Oral glucose is a fast-acting carbohydrate used to rapidly elevate blood sugar levels in a person experiencing hypoglycemia (low blood sugar). This condition requires immediate intervention because the brain relies almost entirely on circulating glucose for energy. Administering oral glucose is a practical, first-line action designed to quickly reverse symptoms and prevent progression to a more dangerous state. This guide covers identifying, treating, and monitoring a hypoglycemic episode using oral glucose.
Identifying Low Blood Sugar (Hypoglycemia)
Recognizing the symptoms of low blood sugar is the first step toward effective treatment. Hypoglycemia is generally defined as a blood glucose reading below 70 milligrams per deciliter (mg/dL). While a blood glucose meter can confirm this level, treatment should not be delayed if symptoms are pronounced and a meter is unavailable.
Common signs reflect the body’s response to insufficient energy, manifesting as shakiness, sweating, and a rapid heartbeat. As the brain becomes more affected, neuroglycopenic signs may appear, including confusion, difficulty concentrating, dizziness, or unusual mood changes like irritability. Prompt recognition of these early warnings is important to prevent progression to severe impairment.
If the person is conscious and able to follow instructions, a blood glucose test should be performed immediately. However, if symptoms are severe or rapidly worsening, administering oral glucose takes precedence over waiting for a meter reading. The goal is to quickly restore adequate glucose to the central nervous system.
Forms of Oral Glucose and Dosage
Oral glucose is favored in an emergency because it is a simple sugar (monosaccharide) that requires minimal digestion before being absorbed directly into the bloodstream. Commercial products are highly recommended because they offer precise, pre-measured dosing for rapid action. These include specialized glucose tablets, liquid dextrose solutions, and glucose gels.
The standard starting dose for treating mild to moderate hypoglycemia in an adult is 15 grams of fast-acting carbohydrate. This amount is typically found in three to four standard glucose tablets, a single tube of glucose gel, or approximately four ounces of sweetened juice or regular soda. Avoid foods high in fat or protein, such as chocolate or milk, as these significantly slow the absorption rate of glucose.
Glucose tablets and gels are preferred over liquids or food alternatives because they are concentrated sources of pure dextrose. This purity ensures the fastest possible entry of glucose into the circulation. Always check the packaging instructions, as the exact amount needed to equal 15 grams can vary slightly between brands.
Step-by-Step Guide to Administration
The method of administration depends entirely on the person’s state of consciousness and ability to swallow safely. If the person is fully awake, alert, and able to chew and swallow, the 15-gram dose of oral glucose should be given immediately. Glucose tablets must be chewed thoroughly before swallowing, as this mechanical action helps increase the surface area for absorption.
If using a glucose gel, the person should squeeze the entire contents of the tube into their mouth and swallow it. For individuals who are drowsy, confused, or uncooperative but still marginally conscious, a glucose gel is often the safest option. The gel can be massaged into the buccal mucosa (the inner lining of the cheek), where some glucose can be absorbed even before swallowing.
A critical safety warning must be observed: never attempt to force any liquid, food, or tablet into the mouth of a person who is unconscious, actively seizing, or unable to swallow. The risk of aspiration (where the substance enters the lungs) is extremely high and can be life-threatening. An unconscious person requires emergency medical intervention and a non-oral treatment like injectable glucagon or intravenous dextrose.
Monitoring and Next Steps
After the initial 15 grams of oral glucose has been administered, the next steps involve a structured monitoring process known as the 15-15 rule. The clock starts immediately after consumption, and the person must wait 15 minutes before taking further action. This waiting period allows the simple sugar sufficient time to be absorbed and begin raising the blood glucose level.
After 15 minutes, the blood glucose level must be rechecked using a meter. If the reading is still below 70 mg/dL, the person should consume another 15-gram dose of fast-acting carbohydrate. This cycle of treating with 15 grams, waiting 15 minutes, and rechecking must be repeated until the glucose level is successfully above the target.
Once the blood glucose level has stabilized above 70 mg/dL, a follow-up snack containing both carbohydrate and protein is necessary. This provides a source of slower-releasing energy to prevent the blood sugar from dropping low again before the next scheduled meal. If the person loses consciousness, begins to seize, or if the blood sugar remains low after two rounds of the 15-15 treatment, emergency medical services should be called immediately.