Glucose gel is a concentrated, fast-acting carbohydrate formulation designed for the immediate management of low blood sugar. This simple, over-the-counter product contains dextrose, a form of glucose and the body’s primary fuel source. It is packaged in small, single-use tubes, making it a portable option for individuals who need a rapid boost of sugar.
The Primary Role of Glucose Gel
The sole purpose of glucose gel is to reverse hypoglycemia, the medical term for dangerously low blood sugar. For most people with diabetes, this condition is defined as a blood glucose level falling below 70 milligrams per deciliter (mg/dL). Hypoglycemia is a common complication for individuals managing their blood sugar with insulin or certain oral diabetes medications, especially if they skip meals, engage in excessive exercise, or take too high a dose.
Recognizing the symptoms of low blood sugar is necessary for timely intervention. Mild-to-moderate symptoms often present as the body’s warning signs, including feeling shaky, sweating, intense hunger, or a rapid heart rate. As the condition progresses, neuroglycopenic symptoms appear due to the brain being deprived of glucose, causing confusion, slurred speech, dizziness, or headache. If the blood sugar continues to drop, the episode can advance to severe hypoglycemia, potentially leading to seizures or loss of consciousness.
The Mechanism of Rapid Absorption
Glucose gel is an effective treatment because its high concentration of simple sugar allows for rapid entry into the bloodstream. Unlike solid foods or liquids, the gel is designed to be absorbed directly through the mucous membranes lining the mouth, a process known as buccal absorption. This mechanism bypasses the slower digestive process required for most other forms of carbohydrate.
The high dextrose concentration ensures a therapeutic dose of sugar is delivered quickly, allowing for an increase in blood glucose levels. While some of the gel may be swallowed and absorbed through the small intestine, the direct absorption in the mouth provides a rapid effect. This rapid uptake is important in an emergency situation, as studies show that glucose gel can begin to increase blood sugar within 10 to 15 minutes of administration. The quick onset helps resolve the symptoms of hypoglycemia before they progress to a severe state.
Practical Guide to Administration
The first step in treating an episode is to confirm the low blood sugar reading, ideally using a portable glucometer; however, treatment should not be delayed if symptoms are present. Once hypoglycemia is confirmed, the recommended initial dose for most adults is a single tube of glucose gel, typically containing 15 to 20 grams of fast-acting carbohydrate. The patient must be conscious and fully able to follow instructions before the gel is administered.
To apply the gel, the entire contents of the tube should be squeezed directly into the mouth. The best technique is to place the gel between the cheek and the gum, rather than on the tongue, and then lightly massage the outside of the cheek. This placement allows the gel to dissolve and be absorbed through the buccal mucosa, maximizing the speed of entry into the circulation. The patient should hold the gel in the mouth momentarily to facilitate rapid absorption before swallowing.
After administering the dose, the patient should be monitored closely, and blood glucose should be rechecked after 15 minutes. If the blood sugar level has not risen sufficiently or if symptoms persist, a second dose of the gel may be given. Once the immediate crisis is averted and the blood sugar is trending upward, the patient should consume a follow-up snack containing 15 to 20 grams of a slower-acting carbohydrate. This sustained source, such as a piece of fruit or a half sandwich, helps stabilize the blood glucose and prevent it from dropping again.
Important Safety Considerations
The absolute contraindication for use is in any patient who is unconscious or has an impaired gag reflex. Administering the thick gel to a person unable to swallow safely poses a risk of aspiration, where the gel could be inhaled into the lungs. This potentially life-threatening complication can lead to a blocked airway or aspiration pneumonia.
If a person experiencing low blood sugar becomes unconscious, oral glucose gel should not be used, and emergency medical services must be called immediately. In these severe cases, treatment must be administered by a trained professional, typically involving an injection of the hormone glucagon or intravenous dextrose. For conscious patients, the gel is generally well-tolerated, though the main safety consideration is the risk of over-treating the low blood sugar and causing rebound hyperglycemia. If blood sugar levels do not respond after two doses of glucose gel, the patient requires emergency medical attention.