If your blood sugar is low, eat or drink 15 grams of fast-acting carbohydrates right away. Low blood sugar, called hypoglycemia, is anything below 70 mg/dL, and it can worsen quickly if you don’t act. Below 54 mg/dL is considered severe and may require emergency help.
Recognize the Symptoms
Low blood sugar produces two waves of symptoms. The first wave is your body’s alarm system kicking in: a pounding heart, shaking or trembling, sweating, sudden hunger, anxiety, and tingling in your lips or fingers. These are the symptoms most people notice first, and they’re your signal to check your blood sugar or eat something immediately.
If blood sugar keeps dropping, a second wave of symptoms appears as your brain runs short on fuel. You may feel confused, have difficulty thinking clearly, become unusually drowsy or weak, feel dizzy, or even faint. By this stage, you may need someone else’s help to treat the episode safely.
Follow the 15-15 Rule
The standard approach is simple: eat 15 grams of fast-acting carbohydrates, wait 15 minutes, then recheck your blood sugar. If it’s still below 70 mg/dL, repeat the process. Keep cycling through these steps until your reading is back in your target range.
Here’s what 15 grams of fast-acting carbohydrates looks like in practice:
- Glucose or dextrose tablets: 4 to 5 tablets (the preferred option because they’re pre-measured)
- Fruit juice or regular soda: 2/3 cup (about 150 mL, not diet versions)
- Hard candy like Life Savers: 6 pieces
- Table sugar: 1 tablespoon dissolved in water
- Honey: 1 tablespoon
Glucose tablets are the most reliable choice because you know exactly how many grams you’re getting. Juice boxes are another good option since they come in measured portions. Avoid chocolate, cookies, or other foods with fat in them for this step. Fat slows digestion, which delays the sugar from reaching your bloodstream when you need it fast.
For young children, especially infants and toddlers, 15 grams may be too much. Their doses should be adjusted based on their size and their doctor’s guidance.
Eat a Stabilizing Snack Afterward
Once your blood sugar is back above 70 mg/dL, you’re not done. The fast-acting sugar you just consumed will burn through quickly, and without a follow-up snack or meal, your blood sugar can drop right back down. Eat something that combines complex carbohydrates with protein and healthy fat. This combination slows digestion and keeps your blood sugar steady over the next few hours.
Nuts are one of the simplest options because they deliver all three at once: carbohydrates, protein, and fat. A handful of almonds or peanuts with a piece of whole-grain toast, or cheese and crackers, works well too. If it’s close to a mealtime, go ahead and eat your regular meal instead.
Eating smaller meals or snacks every two to four hours throughout the day can also help prevent blood sugar from dipping again later.
What to Do in a Severe Episode
Severe hypoglycemia, below 54 mg/dL, is a medical emergency. If someone with low blood sugar has passed out, is having a seizure, or can’t swallow safely, do not try to give them food or drink. They could choke. This is when glucagon, an injectable emergency medication, is needed. Glucagon raises blood sugar by triggering the liver to release stored glucose.
If you take insulin, ask your doctor about keeping a glucagon kit at home and make sure the people around you know where it is and how to use it. After glucagon is given, call for emergency medical help immediately. Even if the person wakes up, they still need medical evaluation because prolonged unconsciousness from low blood sugar can cause harm.
If nausea and vomiting prevent someone from eating or drinking for an hour after receiving glucagon, they need emergency care. The same applies if symptoms don’t improve after consuming sugar: get to a hospital.
Common Triggers to Watch For
Knowing what caused the drop helps you prevent the next one. The most common triggers for people with diabetes include taking too much insulin or other blood sugar-lowering medication, skipping or delaying meals, and exercising harder or longer than usual without adjusting food intake or medication. Alcohol is another frequent culprit because it blocks the liver from releasing stored glucose, sometimes causing blood sugar to fall hours after drinking.
If you notice a pattern, like lows that happen after afternoon workouts or on days you eat lunch late, that’s useful information to bring up with your care team. Small adjustments to meal timing, snack choices, or medication doses can often break the cycle.
Keep Supplies Within Reach
Low blood sugar doesn’t wait for a convenient moment. Keep glucose tablets or a juice box in your bag, your car, your desk drawer, and on your nightstand. Nighttime lows are particularly dangerous because you may sleep through the early warning signs. If you use a continuous glucose monitor, setting an alert for readings approaching 70 mg/dL gives you a head start before symptoms even begin.
Wearing medical identification that lists your diabetes and medications is another simple precaution. If you ever can’t speak for yourself during a severe episode, it helps first responders act faster.