09/24/2025
Make sure you have the necessary items on hand to treat low blood sugar (hypoglycemia), including your glucosse meter and in date test strips/lancets, glucose tablets and food sources of glucose.
Learn the treatment acronym 15-15-15-15 then eat.
Your personal pharmacist at the Medicine Shoppe can offer you help to plan your treatment plan
LEVEL OF HYPOGLYCEMIA TREATMENT
Level 1
Glucose level below normal (often between 3.0–3.9 mmol/L)
Associated with autonomic symptoms
Without neuroglycopenic symptoms or changes to mental status
15 g of oral carbohydrate:
4 glucose tablets (4 g)
15 mL (3 teaspoons) or 3 packets of table sugar dissolved in water
5 cubes of sugar
•50 mL juice or regular (not diet) soft drink
6 Life Savers
15 mL (1 tablespoon) honey
Retest blood glucose after 15 minutes and retreat with 15 g carbohydrate if blood glucose is < 3.9 mmol/L
Level 2
Glucose level below normal (often < 3.0 mmol/L)
Associated with neuroglycopenic symptoms
Without significant impact on mental status
With or without autonomic symptoms
Level 3
Glucose level below normal (regardless of how much the glucose reading is below normal)
Associated with neuroglycopenic symptoms resulting in significantly altered mental/physical status
Requires assistance to treat
IF CONSCIOUS AND CAPABLE OF SWALLOWING:
20 g oral carbohydrate, preferably as glucose tablets or equivalent OR
glucagon 3 mg intranasally or 1 mg IM/SC
Retest blood glucose in 15 minutes and retreat with 15 g carbohydrate if blood glucose is
< 3.9 mmol/L
IF CONSCIOUS AND UNABLE TO SWALLOW:
Treat with glucagon
3 mg intranasally or
1 mg IM/SC
IF UNCONSCIOUS:
Treat with glucagon
3 mg intranasally or
1 mg IM/SC and call for emergency services
NOTE: Once the blood glucose reaches a safe level, a meal or snack that is normally consumed at that time of day should be eaten to avoid repeat hypoglycemia. If a meal is more than one hour away, a snack that contains 15 g carbohydrate and a protein source should be consumed.
IM–intramuscular; SC–subcutaneous