Low blood sugar, known as hypoglycemia, is a serious and immediate concern for people with diabetes. When blood glucose levels drop too low, the body is deprived of its primary fuel source, which can rapidly lead to confusion, loss of coordination, and even unconsciousness. Being prepared with a readily available source of fast-acting carbohydrates is a matter of safety. The goal during a low sugar event is to raise blood glucose levels quickly enough to prevent symptoms from worsening.
Understanding Hypoglycemia and the 15-15 Rule
Hypoglycemia is defined as a blood glucose level falling below 70 milligrams per deciliter (mg/dL). Immediate intervention is needed to restore balance and prevent the condition from progressing to a severe state. The standard protocol for treating mild to moderate low blood sugar is called the 15-15 Rule.
The 15-15 Rule involves consuming 15 grams of fast-acting carbohydrate, waiting 15 minutes, and then rechecking the blood glucose level. If the level remains below 70 mg/dL, the process is repeated. This cycle continues until blood sugar returns to a safe range, which helps avoid over-treating the low and subsequent high blood sugar levels.
Characteristics of Ideal Fast-Acting Sugars
The effectiveness of treatment is determined by how quickly the body can absorb the sugar into the bloodstream. The most efficient treatment involves consuming simple carbohydrates that contain little to no fat or protein. Fat and protein significantly slow down the digestion and absorption of sugar, delaying the necessary rise in blood glucose.
The most effective sugar is glucose itself, also known as dextrose, because it is the exact form the body uses for fuel. Glucose does not require additional digestion before entering the bloodstream, making it the fastest option for immediate relief. Other simple sugars like sucrose (table sugar) are half glucose and half fructose, meaning only half is immediately absorbed. Fructose (fruit sugar) must be processed by the liver before it can affect blood glucose, making it a slower carbohydrate source.
Top Candy and Glucose Product Recommendations
Specialized glucose products are the most reliable option because they offer a precise, pre-measured dose of the fastest-acting sugar. Glucose tablets, which are pure dextrose, often provide 4 grams of carbohydrate per tablet; three to four tablets deliver the target 15 grams. Glucose gels come in single-serving tubes containing 15 grams, which can be rubbed on the inside of the cheek if swallowing is difficult. These products are highly portable and designed specifically for this medical purpose.
For a non-specialized option, certain candies consisting mainly of simple sugars without added fat can be used effectively. Hard candies like Life Savers or gummy candies like Skittles and Starburst are good choices. The exact serving size needed to reach 15 grams of carbohydrate must be known (e.g., five to six Life Savers or about 15 Skittles). Fruit juice or non-diet soda also works well, with four ounces (half a cup) providing approximately 15 grams of fast-acting carbohydrate.
Foods to Avoid During a Low Sugar Event
Many common foods containing sugar should be avoided when treating hypoglycemia because they also contain fat, protein, or fiber. Any food with a high fat content, such as chocolate, candy bars, or ice cream, significantly slows the speed at which sugar is absorbed. This delay prolongs the hypoglycemic event, leaving the individual symptomatic for a longer period.
Foods high in protein, like nuts, peanut butter, or milk, are poor choices because protein slows the glucose response. Even healthy options like whole fruit and crackers contain fiber, which slows digestion and prevents the rapid spike in blood sugar needed. The goal during a low is speed, requiring the selection of pure, simple sugar sources and avoiding anything that impedes their rapid entry into the bloodstream.