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How is hypoglycemia treated?

The acute management of hypoglycemia involves the rapid delivery of a source of easily absorbed sugar. Regular soft drinks, juice, lifesaver candies, table sugar, and the like are good options. In general, 15 grams of glucose is the dose that is given, followed by an assessment of symptoms and a blood glucose check if possible. If after 10 minutes there is no improvement, another 10-15 grams should be given. This can be repeated up to three times. At that point, the patient should be considered as not responding to the therapy and an ambulance should be called.

The equivalency of 10-15 grams of glucose (approximate servings) are:

  • Four lifesavers
  • 4 teaspoons of sugar
  • 1/2 can of regular soda or juice

Many people like the idea of treating hypoglycemia with dietary treats such as cake, cookies, and brownies. However, sugar in the form of complex carbohydrates or sugar combined with fat and protein are much too slowly absorbed to be useful in the acute treatment of hypoglycemia.

Once the acute episode has been treated, a healthy, long-acting carbohydrate to maintain blood sugars in the appropriate range should be consumed. Half a sandwich is a reasonable option.

If the hypoglycemic episode has progressed to the point at which the patient cannot or will not take anything by mouth, more drastic measures will be needed. In many cases, a family member or roommate can be trained in the use of glucagon. Glucagon is a hormone that causes a rapid release of glucose stores from the liver. It is an injection given intramuscularly to an individual who cannot take glucose by mouth. A response is usually seen in minutes and lasts for about 90 minutes. Again, a long-acting source of glucose should thereafter be consumed to maintain blood sugar levels in the safe range. If glucagon is not available and the patient is not able to take anything by mouth, emergency services (for example 911) should be called immediately. An intravenous route of glucose administration should be established as soon as possible.

With a history of recurrent hypoglycemic episodes, the first step in treatment is to assess whether the hypoglycemia is related to medications or insulin treatment. Patients with a consistent pattern of hypoglycemia may benefit from a medication dose adjustment. It is important that people with diabetes who experience hypoglycemia check blood glucose values multiple times a day to help define whether there is a pattern related to meals or medications. Some people who experience recurrent hypoglycemia will benefit from changes in their dietary patterns; for example, eating multiple small meals and frequent small snacks throughout the day rather than three larger meals.

Return to Low Blood Sugar (Hypoglycemia)

See what others are saying

Comment from: Gustalynn, 55-64 Female (Patient) Published: October 27

I carry glucose tablets in my purse but I find I have to have a few to get me up. It dropped at home and hit me suddenly, I felt hungry, and then I started to go to the kitchen. Then I started having the shakes. I tested my sugar and it was 52. I started walking like a drunk with difficulty to talk. I woke my husband up because I was getting drowsy, and so weak I could not stand. I started with milk while my husband fixed me with 2 wheat toasts with peanut butter and jelly and my milk. I am feeling a lot better and I will recheck the sugar. I did and it's 114, 30 minutes after eating.

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Comment from: Mamab, 35-44 Female (Patient) Published: January 23

I am a 36 year old mother of 6 and I have had hypoglycemia for about 15 years now. I never think too much of it, if I feel like my blood sugars are getting low I eat. But I had my worst, most scary episode with it in November. I was shopping with my sister, I remember feeling like I needed to eat and the next thing I know I'm waking up in the ambulance; I had a 3 minute grand mal seizure. Never in my life have I ever had anything like this happen. My blood sugar spiked because I made sure I had my sugars before shopping and then they dropped rapidly with no major sign to me. I didn't have the feelings leading up to it as I usually do because it usually drops at a slower rate but this day it dropped fast, too fast for me to react. So know I am trying to learn how to eat making sure I have the sugars to keep it up and also the protein to hold onto the sugars longer.

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Comment from: Veronica, 19-24 Female (Patient) Published: October 31

I'm 21 and found out I have hypoglycemia from when I was 7. Now it just gets worse and has gotten much worse over the past year. I have to limit my alcohol as a result of fainting. I have to eat sugary substances every couple hours now and can't be in any physical activities anymore because when my sugar drops, sometimes I even have seizures and I vomit. Sometimes I feel like it's worse than diabetes.

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