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Diabetes management

How to handle a low blood sugar episode

The 15-15 rule, fastest-acting carbs, when to use glucagon, and how to prevent the next low.

June 25, 2026 4 min read

Hypoglycemia (low blood sugar) is dangerous and scary — but very manageable if you act fast.

Symptoms to recognize

Early: - Shakiness, sweating - Hunger, dizziness - Pounding heart - Confusion or irritability

Severe: - Difficulty speaking - Loss of coordination - Seizures or unconsciousness

The 15-15 rule

  1. Eat 15g fast-acting carbs
  2. Wait 15 minutes
  3. Re-check glucose
  4. If still under 70 mg/dL, repeat
  5. Once back above 70, eat a small protein/carb snack to prevent rebound low

Best fast-acting carbs (15g each)

  • 4 glucose tabs
  • 4 oz juice (orange, apple, grape)
  • 1 tablespoon honey
  • 6 jellybeans / 15 Skittles
  • Half a can of regular (not diet) soda
  • 1 tube of glucose gel

What NOT to use

  • Chocolate (fat slows absorption)
  • Protein bars (too slow)
  • Ice cream (fat slows absorption)
  • Diet drinks (no sugar)
  • Whole fruit (slower than juice)

When to use glucagon

Glucagon (injection or nasal spray) is for severe lows when the person can't safely swallow. If they're unconscious or having a seizure:

  1. Give glucagon
  2. Call 911
  3. Turn them on their side
  4. Don't try to put food in their mouth

After the episode

  • Note what caused it (skipped meal, extra exercise, dose error)
  • Adjust your routine to prevent repeat
  • If unexplained, talk to your doctor about medication changes
  • Consider a CGM if you're getting frequent lows

Hypoglycemia unawareness

People who get lows often can lose their warning symptoms. If you no longer feel lows below 70, run your glucose slightly higher for a week or two — symptoms often return.

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