLP-1 agonists can cause gastrointestinal side effects like nausea or vomiting, especially at the beginning. These symptoms can lead to dehydration or reduced food intake, which in turn affects your blood sugar. Stay hydrated, eat slowly, and inform your provider if symptoms persist.
  
• Communicate with your healthcare provider regularly: Ongoing support is key to your success. At Genesis Lifestyle Medicine, we’re here to help you every step of the way—through check-ins, coaching, lab monitoring, and lifestyle adjustments.

GLP-1 agonists are powerful tools for managing Type 2 diabetes and obesity, and they typically carry a low risk of hypoglycemia, especially when taken as prescribed. At Genesis Lifestyle Medicine, we offer personalized, medically supervised programs that include advanced GLP-1 treatments like semaglutide. Our expert team will guide you every step of the way to help you lose weight, balance your blood sugar, and feel your best—safely and effectively. Schedule a consultation today!