Level 2 hypoglycemia
Also called level 2 low, very low, clinically significant hypoglycemia.
Level 2 hypoglycemia is glucose under 54 mg/dL (3.0 mmol/L). ADA calls it the threshold where brain symptoms begin and says it needs immediate action. A level 2 low with no symptoms points to impaired awareness of lows. On an AGP report it is the Very Low band. (ADA Standards of Care 2026, section 6; International consensus on time in range, 2019)
Target
Time under 54 mg/dL (3.0 mmol/L) below 1%, about 15 minutes a day. (International consensus on time in range, 2019)
Worked example
A glucose of 50 mg/dL (2.8 mmol/L) is level 2. Over 14 days of 5-minute values, 1% is about 40 values, or 15 minutes a day.
Related terms
Sources, quoted
- ADA Standards of Care 2026, section 6: “Level 2 hypoglycemia (defined as a blood glucose concentration <54 mg/dL [<3.0 mmol/L]) is the threshold at which neuroglycopenic symptoms begin to occur and requires immediate action to resolve the hypoglycemic event.”
- ADA Standards of Care 2026, section 6: “If an individual has level 2 hypoglycemia without adrenergic or neuroglycopenic symptoms, they likely have impaired hypoglycemia awareness”
- International consensus on time in range, 2019: “In the AGP report, glucose ranges are defined as “Very High” (Level 2), “High” (Level 1), “Low” (Level 1), and “Very Low” (Level 2).”
- International consensus on time in range, 2019: “time spent <54 mg/dL (<3.0 mmol/L) to less than 15 min per day”
Every quote above is checked against its source page before each update of this site; last checked 2026-10-06. The worked example is our own arithmetic. This page explains a term; it is not advice for a person's treatment.