How Hypoglycemia Is Treated

Hypoglycemia symptoms may appear unexpectedly, but can promptly be treated fairly easily. It's important to treat hyperglycemia quickly, whether or not you have diabetes because it can lead to serious, potentially life-threatening complications. Treatment involves immediate action to get your blood sugar back up—usually with fast-acting sugars from food, or in severe cases with a medication called ​glucagon. As a follow-up, it's important to identify the cause of the hypoglycemia and address that as well.

Home Remedies and Lifestyle

Treatment to get your blood sugar back up right away will depend on your symptoms and how severe your hypoglycemia is.

Immediate Treatment With Fast-Acting Carbohydrates

If you have the early symptoms of hypoglycemia like shakiness, anxiety, irritability, headaches, sweating, heart palpitations, hunger, blurred vision, difficulty concentrating, and fatigue, or if your blood sugar is 70 mg/dL or below, even if you don't feel symptoms, 15 to 20 grams of fast-acting carbohydrates can get your blood sugar up quickly.

The fastest-acting carbs are simple sugar-based foods that absorb rapidly into your bloodstream after you eat them. They absorb so quickly that they can change your blood glucose levels within five to fifteen minutes. Additional fat or protein slows down the absorption of glucose into your bloodstream.

When you have diabetes, overtreating hypoglycemia can start a cycle of highs and lows that make it difficult to regain control. To avoid over treating hypoglycemia, a good strategy is the "Rule of 15," which basically means to eat 15 grams of fast-acting carbohydrates, wait 15 minutes, and check your blood sugar again. Repeat until your blood sugar is within recommended levels. Once your blood sugar has stabilized, eat a small, balanced snack that contains carbohydrates and protein, like an egg or a peanut butter sandwich, if your next meal or snack is more than an hour or two away.

If you don't have diabetes and you're experiencing symptoms of hypoglycemia, you should still treat it with fast-acting carbohydrates, but then you need to see your doctor as soon as possible to find out what's causing your symptoms. Your doctor will need to treat that condition to prevent hypoglycemia from reoccurring.

Fast-Acting Carbohydrate Options

Here are some choices that provide around 15 grams of fast-acting carbohydrates:

  • Banana (half)
  • Corn syrup (1 tablespoon)
  • Fruit juice (usually 1/2 to 3/4 cup, or 4–6 ounces)
  • Glucose gel (one small tube is usually 15 g)
  • Glucose tablets (3–4)
  • Honey (1 tablespoon)
  • LifeSavers (6–8)
  • 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 sugar cubes)
  • Syrup (1 tablespoon)
  • Hard candies, jelly beans, and gumdrops (check the nutrition facts label to see what serving size provides 15 grams of carbohydrate)

Note that the glucose gel and tablets should always be used if you take Precose (acarbose) or Gyset (miglitol) for your diabetes treatment. These medications slow digestion, so rapid-acting glucose or dextrose is needed.

Good Diabetes Management

Prevention is the smartest strategy to keep hypoglycemia at bay when you have diabetes. Proper diabetes management, including being vigilant about testing your blood sugars, learning to recognize the early symptoms of hypoglycemia, controlling the number of carbohydrates you eat and taking your medication as directed can help keep your blood sugars within an optimal range and ward off episodes of hypoglycemia.

Prescriptions

If your symptoms become so severe that you can't safely ingest fast-acting carbohydrates or you're unconscious, you'll need an injection of glucagon or you'll need to have an intravenous (IV) dose of glucose delivered in the hospital or by a paramedic.

Glucagon

Glucagon is a hormone that's similar to insulin and made in the pancreas. Insulin lowers your blood sugar by helping your body turn glucose (sugar) into energy and storing it in your muscles, liver, and fat cells for future use. Glucagon, on the other hand, increases your blood sugar by sending a signal to your liver and muscles to release glucose into the blood.

If you have diabetes, your doctor will likely give you a prescription for a glucagon kit or two to keep on hand at home. It's important that you train the people close to you on how to use the kit in case you end up in a hypoglycemic emergency. Anyone can be trained to give a glucagon injection.

Make sure the people close to you are familiar with where your kit is, as well as how to use it quickly and calmly. Typically, a glucagon injection will allow you to fully recover between one and six hours after treatment and avoid a trip to the emergency room.

When to use it: A glucagon injection should be used when you're having symptoms of hypoglycemia and/or your blood sugar level is 70 mg/dL or below and you're unable to swallow or you're unconscious. Even if for some reason you or your loved one isn't sure if you're having hypoglycemia or hyperglycemia (too much blood sugar), use the injection anyhow. If it is hypoglycemia, this should get blood sugar levels back to normal and if it's hyperglycemia, it won't be particularly harmful until help arrives. This treatment may save your life.

Storage: Store your glucagon kit at room temperature. If it might be in temperatures that are above 90°F, you can put it in the refrigerator or a cooler temporarily, but don't ever freeze it.

Be sure to check the expiration date and replace your kits as needed. It's not a bad idea to keep your expired kits around so you can teach others how to use them. They can practice mixing the solution up and injecting a piece of fruit.

Instructions: Glucagon comes in a package with a vial of powder, a syringe filled with liquid, and instructions on how to mix and inject it. Here's a summary of what to do:

  1. Inject the liquid in the syringe into the vial of powder and swirl it around gently until it's mixed.
  2. Insert the needle of the syringe into the vial and pull out the liquid from the vial, making sure there aren't any trapped air bubbles.
  3. Turn the person onto his or her side, since these injections can cause vomiting and you don't want your loved one to choke.
  4. If you're giving the injection to an adult, inject all of the liquid into a major muscle such as the buttock, upper arm, or thigh. Make sure you get it deep into the muscle so it can be as effective as possible. For a child, you may only need to use half the injection, wait 20 minutes, and give the rest if needed. Talk to your doctor about how to handle this. Thankfully, there isn't a danger of glucagon overdose.

After injection: The injection should take effect within minutes and the person should regain consciousness within 15 minutes. After 10 minutes, check the blood sugar. If it's still under 60 mg/dL and the person is still unconscious, inject a second dose if it's available. If you don't have a second dose or if you administer the second dose and the person still isn't responding or is having trouble breathing, call 911.

Once you wake up, usually within five to 10 minutes, you may vomit or feel nauseous, but you'll need a snack that has both protein and carbs, like a peanut butter sandwich, as soon as possible. Check your blood sugar over the next few hours to make sure your levels are staying within a normal range and contact your doctor to report the incident.

Treating Underlying Causes

If you don't have diabetes, your doctor will need to treat the underlying cause of your hypoglycemia. For instance, if it's caused by a medication you're on, your doctor may adjust your dose or start you on a different one. If you became hypoglycemic because you have a pancreatic tumor, you will probably have surgery to remove it. If the hypoglycemia is caused by a condition like kidney disease or an adrenal disorder, your doctor will treat that condition to stop hypoglycemia from recurring.

If you have diabetes and you become unconscious from severe hypoglycemia, you have recurrent episodes of hypoglycemia (especially if you have no symptoms), or you suspect you're having nocturnal hypoglycemia, your doctor will need to pinpoint what's going on and probably adjust your medications. It's important to treat the underlying cause of your recurrent hypoglycemia so it doesn't become dangerous.

In Emergencies

If your loved one has diabetes and he or she is acting strangely, has slurred speech, is confused, or has passed out, test the blood sugar if you're able. If it's 70 mg/dL or below and you're trained and feel confident, administer a glucagon injection according to the package directions. This should bring your loved one back to consciousness within 15 minutes. Never try to give someone who is unconscious food or drink because they may aspirate it into their lungs, creating an even bigger problem.

Call 911 in these circumstances:

  • Your loved one is unconscious, you're unsure why, and you're unable to test the blood sugar.
  • You tested your loved one's blood sugar and it's 70 mg/dL or below and he or she is having severe symptoms of hypoglycemia, but you don't feel that you can handle giving a glucagon injection.
  • Your loved one is unconscious and you know it's due to hypoglycemia, but there isn't a glucagon kit available or you don't know where it is.
  • Your loved one is having a seizure and you don't have access to or don't feel comfortable with administering glucagon.
  • Your loved one hasn't woken up within 15 minutes after a glucagon injection.
  • Your loved one's blood sugar is still under 60 mg/dL after a glucagon injection.
  • Your loved one is having trouble breathing.

In these situations, paramedics can administer IV glucose or a glucagon injection to quickly get your loved one's blood sugar back up or get him or her to the hospital for the same treatment.

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