When your blood sugar drops below 70 mg/dL, eat or drink 15 grams of fast-acting carbohydrates immediately. This is the single most important step, and acting quickly prevents the situation from becoming dangerous. The goal is to get sugar into your bloodstream as fast as possible, then follow up to make sure your levels stabilize.
The 15-15 Rule
The standard treatment for low blood sugar is simple: consume 15 grams of fast-acting carbohydrates, wait 15 minutes, then check your blood sugar again. If it’s still below 70 mg/dL, repeat the process. Keep going until your levels return to your target range.
Any of these count as roughly 15 grams of fast-acting carbs:
- 3 to 4 glucose tablets
- Half a cup (4 ounces) of fruit juice
- Half a cup of regular soda (not diet)
- 1 tablespoon of sugar or honey
- One tube of glucose gel
- A small handful of hard candy, jelly beans, or gumdrops
Glucose tablets and gels work fastest because they contain pure glucose that doesn’t need to be broken down. Juice and regular soda are close behind. Chocolate, ice cream, and other foods with fat in them are poor choices here because fat slows digestion and delays the sugar from reaching your bloodstream when you need it most.
Young children typically need less than 15 grams. If you’re managing a child’s blood sugar, work with their doctor to determine the right amount for their age and size.
What to Eat After You Stabilize
Once your blood sugar is back in range, eat a balanced snack or small meal that combines protein with slower-digesting carbohydrates. The initial 15 grams of fast-acting sugar gives you a quick bump, but it won’t last long. Without a follow-up snack, your blood sugar can drop right back down.
Good options include:
- Half a sandwich with meat, cheese, or peanut butter
- A piece of fruit with an ounce of cheese
- Crackers with peanut butter or tuna salad
- A granola bar or trail mix
- Baked tortilla chips with refried beans
The protein and complex carbs provide a slower, steadier source of energy that keeps your levels from crashing again over the next few hours.
Recognizing the Symptoms
Low blood sugar tends to come on fast, and the symptoms vary from person to person. Early and moderate signs include feeling shaky or jittery, sudden hunger, dizziness, lightheadedness, confusion, irritability, a racing or unsteady heartbeat, and headache. Some people notice blurred vision or difficulty speaking clearly.
When blood sugar drops very low, the brain starts losing its fuel supply. At that point, you can lose consciousness or have a seizure. This is considered severe hypoglycemia, and it means you need someone else to help you because you can no longer treat it yourself. If someone near you becomes unconscious from low blood sugar, call emergency services. Do not try to put food or liquid in the mouth of someone who is unconscious.
Low Blood Sugar During Sleep
Nighttime lows are tricky because you can’t feel the warning signs while you’re asleep. Clues that it happened include waking up with damp pajamas or sheets from sweating, feeling unusually tired or confused in the morning, or having vivid nightmares. A partner might notice restless sleep, trembling, sudden changes in breathing, or a racing heartbeat.
Several things raise the risk of nighttime lows: skipping dinner, exercising close to bedtime, and drinking alcohol in the evening. If nighttime episodes happen more than once, a continuous glucose monitor that alerts you when levels start dropping can be a practical solution. Adjusting the timing or dose of evening medications is another common fix that your doctor can help with.
Preventing Lows During Exercise
Physical activity pulls sugar out of your bloodstream for energy, which makes exercise a common trigger for lows, especially if you take insulin or other blood sugar-lowering medications. Check your blood sugar 15 to 30 minutes before you start.
If your level is below 90 mg/dL before a workout, it’s too low to exercise safely. Have a snack with 15 to 30 grams of carbohydrates first, like fruit, crackers, or juice. If you’re between 90 and 124 mg/dL, take about 10 grams of carbs before starting.
During exercise, stop immediately if your blood sugar hits 70 mg/dL or lower. Treat it with the 15-15 rule just as you normally would. After your workout, have a snack with slower-acting carbs (a granola bar, trail mix, or dried fruit) to prevent a delayed drop. Blood sugar can continue falling for hours after exercise ends, so checking again later in the day is important.
Alcohol and Low Blood Sugar
Alcohol interferes with your liver’s ability to release stored sugar into your bloodstream. Normally, when blood sugar starts dipping, your liver acts as a backup generator, converting its glycogen stores into glucose. Alcohol disrupts that process. The risk isn’t just while you’re drinking. A low can hit hours later, including overnight while you’re sleeping. If you drink, pairing alcohol with food and checking your blood sugar before bed can reduce the risk.
When You Stop Feeling the Warning Signs
Some people lose the ability to feel the early symptoms of low blood sugar, a condition called hypoglycemia unawareness. Without those warning signals like shakiness and hunger, blood sugar can drop dangerously low before you realize anything is wrong.
This is more likely if you’ve had diabetes for more than 5 to 10 years, frequently experience lows, or take certain blood pressure medications called beta blockers. If this applies to you, checking your blood sugar more often is essential, particularly before driving or exercising. A continuous glucose monitor with alarms can also fill in for the body’s missing warning system.
Handling Frequent Episodes
An occasional low is common for people managing diabetes with medication. But if lows are happening regularly, something in your management plan likely needs adjusting. That could mean changes to your medication dose, meal timing, or exercise routine. If you have diabetes and notice a pattern of frequent lows, bring it up with your care team so they can fine-tune your plan.
If you don’t have diabetes and are experiencing symptoms of low blood sugar, that’s worth investigating. Low blood sugar in people without diabetes is uncommon and can point to an underlying issue that needs diagnosis.