What to Do When Experiencing Low Blood Sugar: A Comprehensive Guide

Low blood sugar, or hypoglycemia, requires immediate attention and proper management to prevent complications. Effective care involves two key aspects: quickly relieving acute symptoms and identifying or addressing the underlying causes that led to the drop in glucose levels. Recognizing early signs such as shakiness, sweating, palpitations, and dizziness is crucial for prompt intervention.

Immediate Steps for Mild to Moderate Hypoglycemia

If a person experiences symptoms like trembling, nervousness, excessive sweating, or confusion, and a fingerstick blood test shows glucose levels below 3.9 mmol/L (70 mg/dL)—or even dropping under 2.8 mmol/L (50 mg/dL)—it's essential to act fast. For individuals with diabetes, these are classic indicators of hypoglycemia. Consuming fast-acting carbohydrates can rapidly restore blood sugar levels.

Recommended options include drinking fruit juice, regular soda (not diet), sweetened tea, or glucose tablets. Eating small amounts of candy, crackers, white bread, or steamed buns also helps. The "15-15 rule" is widely advised: consume about 15 grams of carbohydrates, wait 15 minutes, then recheck blood glucose. Repeat if necessary until levels stabilize above 3.9 mmol/L.

Managing Severe Hypoglycemia and Emergency Situations

In more serious cases—especially when someone appears confused, unconscious, or unable to swallow—oral intake should be avoided entirely. Attempting to give food or drink to an unresponsive individual can lead to choking or aspiration pneumonia, which poses life-threatening risks.

Emergency Medical Treatment for Critical Cases

When severe hypoglycemia is suspected, immediate administration of glucose is critical. Paramedics or healthcare providers typically administer 50% dextrose solution intravenously. If IV access isn't available, glucagon injections (available in nasal spray or injectable forms) can be used by trained caregivers or family members.

After initial stabilization, patients are often transitioned to a continuous IV infusion of 5%–10% dextrose to maintain stable glucose levels. Continuous monitoring in a medical setting is recommended, especially for those who have required emergency intervention.

Addressing Underlying Causes: Preventing Recurrence

Medication-related hypoglycemia is one of the most common triggers, particularly among people using insulin or sulfonylureas for type 2 diabetes. Adjusting dosages, changing medication timing, or switching therapies under medical supervision can significantly reduce risk.

Other potential causes include skipped meals, excessive alcohol consumption without food, intense physical activity without adequate carbohydrate intake, and certain rare conditions like insulinoma or adrenal insufficiency. A thorough evaluation by a healthcare provider can help identify contributing factors and guide long-term prevention strategies.

To support lasting health, individuals prone to low blood sugar should maintain consistent meal schedules, monitor glucose regularly, carry quick-acting sugar sources at all times, and educate friends, coworkers, and family on how to respond during an episode.