How Hypoglycemia Is Treated

In This Article

The treatment of hypoglycemia (low blood sugar) can vary by the severity of symptoms and how far your blood sugar level has fallen. In milder cases, hypoglycemia can be treated with high-sugar foods or drinks or by taking over-the-counter glucose tablets or gels. For people with severe hypoglycemia due to diabetes, there are prescription drugs containing a hormone called glucagon that is delivered either by injection or nasal inhalation. 

Hypoglycemic emergencies, in which blood sugar levels cannot be restored even with appropriate treatment, require 911 medical assistance.

Home Remedies

Mild hypoglycemia can often be treated at home with fast-acting carbs that are quickly absorbed in the gut and quickly released into the bloodstream, usually within five to 15 minutes. These are simple carbohydrates that don't need to be broken down much during metabolization.

The American Diabetes Association defines hypoglycemia as a blood glucose level below 70 milligrams per deciliter (mg/dL).

If you have diabetes, you should eat between 15 to 20 grams (g) of fast-acting carbs if either the following occurs:

  • You develop symptoms of hypoglycemia such as shakiness, anxiety, headaches, sweating, heart palpitations, blurred vision, and lightheadedness.
  • Your blood sugar drops below 70 mg/dL even if there here are no symptoms.

While foods are generally the first-line defense against hypoglycemia, you should not overtreat hypoglycemia by eating too many carbs. Doing so can trigger hyperglycemia (high blood sugar) and require diabetes medications to bring your blood sugar under control.

A good strategy is to abide by the "15-15 Rule" in which you eat 15 grams of fast-acting carbs, wait 15 minutes, check your blood sugar, and repeat until your blood sugar returns to at least 70 mg/dL.

Here are some foods that deliver around 15 grams of fast-acting carbs:

  • Banana (half)
  • Corn syrup (1 tablespoon)
  • Fruit juice (1/2 to 3/4 cup or 4 to 6 ounces)
  • Honey (1 tablespoon)
  • LifeSavers (six to eight)
  • Orange juice (1/2 cup or 4 ounces)
  • Raisins (2 tablespoons)
  • Nonfat milk (1 cup or 8 ounces)
  • Soda with sugar (1/2 cup or 4 ounces)
  • Sugar (1 tablespoon or 5 small cubes)
  • Syrup (1 tablespoon)
  • Hard candies, jelly beans, and gumdrops (check the nutrition facts label to ascertain how many candies equal 15 g of carbohydrate)

Once your blood sugar has normalized, eat a small snack containing carbs and protein (like an egg or peanut butter sandwich).

Even if you don't have diabetes, you can still treat hypoglycemia with fast-acting carbs. However, it is important to see a doctor afterward as frequent unexplained crashes may be an early sign of prediabetes.

Over-the-Counter (OTC) Therapies

Hypoglycemia can also sometimes hit when you are nowhere near food and have forgotten to bring an emergency supply with you. Others find that keeping food down during a hypoglycemic event is difficult, leading to nausea or vomiting.

In such cases, over-the-counter (OTC) glucose tablets or gels offer a handy solution. Not only do these products have a long shelf life but they can be safely stored in your office desk or glove compartment. Moreover, because they don't have to be broken down by the body, they deliver results much faster, often within a matter of minutes.

Most glucose tablets are available in 4-mg formulations and require three to four tablets to return your blood sugar to normal. Glucose gel formulations are typically packaged in single-serve 15-gram tubes.

Your doctor may recommend glucose tablets or gels over fast-acting carbs if you have frequent hypoglycemic crashes. Glucose tablets or gels may also be preferred based on the types of diabetes medications you take.

If you take Precose (acarbose) or Gyset (miglitol), glucose tablets or gels should be used instead of fast-acting carbs. This is because the drugs slow the absorption of glucose and may blunt the absorption of anything other than pure glucose.

Prescriptions

If your hypoglycemia symptoms are severe and glucose tablets or fast-acting carbs are unable to provide relief, your doctor may recommend prescription medications that spur the body to produce its own glucose. This is especially true if your diabetes is poorly controlled.

This would involve either the injection or nasal inhalation of a substance called glucagon. Glucagon is a hormone produced by the pancreas that triggers the release of stored glucose (glycogen) from the liver, fat cells, and muscles.

There are two injectable forms and one intranasal form of glucagon approved for the treatment of severe hypoglycemia.

Glucagon Injections

Glucagon injections are made with a synthetic form of glucagon and are used in the event of an emergency. Because they are injectable, they can be used even if the affected person falls unconscious.

There are two injectables currently approved by the U.S. Food and Drug Administration (FDA):

  • GlucaGen, approved in 1998, comes in a kit with a vial of glucagon powder and a separate syringe prefilled with sterile water to mix with the powder to create a 1 milligram (mg) injection. It can be used in adults, children 6 and over, or children under 6 who weigh at least 55 pounds (25 kilograms).
  • Gvoke, approved in 2019, comes in a prefilled syringe with either 0.5 mg or 1 mg of glucagon solution. It can be used in adults and children 2 and over.

A generic form of GlucaGen, simply referred to as glucagon for injection, is also available.

A glucagon injection is given if your blood sugar is below 70 mg/dL and/or you are experiencing symptoms of hypoglycemia. The shot is given intramuscularly (into a large muscle) and usually normalizes blood sugar within 10 to 15 minutes.

Even if you are not sure you are having a hypoglycemic emergency, you should use the injection anyway. If your doctor has prescribed an emergency glucagon kit, it is because you need it.

Side effects tend to be mild and may include headache, stomach upset, nausea, vomiting, and injection site pain.

Baqsimi (Glucagon Nasal Powder)

In July 2019, the FDA approved Baqsimi, an intranasal formulation of glucagon used for the treatment of severe hypoglycemia. Rather than having to inject glucagon, Basqimi is inhaled into a nostril via a prefilled nasal applicator. Each dose delivers 3 grams of glucagon in powder form.

Baqsimi is used under the same circumstances as injected glucagon and with similar effectiveness. Side effects tend to be mild and include headache, nasal congestion, cough, runny nose, watery eyes, nausea, vomiting, and itchy nose, throat, or eyes.

Because Basqimi needs to be inhaled, it may not be the best option if you have a history of passing out or nearly passing out during a hypoglycemic crash. In such cases, glucagon injections may be preferred because someone else can give you the shot if you are unable to do so yourself.

When to Call 911

If someone you know falls unconscious due to a hypoglycemic event, you need to act quickly If you are unable to provide emergency treatment.

Call 911 immediately if the individual has persistently low blood sugar (below 70 mg/dL) and/or the following symptoms despite appropriate treatment:

  • Confusion
  • Dizziness
  • Nausea or Vomiting
  • Shortness of Breath
  • Tremors or Chills
  • Extreme Anxiety
  • Irritabilibility and Changes in Behavior
  • Profuse Sweating
  • Pale, Clammy Skin
  • Rapid Heartbeat
  • Extreme Fatigue or Sleepiness
  • Loss of Consciousness
  • Seizures

As you await emergency services, the 911 staff can provide you step-by-step instructions on how to deliver a glucagon injection if an emergency kit is available.

Never give an unconscious person food or drink as this can cause choking, vomiting, and asphyxiation.

In emergency situations, glucagon may be delivered intravenously (into a vein) to rapidly elevate blood sugar. Emergency medical personnel also commonly use intravenous dextrose, a form of sugar, until blood sugar levels are fully normalized. Once the individual is stabilized, oral glucose or sucrose is administered to help replenish the glycogen stores.

A Word From Verywell

Prevention is the best strategy to keep hypoglycemia at bay if you have diabetes. Proper diabetes management involves more than just monitoring your blood sugar. It demands that you recognize the early symptoms of hypoglycemia, controls your intake of carbs, and take your medications as prescribed to help keep your blood sugars within the optimal range.

If you don't have diabetes, your doctor will need to identify and treat the underlying cause of hypoglycemia. Until you are able to pinpoint the cause — whether it is diabetes-related or not — you may find yourself hard-pressed to prevent future episodes. Don't ignore the symptoms; see a doctor as soon as possible and have it checked out.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Diabetes Association. Hypoglycemia? Low blood glucose? Low blood sugar?. Clin Diabetes. 2012;30(1):38-8. doi:10.2337/diaclin.30.1.38

  2. Evert AB. Treatment of mild hypoglycemia. Diabetes Spectr. 2014;27(1):58-62. doi:10.2337/diaspect.27.1.58

  3. Eckert-Norton M, Kirk S. Non-diabetic hypoglycemia. J Clin Endocrinol Metab. 2013;98(10):39A-40A. doi:10.1210/jc.2013-v98i10-39A

  4. Derosa G, Maffioli P. α-Glucosidase inhibitors and their use in clinical practice. Arch Med Sci. 2012;8(5):899-906. doi:10.5114/aoms.2012.31621

  5. Novo Nordisk. GlucaGen (glucagon [rDNA origin] for injection). Updated December 2010.

  6. Xeris Pharmaceuticals. Gvoke (glucagon) injection, for subcutaneous use. Updated September 2019.

  7. U.S. Food and Drug Administration. Information for the physician: glucagon for injection. Updated 2018.

  8. Lilly USA. Baqsimi (glucagon) nasal powder. Updated July 2019.

  9. Sua YJ, Liao CJ. Hypoglycemia in emergency department. J Acute Dis. 2015 Mar;4(1):59-62. doi:10.1016/S2221-6189(14)60085-8

Additional Reading
Related Articles