Hypoglycemia: The 15-15 Rule, Symptoms, and Emergencies
Hypoglycemia can progress quickly. A written plan and fast-acting carbohydrate kept nearby reduce the time to treatment.
Recognizing a low
The CDC defines low blood sugar as below 70 mg/dL and severe low as below 54 mg/dL. Shaking, sweating, hunger, palpitations, dizziness, irritability, or confusion may occur. Some people lose early warning signs.
The 15-15 rule
If the person is awake and able to swallow, take 15 grams of fast-acting carbohydrate, wait 15 minutes, and recheck. If still below 70 mg/dL, repeat. Common examples include measured glucose tablets or four ounces of juice; read the label to reach 15 grams.
After recovery
Once glucose returns to the target range, eat a balanced snack or meal if the next meal is not soon. Record the timing, medicine, activity, alcohol, and previous food to review the cause with your clinical team. Avoid repeatedly eating sweets without checking because a large rebound high may follow.
Emergency: nothing by mouth
Seizure, unconsciousness, inability to swallow, or severe confusion requires another person’s help. Use glucagon when available and trained to do so, place the person on their side, and call emergency services. Never put food or liquid into an unconscious person’s mouth.
Frequently asked questions
Is chocolate good for treating a low?
It is not the first choice because fat can slow absorption. Use a measured fast-acting carbohydrate.
What if I cannot test but have symptoms?
Follow your clinician’s plan; when a low is suspected and you can swallow, prompt treatment is generally the priority.