From the Guidelines
The recommended treatment for hypoglycemia is to consume 15-20 grams of fast-acting carbohydrates, such as glucose tablets or glucose-containing foods, and wait 15 minutes before rechecking blood sugar levels. According to the most recent and highest quality study 1, administration of 20 g oral glucose or the equivalent in glucose-containing foods can rapidly restore blood glucose levels. Good options for fast-acting carbohydrates include 4 ounces of fruit juice or regular soda, 1 tablespoon of honey or sugar, 8 ounces of milk, or 3-4 glucose tablets. If blood sugar remains low after 15 minutes, the treatment should be repeated 1.
Key Considerations
- For severe hypoglycemia with unconsciousness or inability to swallow safely, bystanders should administer glucagon via injection or nasal spray and call emergency services 1.
- People with diabetes or those prone to hypoglycemia should carry fast-acting carbohydrates at all times and wear medical identification.
- Regular meals, monitoring blood sugar, and adjusting medications as directed by healthcare providers help prevent hypoglycemic episodes.
- It is essential to recheck blood sugar levels 15 minutes after treatment and repeat the treatment if hypoglycemia persists 1.
Prevention and Management
- Hypoglycemia unawareness or one or more episodes of level 3 hypoglycemia should trigger hypoglycemia avoidance education and reevaluation and adjustment of the treatment plan to decrease hypoglycemia 1.
- Ongoing assessment of cognitive function is suggested with increased vigilance for hypoglycemia by the clinician, patient, and caregivers if impaired or declining cognition is found 1.
- Glucagon should be prescribed for all individuals at increased risk of level 2 or 3 hypoglycemia, so that it is available should it be needed 1.
From the FDA Drug Label
When the patient has responded to the treatment and is able to swallow, give oral carbohydrates to restore the liver glycogen and prevent recurrence of hypoglycemia. The recommended treatment for hypoglycemia includes administering glucagon and then giving oral carbohydrates to restore liver glycogen and prevent recurrence of hypoglycemia, after the patient has responded to the initial treatment and is able to swallow 2.
- The type and amount of carbohydrates are not specified in the label.
- Glucagon is administered first to raise blood glucose levels.
- Oral carbohydrates are given after the patient responds to glucagon treatment.
From the Research
Hypoglycemia Treatment
The recommended treatment for hypoglycemia (low blood sugar) typically involves the consumption of rapid-acting carbohydrates.
- The optimal dose of carbohydrates for treating nonsevere hypoglycemia is generally considered to be 15-20 grams of oral glucose, as stated in 3, 4.
- This dose may need to be individualized based on factors such as body weight or type of insulin delivery system, as noted in 3, 5.
- For mild-to-moderate hypoglycemia, 15-16 grams of carbohydrates are often recommended, with the treatment repeated after 15 minutes if hypoglycemia persists, as mentioned in 3, 5.
Severe Hypoglycemia
In cases of severe hypoglycemia, treatment may involve the administration of glucagon or intravenous glucose.
- Intramuscular glucagon (1mg) or intravenous dextrose (25g) can be used to treat hypoglycemic coma, with intravenous dextrose resulting in faster restoration of normal conscious level, as reported in 6.
- Current and new formulations of glucagon are available for the treatment of severe hypoglycemia, and education on symptoms, prevention, and treatment is essential for optimal management of diabetes, as discussed in 7.