When your blood sugar drops below 70 mg/dL, you need fast-acting carbohydrates, and you need them quickly. The standard approach is called the 15-15 rule: eat or drink 15 grams of simple carbohydrates, wait 15 minutes, then check your blood sugar again. If it’s still below 70, repeat. Once your levels stabilize, follow up with a more substantial snack that includes protein to keep them steady.
The 15-15 Rule
This is the cornerstone of treating low blood sugar at home, recommended by the CDC and the American Diabetes Association. You consume 15 grams of fast-acting carbs, wait 15 minutes for your body to absorb them, then recheck your blood sugar. If you’re still under 70 mg/dL, you take another 15 grams and repeat the cycle. Most mild episodes resolve within one or two rounds.
The key word here is “fast-acting.” You want carbohydrates that hit your bloodstream quickly, without fat or fiber slowing them down. That rules out some things you might instinctively reach for, like chocolate or a granola bar. The fat in chocolate delays sugar absorption, which is the opposite of what you need when your blood sugar is actively dropping. Save those for later.
Best Options for Quick Relief
Glucose tablets are the gold standard because they’re pre-measured, portable, and contain nothing but fast-acting sugar. Most tablets come in 4-gram doses, so you’d chew three or four to hit 15 grams. Glucose gel works the same way and can be easier to swallow if you’re feeling shaky or nauseous.
If you don’t have glucose tablets on hand, these common items deliver roughly 15 grams of fast-acting carbs:
- 4 ounces (half a cup) of fruit juice: orange or apple juice works well
- 4 ounces of regular soda: not diet, which has no sugar
- 1 tablespoon of honey or sugar: dissolved in water if needed
- Hard candy: about 3 to 4 pieces, depending on the brand
Fruit juice is probably the most accessible option in most kitchens. Just make sure it’s 100% juice, not a sugar-free variety. Regular soda works in a pinch too. The goal is pure, simple sugar with no fat or protein competing for digestion time.
What to Eat After Your Levels Stabilize
Once your blood sugar climbs back above 70 mg/dL, you’re not done. Fast-acting carbs burn off quickly, and without a follow-up snack, your levels can slide right back down. This is where protein and complex carbohydrates come in.
Peanut butter on crackers is a classic choice. The crackers provide a slow, gradual rise in blood sugar, while the protein and fat in the peanut butter help sustain it over time. Other good options include cheese and whole grain crackers, a small handful of nuts with dried fruit, or half a sandwich. If your next full meal is less than an hour away, you can skip the snack and just eat your meal. The point is to give your body something with staying power so the episode doesn’t repeat.
When Someone Can’t Eat or Drink
Severe low blood sugar, defined as below 54 mg/dL, can cause confusion, loss of coordination, or unconsciousness. At that point, the person may not be able to safely chew or swallow, and putting food or liquid in their mouth creates a choking risk. Never put anything in the mouth of someone who is unconscious or can’t sit up on their own.
This is where emergency glucagon comes in. Glucagon is a hormone that signals the liver to release stored sugar into the bloodstream, rapidly raising blood glucose levels. It’s available in two forms that don’t require any mixing or medical training to use. The Baqsimi nasal spray delivers a dose through the nose, similar to how you’d use a nasal decongestant. The Gvoke HypoPen is an auto-injector, similar to an EpiPen, that delivers glucagon through the skin. Both are designed so a family member, coworker, or friend can administer them in an emergency.
If you take insulin or are at risk for severe lows, ask your doctor about keeping a glucagon device at home and at work. Make sure the people around you know where it’s stored and how to use it. If no glucagon is available and the person can’t be woken, call 911.
Handling Low Blood Sugar at Night
Nighttime lows are particularly tricky because you’re asleep when they happen. You might wake up with a headache, damp sheets from sweating, or a feeling of exhaustion that doesn’t match how much sleep you got. Some people sleep through the episode entirely and only catch it on a continuous glucose monitor.
If you wake up with symptoms, sit up and treat it the same way you would during the day: 15 grams of fast-acting carbs, wait, recheck. Keep glucose tablets or juice boxes on your nightstand so you don’t have to stumble to the kitchen in the dark while your coordination is impaired.
If your partner or roommate finds you unresponsive, the same rules apply as any severe episode. They should not try to put food in your mouth. If a glucagon kit is available (ideally stored in a bedside drawer), they should use it and call your doctor afterward. Johns Hopkins Medicine recommends checking blood sugar every few hours for the rest of the night after a nocturnal episode, and contacting your doctor as soon as possible to adjust medications or timing. For people who experience frequent nighttime lows, a continuous glucose monitor with a low-alarm feature can wake you before levels drop dangerously.
Recognizing the Early Signs
Treating low blood sugar quickly depends on catching it early. The first symptoms tend to be physical and somewhat obvious: shakiness, sweating, a rapid heartbeat, sudden hunger, or feeling lightheaded. These are your body’s adrenaline response, an alarm system designed to get your attention.
As blood sugar continues to drop, the symptoms shift from physical to cognitive. You might have trouble concentrating, feel confused, slur your words, or become unusually irritable. Some people describe it as feeling “off” without being able to pinpoint why. By the time these cognitive symptoms appear, you’re moving toward the severe range, so it’s important to act on the earlier physical cues rather than waiting to see if they pass. If your blood sugar is trending downward but still above 70, you can preemptively eat a slower-acting snack, like peanut butter crackers, to head off a full episode before it starts.
What to Keep on Hand
Preparedness makes a real difference in how smoothly you can handle a low. Consider stashing fast-acting glucose in the places where you spend time: your car, your desk, your gym bag, your nightstand. Glucose tablets are the easiest to store because they don’t melt, leak, or expire quickly. Juice boxes are another reliable option.
If you’re at risk for severe episodes, a glucagon device belongs in your emergency kit alongside your glucose tablets. Make sure it hasn’t expired, and replace it when it does. Let the people closest to you, whether that’s a spouse, a coworker, or a roommate, know what low blood sugar looks like and where your supplies are. A 30-second explanation now can prevent a crisis later.