For low blood sugar, you need fast-acting carbohydrates, specifically 15 grams, to bring your levels back up quickly. Blood sugar is considered low at 70 mg/dL or below, and the standard approach is called the 15-15 rule: eat or drink 15 grams of fast-acting carbs, wait 15 minutes, then recheck. If you’re still below 70 mg/dL, repeat until your blood sugar returns to your target range.
Best Fast-Acting Carbohydrates to Take
The goal is to get sugar into your bloodstream as quickly as possible, which means choosing simple carbohydrates that don’t contain fat, protein, or fiber (all of which slow digestion). Here’s what provides roughly 15 grams of carbs:
- Glucose tablets: 3 to 4 tablets, depending on the brand. These are the most precise option because each tablet has a standardized amount of glucose.
- Fruit juice: ½ cup (4 ounces) of unsweetened juice, such as orange or apple.
- Regular soda: ½ cup (4 ounces) of non-diet soda.
- Hard candy: 3 pieces.
- Glucose gel: one tube, typically sold in single-serving packets.
- Honey or table sugar: about 1 tablespoon.
Avoid chocolate, cookies, or ice cream as your first-line treatment. The fat in these foods slows absorption, meaning your blood sugar takes longer to rise when you need it most. Save the proper meal or snack for after your levels stabilize. Once your blood sugar returns to a safe range, eating something with protein and complex carbs (like peanut butter on whole-grain crackers) helps prevent another drop.
How to Recognize Low Blood Sugar
The symptoms come in stages, and recognizing the early ones lets you treat the problem before it becomes dangerous. Mild to moderate low blood sugar typically causes shakiness, sweating, a fast heartbeat, sudden hunger, dizziness, and difficulty concentrating. You might feel anxious or irritable for no clear reason, or notice tingling in your lips, tongue, or cheek.
As blood sugar continues to fall, symptoms shift from uncomfortable to alarming. Confusion sets in, coordination suffers, speech becomes slurred, and vision may blur. If you’re asleep, you might have vivid nightmares. These are signs that your brain is running short on fuel, and you need carbohydrates immediately.
At its most severe, low blood sugar can cause seizures or loss of consciousness. There is no single blood sugar number that triggers this level of emergency. It depends on the individual and how quickly levels are dropping. The clinical threshold for “clinically significant” hypoglycemia is below 54 mg/dL, but some people experience severe symptoms at higher readings while others tolerate lower ones.
What to Do in a Severe Episode
If someone is unconscious, confused to the point of not being able to swallow safely, or having a seizure, do not try to give them food or liquid. They could choke. This is where glucagon comes in.
Glucagon is a hormone that signals the liver to release stored sugar into the bloodstream. It’s available by prescription in several forms designed for use by family members, coworkers, or bystanders:
- Nasal spray: A dry powder sprayed into one nostril. The person does not need to inhale. You insert the tip, press the plunger, and the dose is delivered. If there’s no response, a second dose from a new device can be given.
- Auto-injector: Works like an EpiPen. You press it against the outer thigh, abdomen, or upper arm, and it injects automatically. No mixing required. If the person doesn’t respond within 15 minutes, a second dose can be given.
- Traditional emergency kit: Contains a vial of glucagon powder and a syringe of liquid. You inject the liquid into the vial, shake until clear, draw the solution back into the syringe, and inject it into the thigh or abdomen. This is more complex than the other options, so practicing the steps beforehand matters.
If the person is unconscious and glucagon isn’t available or no one knows how to use it, call 911 immediately. Severe hypoglycemia is life-threatening and requires emergency medical treatment.
Low Blood Sugar Without Diabetes
Most searches about low blood sugar come from people managing diabetes, but hypoglycemia happens in people without diabetes too. This is sometimes called reactive hypoglycemia, where blood sugar drops a few hours after eating, particularly after high-sugar meals.
The treatment approach differs from the acute 15-15 rule used in diabetes-related episodes. For recurring low blood sugar without diabetes, the core strategy is dietary: eating smaller, more frequent meals with one to two snacks throughout the day, choosing foods with a lower glycemic index, and avoiding large amounts of sugar, alcohol, and caffeine. These changes smooth out the blood sugar spikes and crashes that trigger symptoms.
If dietary changes aren’t enough, a doctor will look for an underlying cause. Certain medications can lower blood sugar as a side effect. People who’ve had gastric bypass surgery are prone to reactive episodes and may need additional treatment. Rarely, a benign tumor on the pancreas called an insulinoma produces excess insulin and requires surgical removal. The key point is that persistent low blood sugar in someone without diabetes warrants investigation, not just repeated glucose tablets.
Preventing Repeat Episodes
Treating a low is straightforward. Preventing the next one takes a bit more planning. If you take insulin or certain diabetes medications, the most common triggers are skipping meals, eating less than usual, exercising more intensely than planned, or taking too much medication. Alcohol is another frequent culprit because it blocks the liver’s ability to release stored sugar.
Keeping fast-acting carbs within reach at all times reduces risk. Glucose tablets in a bedside drawer, a juice box in your desk, a tube of glucose gel in your gym bag. If you’ve had one severe episode, talk to your care team about getting a glucagon prescription and showing the people around you how to use it. The nasal spray and auto-injector options make this much simpler than it used to be.
Wearing a continuous glucose monitor can also help by alerting you when levels start trending downward, giving you time to eat something before symptoms even begin. For people who experience lows frequently or don’t feel symptoms until they’re already in a dangerous range (a condition called hypoglycemia unawareness), a continuous monitor can be a significant safety net.