Treating Low Blood Sugar: The 15-15 Rule and Glucagon

Key points

• Blood sugar below 70 mg/dL is low — hypoglycemia — and can be very dangerous.
• Know how to treat it immediately.

The 15-15 rule

If your blood sugar is low:

1. Have 15 grams of carbs, then wait 15 minutes.
2. Check your blood sugar. If it's still below 70 mg/dL, repeat.
3. Keep repeating until you're back in your target range.
4. Then eat a balanced snack or meal with protein and carbs.

Tips

• Young children, especially infants and toddlers, may need less than 15 grams — ask your doctor how much.
• Check often when lows are more likely, such as in hot weather or while traveling.

What to eat

You need sugar that absorbs fast. Fiber (fruit, beans, lentils) and fat (chocolate, baked goods) slow absorption. Always keep at least one of these at home and with you:

Severely low blood sugar

Below 55 mg/dL is severely low. The 15-15 rule may not work, and you may not be able to check or treat it yourself.

• Injectable glucagon is the best treatment. Kits are prescription — ask your doctor whether you should have one, and learn to use it.
• Get emergency medical care right after a glucagon injection.
• Someone who has fainted usually wakes within 15 minutes. If not, give one more dose.
• Once they're awake and can swallow, give a fast sugar (regular soda or juice), then long-acting carbs with protein — crackers and cheese, or a meat sandwich.

Prevention

Check your blood sugar often to spot trends and adjust before it drops too low. If lows keep happening, share your readings, medicines, activity and eating patterns with your doctor, who may be able to find the pattern and adjust your plan. Don't change your medicines without talking to your doctor. More on managing blood sugar.

What loved ones should know

Make sure friends, family, co-workers, caregivers, teachers and others around you know the signs of low blood sugar, how to test your blood sugar and what to do — including how to use your glucagon kit and where it's kept. When blood sugar is severely low, you may be unconscious or too confused to treat yourself.

Sources

Based on "Treatment of Low Blood Sugar (Hypoglycemia)," Centers for Disease Control and Prevention; a work of the United States government in the public domain.