Patient Education for Intermittent Hypoglycemic Episodes
Immediate Self-Treatment Steps
If you feel symptoms of low blood sugar and can swallow safely, immediately take 15-20 grams of fast-acting carbohydrates, wait 15 minutes, recheck your blood glucose, and repeat if still low. 1, 2
What to Take for Mild Hypoglycemia (When You're Conscious and Alert)
- Glucose tablets are the preferred treatment if available—take enough to equal 15-20 grams of glucose 1, 2
- If glucose tablets are unavailable, use these alternatives 1:
- 4-8 ounces of regular (not diet) juice or soda 1
- 3-4 glucose tablets or glucose gel
- 1 tablespoon of sugar, honey, or corn syrup
- Hard candies (check label for 15-20 grams of carbohydrate)
The 15-15 Rule
- Wait 15 minutes after taking carbohydrates, then recheck your blood glucose 1, 2
- If your blood glucose is still below 70 mg/dL (3.9 mmol/L), repeat the 15-20 grams of fast-acting carbohydrates 1, 2
- Once your blood glucose is above 70 mg/dL, eat a meal or snack containing protein and complex carbohydrates to prevent recurrence 1, 2
When to Call 911 Immediately
Call emergency services right away if you or someone with diabetes: 1
- Becomes unconscious or cannot be awakened
- Has a seizure
- Cannot follow simple commands or swallow safely
- Does not improve after 15 minutes of treatment, or worsens during that time 1
Emergency Treatment by Others (For Severe Hypoglycemia)
If You Cannot Swallow or Are Unconscious
Family members and caregivers should administer glucagon immediately—they do not need to be healthcare professionals to give this injection. 3, 4
- Glucagon dose: 1 mg injected into the upper arm, thigh, or buttocks for adults and children over 25 kg (or age 6 and older); 0.5 mg for children under 25 kg (or under age 6) 4
- Call 911 immediately after giving glucagon 4
- Turn the person on their side after giving glucagon to prevent choking if they vomit 4
- If no response after 15 minutes, a second dose may be given while waiting for emergency help 4
- Never put food, drink, or glucose tablets in the mouth of an unconscious person—this causes choking risk 3
Essential Supplies to Carry at All Times
Always carry a source of fast-acting sugar with you wherever you go, especially if you're on tight blood glucose control 1, 2
- Glucose tablets or glucose gel (preferred)
- Small juice boxes or regular soda
- Hard candies
- Sugar packets
Educate Your Family and Close Contacts
Teach people who spend time with you about hypoglycemia symptoms, treatment, and how to give glucagon. 1, 3
What They Need to Know:
- Early warning symptoms: sweating, tremor, palpitations, hunger, anxiety, confusion, weakness, blurred vision, slurred speech 1, 5
- How to give you sugar if you're conscious
- How to inject glucagon if you're unconscious 3, 4
- To call 911 immediately in severe cases 1, 3
- To stay calm—most people recover quickly with proper treatment 1
Wear Medical Identification
Wear a medical alert bracelet or necklace stating you have diabetes so others can recognize that unusual behavior, seizures, or unconsciousness may be due to low blood sugar 1
- This helps you receive appropriate emergency treatment faster
- Medical identification can be purchased online or from medical supply stores 1
Alcohol Precautions
Limit alcohol to 1-2 drinks per day maximum—alcohol prevents your liver from releasing glucose and significantly increases hypoglycemia risk 1, 2
- Never drink on an empty stomach
- Always eat food when consuming alcohol
- Check your blood glucose more frequently when drinking 1
When to Check Blood Glucose More Often
Increase the frequency of blood glucose monitoring during: 1
- Physical or emotional stress
- Illness or infection
- Changes in meal timing or food intake
- Increased physical activity or exercise
- After any hypoglycemic episode
Common Triggers to Avoid
Be aware that hypoglycemia risk increases with 3:
- Skipping or delaying meals
- Taking diabetes medication but not eating enough
- Exercising more than usual without adjusting food or medication
- Drinking alcohol, especially without food
- Taking too much diabetes medication
Follow-Up After Any Severe Episode
Contact your healthcare provider after any severe hypoglycemic episode or if you're having frequent mild episodes 3, 6
- Your diabetes medication regimen may need adjustment
- Your blood glucose targets may need to be relaxed temporarily 1
- You may need additional education on preventing future episodes 3
Critical Safety Points
- Never delay treatment if you suspect low blood sugar—treat first, confirm with testing after if needed 6
- Keep glucagon at home and ensure family members know where it is and how to use it 3, 4
- Replace expired glucose tablets and glucagon before expiration dates 4
- After using glucagon, you must still seek emergency medical care even if you feel better 4