How Hypoglycemia Is Treated

In This Article

The treatment of hypoglycemia (low blood sugar) depends on the severity of symptoms and the degree to which blood sugar levels have fallen. In mild cases, hypoglycemia can be treated with high-sugar foods or beverages or with over-the-counter (OTC) glucose tablets or gels. For severe hypoglycemia due to diabetes, there are prescription drugs delivered either by injection or nasal inhalation that contain a hormone called glucagon.

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

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

Home Remedies

Mild hypoglycemia often can be treated with fast-acting carbs that are quickly absorbed in the gut and then 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.

If you have diabetes, ingest between 15 grams and 20 grams of fast-acting carbs if either of 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 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" which involves eating 15 grams of fast-acting carbs, waiting 15 minutes, checking your blood sugar, and repeating until it returns to at least 70 mg/dL.

Foods That Deliver 15 Grams of Fast-acting Carbs
Food Quantity
Banana One half
Corn syrup 1 tablespoon 
Fruit juices 1/2 to 3/4 cup or 4 to 6 ounces
Honey 1 tablespoon
LifeSavers Six to eight candies
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, or gumdrops Consult nutrition facts labels

Once your blood sugar has normalized, eat a small snack containing carbs and protein, such as 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

If you develop hypoglycemia and are nowhere near food, or if you find that keeping food down during the event is difficult, 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 an office desk or glove compartment. Moreover, because they don't have to be broken down by the body, they deliver results quickly, often within a matter of minutes.

Most glucose tablets are available in 4-milligram tablets; it typically takes three or four tablets to return blood sugar to normal. Glucose gel formulations are packaged in single-serve 15-gram tubes.

Your doctor may recommend glucose tablets or gels rather than 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), use glucose tablets or gels instead of fast-acting carbs. These 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 by the U.S. Food and Drug Administration (FDA) for treating severe hypoglycemia.

Glucagon Injections

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

  • 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, for the treatment of severe hypoglycemia. 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 .

When to Call 911

If someone you know falls unconscious due to a hypoglycemic event, act quickly If you are unable to provide emergency treatment yourself (such as giving a shot).

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
  • Irritability 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 try to 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, control 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.

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

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