What to Do When Your Blood Sugar Levels Drop Too Low

Your Hypoglycemia Action Plan

If you are at risk for low blood sugar due to your diabetes treatment, it is important to always have some rapid-acting sugar with you in case you need to treat yourself. If you experience symptoms of hypoglycemia, take action with these steps:

Test your blood sugar. If you recognize any of these symptoms and believe your blood sugar may be too low, test your blood sugar with your glucose meter, Dr. Tan says. Anything less than 70 milligrams per deciliter (mg/dl) is considered low blood sugar, according to the NIDDK. However, target levels are often individualized, so talk with your healthcare provider about your optimal numbers, Tan adds.

Eat or drink fast-acting carbs. If you have low blood sugar, you need to take action right away. Your best bet is to consume about 15 grams (g) of carbohydrates, the NIDDK says. Some options include:

  • ½ cup or 4 ounces (oz) of orange or apple juice
  • ½ cup or 4 oz of regular soda (not diet)
  • 1 tablespoon (tbsp) of sugar dissolved in water
  • 1 tbsp of honey or maple syrup
  • 5 or 6 hard candies, jelly beans, or gumdrops
  • 2 tbsp of raisins
  • ½ cup of applesauce

You can also take three to four glucose tablets or a tube of glucose gel, Dr. Galindo says.

Wait, then retest. The next step is to wait 15 minutes, then test your blood sugar again. If blood sugar has reached 100 mg/dl or greater, you’re fine. If not…

…Repeat. If your blood sugar is still low, eat another 15 g of carbohydrates, wait another 15 minutes, and retest. “You need to repeat these steps until your blood sugar is corrected,” Galindo says. It is important not to treat low glucose with foods like chocolate or cake because the fat in these foods may not allow the sugar to be absorbed quickly enough.

What to do when your blood sugar is back to normal. Once you feel better, it’s important to eat some protein to keep your blood sugar within normal range, Tan says. Smart options include a handful of peanuts, some peanut butter, or cheese. “A sandwich with ham or turkey is a good choice, too,” says Bruce Evans, a paramedic, board member of the National Association of Emergency Medical Technicians, and chief of the Upper Pine River Fire Protection District in Bayfield, Colorado. But once your blood sugar levels are stable again, you can otherwise resume your activities, Tan adds.

When to call your doctor. If you’re having trouble keeping your blood sugar up, call your doctor or go to the nearest emergency room. Untreated hypoglycemia could cause you to have a seizure or become unconscious, the NIDDK says.

How to Help Others Help You

It’s vital to know the signs of low blood sugar, have an action plan, and be prepared with your glucose meter and glucose tablets. But sometimes you might need to rely on other people to help when your blood sugar drops too low, and especially since low blood sugar can also affect your alertness and thinking. Take these additional steps so you’re prepared — and they are, too:

Teach your loved ones. If you’re unable to help yourself, your friends, family, or colleagues may need to treat you with glucagon (Glucagen), a hormone that tells your liver to release stored glucose, the American Diabetes Association (ADA) says. Glucagon can be given by simple injection into the fat of the belly, thigh, or arm, or by using a prefilled pen-like device, prefilled syringe or vial, or also by nasal spray. For this reason, it’s a good idea to carry an emergency glucagon kit and teach those close to you what to do. If they don’t know how to give you the injection or if glucagon isn’t available, they must call 911 and get you the help you need, Evans says. Low blood sugar that’s sustained for a prolonged time can lead to irreversible brain damage, according to the ADA.

Wear an ID bracelet. Evans suggests that everyone with diabetes should wear a medical ID bracelet or carry a wallet card. These identifiers should clearly note that you have diabetes and whether you’re on insulin or other medications, the Joslin Diabetes Center in Boston recommends.

Talk to your doctor about your low blood sugar risk. If you have frequent bouts of hypoglycemia, be sure to talk with your doctor. The solution may be as simple as changing how much or the kind of diabetes medicine you take. However, never make any changes to your medication regimen without your doctor’s approval.

Check out this Diabetes Daily story to read about one woman’s experience managing diabetes.

Additional reporting by Andrea Peirce.

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