Zhang Linghe’s hypoglycaemia: Why it happens and how to prevent it

Health concerns erupted among fans after videos of Chinese actor and Pursuit of Jade leading man Zhang Linghe appearing to limp on set began circulating on social media.

Fresh off the success of his breakthrough role as Xie Zheng (also known as the Marquis of Wei’an) alongside Chinese actress Tian Xiwei, the 28-year-old actor has been busy filming his upcoming period drama The Road to Glory, which reportedly involves physically demanding action scenes and wire work.

In several videos making the rounds online, the actor could be seen struggling to get up from the ground, while co-star Jelly Lin and crew members rushed forward to assist him.

His agency later clarified on April 28 via Chinese social media that Linghe had experienced mild hypoglycaemia while filming a fight scene due to intense physical exertion coupled with insufficient sugar intake. The condition was further aggravated by a muscle strain. He has since consulted a specialist and was found to have no other serious health concerns.

According to Dr Lim Wee Peng, Medical Director at Parkway Shenton, hypoglycaemia — commonly known as low blood sugar — can occur when intense physical exertion is combined with inadequate food intake.

Contrary to popular belief, hypoglycaemia is not exclusive to people with diabetes and can also affect otherwise healthy individuals.

How does hypoglycaemia happen?

Hypoglycaemia occurs when blood sugar levels fall below what the body needs to function properly — essentially when the body uses energy, or glucose, faster than it can be replaced. While the condition is more commonly associated with diabetes, it can also occur in healthy individuals if they go too long without eating, engage in intense physical activity, or consume alcohol without food.

Dr Lim explains that poor sleep and exhaustion can also make the body less resilient. People with diabetes remain at higher risk, particularly if they are taking medications that lower blood sugar levels. However, even individuals without diabetes can be vulnerable if they are under-fuelled, physically overexerted, or recovering from an illness.

“Not everyone has the same buffer — some people are less resilient to fasting, stress and intense exertion,” says Dr Lim.

Common warning signs and symptoms

Early signs of hypoglycaemia often include shakiness, sweating, dizziness, weakness, sudden hunger, heart palpitations, headaches, nausea and difficulty concentrating. Some people may also feel unusually anxious, irritable or light-headed.

If blood sugar levels continue to drop, symptoms can become more severe and affect both physical and mental functioning. Individuals may begin experiencing confusion, poor coordination, blurred vision, drowsiness or even fainting.

“If someone feels shaky, sweaty, light-headed and unable to focus during or after exertion, low blood sugar is one possible cause to consider,” says Dr Lim.

What are the best ways to prevent hypoglycaemia?

Prevention often comes down to planning ahead. Dr Lim advises against doing strenuous activities on an empty stomach and recommends maintaining regular meals throughout the day. If exercise or a physically demanding schedule is planned, having a light snack beforehand can help maintain stable energy levels.

He adds that staying hydrated and paying attention to early warning signs of fatigue or light-headedness are equally important.

“For example, if you know you have a long day of meetings followed by an evening workout, or you’re heading for a spin class after barely eating all afternoon, it helps to have a balanced snack beforehand rather than relying on coffee alone,” he says.

For longer workouts or particularly demanding days, keeping a quick source of sugar nearby — such as fruit juice, sweets, glucose tablets or a sports drink — can also be helpful.

“Good preparation matters — enough food, enough fluids, and not pushing through warning signs.”

What should you do if you suspect low blood sugar?

If someone suspects they are experiencing low blood sugar, Dr Lim recommends stopping their activity immediately and moving to a safe place to sit or lie down.

If the individual is fully alert and able to swallow, they should consume a fast-acting source of sugar, such as fruit juice, a sugary drink, glucose tablets or sweets. Once symptoms improve, this should ideally be followed by a proper snack or meal if the next meal is not happening soon.

He also cautions against immediately resuming exercise, driving or operating machinery until symptoms have fully resolved.

“The first step is simple: stop, take sugar if it is safe to do so, and don’t try to push through it,” he says.

While a quick source of sugar can provide immediate relief, Dr Lim stresses the importance of understanding what triggered the episode in the first place.

“Low blood sugar is not just a diabetes issue and it should not be brushed off if it keeps happening.”

When should you seek medical attention?

Medical attention should be sought if symptoms become severe, particularly if a person becomes confused, faints, has a seizure, or does not improve after consuming sugar.

Dr Lim also notes that recurring episodes should never be dismissed as simple fatigue or stress.

“Repeated low blood sugar symptoms should not be brushed off as ‘just tiredness’ or ‘just stress’. Sometimes there may be an underlying issue that requires further assessment,” he says.

“If symptoms are severe, recurrent, or don’t settle promptly, it’s important to get checked.”