If you have diabetes, check your blood sugar level whenever you have symptoms of low blood sugar. If your blood sugar is low (70 mg/dL), you need to treat yourself right away.
Eat something that has about 15 grams of carbohydrates. Examples are:
3 glucose tablets
A 1/2 cup (4 ounces) of fruit juice or regular, non-diet soda
5 or 6 hard candies
1 tablespoon sugar, plain or dissolved in water
1 tablespoon honey or syrup
Wait about 15 minutes before eating anything else. Be careful not to over-treat by eating too much. This can cause high blood sugar and weight gain.
Check your blood sugar again.
If you don't feel better in 15 minutes and your blood sugar is still low (less than 70 mg/dL), eat something that has 15 grams of carbohydrates again.
You may need to eat a snack that has carbohydrates and protein if your blood sugar is in a safer range (over 70 mg/dL) and your next meal is more than an hour away.
If these steps for raising your blood sugar do not work, call your doctor right away.
Persons with severe hypoglycemia are treated with glucose injections or the hormone glucagon. Immediate treatment is needed to prevent serious complications or death.
If hypoglycemia is caused by an insulinoma (insulin-releasing tumor), surgery to remove the tumor is the best treatment.
Untreated, hypoglycemia from too much insulin can lead to loss of consciousness and coma.
Severe hypoglycemia is a medical emergency that may cause seizures and permanent damage to the nervous system if not treated. Severe hypoglycemia in which you become unconscious is also called insulin shock.
Learn to recognize the early warning signs of hypoglycemia and treat yourself quickly.
Calling your health care provider
If signs of low blood sugar do not improve after you have eaten a snack that contains sugar:
GET A RIDE to the emergency room, or
Call a local emergency number (such as 911)
DO NOT drive when your blood sugar is low.
Get medical help right away for a person with diabetes or low blood sugar who:
Becomes less alert
Cannot be woken up
If you have diabetes, follow your doctor's advice about diet, medicine, and exercise.
Preventing low blood sugar is better than having to treat it. When you exercise, check your blood sugar levels. Make sure you have snacks with you if you take insulin or other medicines that lower your blood sugar.
Ask your doctor or nurse if you need to eat a bedtime snack to prevent low blood sugar overnight. Protein snacks may be best.
Do not drink alcohol without eating food. If you do drink, have only one or two drinks at the most.
Your doctor may tell you to change your diet so that you get even amounts of sugar into your body throughout the day. You may be told to eat small, frequent meals that contain complex carbohydrates, fiber, and fat, and to avoid simple sugars, alcohol, and fruit juice.
Eat meals at regular times. Eat extra food when you exercise more.
If you have a history of hypoglycemia, keep a snack or drink containing sugar with you at all times. Eat the snack as soon as symptoms appear.
American Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care. 2011;34 Supl 1:S11-S61.
Cryer PE. Glucose homeostasis and hypoglycemia. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 33.
Ari S. Eckman, MD, Division of Endocrinology, Diabetes and Metabolism, Trinitas Regional Medical Center, Elizabeth, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.