For mild or moderate episodes of hypoglycemia the “Rule of 15” applies. Here’s what to do:
- Consume 15 grams of simple carbohydrates if blood glucose is 50–70 mg/dL or 2.8-3.9 mmol/L. Up it to 30 g if blood glucose is <50 mg/dL or <2.8 mmol/L.
- Wait 15 min.
- Check blood glucose again.
- If the level is still <70 mg/dL or <3.9 mmol/L, repeat steps 1–3.
- Repeat until blood glucose is >70 mg/dL or >3.9 mmol/L and then consider eating a snack or small meal to keep levels from dropping again.
This stepwise approach can help you avoid overtreatment, which can lead to high blood glucose.
Children: Young children usually need <15 g to fix a low blood glucose level: infants may need 6 grams, toddlers may need 8 grams, and small children may need 10 grams. This needs to be individualized for the patient, so discuss the amount needed with your diabetes team.
When treating a low, the choice of carbohydrate source is important. According to some research, people with a history of severe hypoglycemia tend to treat their lows with foods that don’t raise blood glucose rapidly. Complex carbohydrates or foods that contain fats along with glucose can slow the absorption of glucose and should not be used to treat an emergency low.
Severe hypoglycemia can cause a loss of consciousness, seizure, coma, or an inability to eat or drink fast-acting carbs to correct a low. This is the scenario that requires help from your family, friends, roommates, coworkers, or other people in your life. They’ll need training to recognize severe hypoglycemia and to administer glucagon.
Every person with type 1 diabetes should have a nonexpired glucagon kit somewhere nearby in case of emergency, but it also requires that someone else is capable of using it. If this isn’t the case, then 911 should be called so that paramedics can treat the low blood glucose reaction.
It is helpful if people with type 1 diabetes carry some form of identification, so the need for immediate treatment with glucagon or intravenous glucose is easily understood. These should say “Type 1 Diabetes, Insulin.”