From the Guidelines
For a patient with a blood sugar level of 60 mg/dL, I recommend administering 15-20 grams of fast-acting carbohydrates, such as glucose tablets or glucose gel packets, as the most effective treatment to rapidly restore blood glucose levels. This approach is supported by the most recent guidelines from the American Heart Association and American Red Cross, which suggest that administration of 20 g oral glucose or the equivalent in glucose-containing foods can rapidly restore blood glucose levels 1. The American Diabetes Association also recommends glucose (15 to 20 g) as the preferred treatment for conscious persons with hypoglycemia (glucose alert value of ≤3.9 mmol/L [70 mg/dL]) 1.
Key Considerations
- The patient should be given 15-20 grams of fast-acting carbohydrates, which can be in the form of glucose tablets (typically 4 grams per tablet, so 4-5 tablets), 4 ounces (120 mL) of fruit juice, 1 tablespoon of honey, or 3-4 glucose gel packets.
- After administering the sugar, wait 15 minutes and recheck the blood glucose level.
- If it remains below 70 mg/dL, repeat the treatment with another 15 grams of carbohydrates.
- Once the blood sugar rises above 70 mg/dL, the patient should consume a small meal or snack containing both carbohydrates and protein to maintain stable blood sugar levels.
Important Notes
- For patients experiencing severe hypoglycemia with unconsciousness or inability to swallow safely, oral sugar is not appropriate, and emergency medical services should be called for injectable glucagon or IV dextrose administration.
- Glucagon should be prescribed for all patients at increased risk for clinically significant hypoglycemia, defined as blood glucose less than 3.0 mmol/L (54 mg/dL), so that it is available if needed 1.
- The treatment approach is based on the most recent and highest quality studies, which prioritize the administration of fast-acting carbohydrates to rapidly restore blood glucose levels and alleviate symptoms of hypoglycemia 1.
From the Research
Hypoglycemia Treatment
The provided studies do not directly address the question of how much sugar pill in grams should be given to a patient with a blood sugar level of 60. However, they do discuss the management of hypoglycemia and blood glucose levels.
Blood Glucose Management
- The studies suggest that hypoglycemia can be life-threatening and requires immediate treatment to raise glucose levels 2, 3.
- Blood glucose monitoring is crucial in managing diabetes and preventing complications 4.
- The target blood glucose level for hospitalized patients is between 140 to 180 mg per dL 5.
Glucagon and Hypoglycemia
- Glucagon is an emergency medication that can quickly raise glucose levels in people with severe hypoglycemia 2, 6.
- Glucagon plays a critical role in preventing hypoglycemia in normal physiology and is involved in the pathophysiology of diabetes 6.