The treatment of hypoglycemia (low blood sugar) depends on the severity of symptoms and the degree to which blood sugar levels have fallen.

In mild cases, hypoglycemia can be treated with high-sugar foods or beverages or with over-the-counter (OTC) glucose tablets or gels. For severe hypoglycemia due to diabetes, a prescription medication containing the hormone glucagon can be delivered by injection or nasal inhalation.

Hypoglycemic emergencies, in which blood sugar levels cannot be restored even with appropriate treatment, require 911 medical assistance.

Home Remedies

Mild hypoglycemia often can be treated with fast-acting carbs that are quickly absorbed in the gut and released into the bloodstream within five to 15 minutes. These are simple carbohydrates that don’t need to be broken down much during digestion.

The American Diabetes Association defines hypoglycemia as a blood glucose level below 70 milligrams per deciliter (mg/dL).

If you have diabetes, ingest between 15 grams and 20 grams of fast-acting carbs if:

  • You develop symptoms of hypoglycemia, such as shakiness, anxiety, headaches, sweating, heart palpitations, blurred vision, light-headedness, mental confusion, or numbness or tinglingYour blood sugar drops below 70 mg/dL—even if you have no symptoms

Pure glucose is the preferred treatment for hypoglycemia, but any form of carbohydrate that contains glucose will raise blood glucose. The glucose content of food is a better indication of quick response than carbohydrate content.

You should not overtreat hypoglycemia by eating too many carbs, as doing so can trigger hyperglycemia (high blood sugar). Hyperglycemia could require diabetes medications to bring your blood sugar back under control.

A good strategy is to follow the “15-15 Rule,” which means eating 15 grams of fast-acting carbs, waiting 15 minutes, checking your blood sugar, and then repeating this process until your blood sugar returns to at least 70 mg/dL.

Once your blood sugar has normalized, eat a small snack containing carbs and protein, such as an egg or peanut butter sandwich.

Over-the-Counter Therapies

If you develop hypoglycemia and are nowhere near food, or if you find keeping food down during the event is difficult, over-the-counter glucose tablets or gels offer a handy solution. Not only do these products have a long shelf life, they can be safely stored in an office desk, purse, or pocket.

Even if you don’t have diabetes, you can treat hypoglycemia with fast-acting carbs. However, it is important to see a healthcare provider afterward, since frequent unexplained crashes may be an early sign of prediabetes.

Moreover, because they don’t have to be broken down by the body, they deliver results quickly. It usually only takes a few minutes for hypoglycemia symptoms to begin to subside.

Most glucose tablets are available in 4-gram (g) tablets. Typically, three or four tablets are necessary to return blood sugar to normal. Glucose gel formulations are packaged in single-serve 15-gram tubes.

Your healthcare provider may recommend glucose tablets or gels rather than fast-acting carbs if you have frequent hypoglycemic crashes. Glucose tablets or gels also may be preferred if you take certain types of diabetes medications.

Prescription Medications

If your hypoglycemia symptoms are severe and glucose tablets or fast-acting carbs don’t help, your healthcare provider may recommend prescription medications that spur the body to produce its own glucose—especially if your diabetes is poorly controlled.

If you take an alpha-glucosidase inhibitor like Precose (acarbose) or Gyset (miglitol), use glucose tablets or gels instead of fast-acting carbs. Medications in this class of drugs inhibit the absorption of sucrose (table sugar) and similar simple sugars. These medications may slow the body’s ability to take up anything other than pure glucose.

This would involve either the injection or nasal inhalation of glucagon, a hormone produced by the pancreas that triggers the release of stored glucose (glycogen) from the liver, fat cells, and muscles.

Glucagon Injections

Glucagon injections are made with a synthetic form of glucagon and are used in an emergency. Because they are injectable, they can be administered to a person who is unconscious or unable to consume carbs by mouth.

  • GlucaGen, approved in 1998, comes in a kit with a vial of glucagon powder and a separate syringe pre-filled with sterile water to mix with the powder to create a 1-mg injection. It can be given to adults, children 6 and over, or children under 6 who weigh at least 55 pounds (25 kilograms). A lower dose (0.5-mg injection) can be given to children under 55 pounds or those under 6 whose weight isn’t known.Gvoke, approved in 1960, comes in a pre-filled syringe with either 0.5 mg or 1 mg of glucagon solution. It can also be delivered with a HypoPen, a pre-mixed auto-injector, and is approved by the Food and Drug Administration (FDA) for adults and children 2 and over.Zegalogue was approved in 2021 to treat severe hypoglycemia in adults and children 6 and older with diabetes.

If you are experiencing symptoms of severe hypoglycemia and can’t give yourself carbohydrates, you may be given a glucagon shot intramuscularly (into a large muscle), which should normalize your blood sugar levels within 10 to 15 minutes.

In December 2020, the FDA approved the first generic version of glucagon for injection. The product is packaged in an emergency kit and is indicated for the treatment of severe hypoglycemia in patients with type 1 diabetes. It is less costly than brand name versions but is just as safe and effective.

If you are fully conscious and able to self-administer carbohydrates, take 15 to 20 grams of glucose, then follow the 15-15 rule. If your symptoms still do not improve, follow the guidelines in “When to Call 911” below.

Side effects tend to be mild and may include headache, stomach upset, nausea, vomiting, and injection site pain.

If you’re unsure whether you’re experiencing hypoglycemia and are still conscious, try to correct your blood sugar level with food and/or glucose first. A glucagon pen is meant to be used in cases when hypoglycemia is not responsive to treatment or when a person has lost consciousness.

Baqsimi (Glucagon Nasal Powder)

In July 2019, the FDA approved Baqsimi, an intranasal formulation of glucagon, for the treatment of severe hypoglycemia. Baqsimi is dispensed into a nostril via a pre-filled nasal applicator. Each dose delivers 3 mg of glucagon in powder form.

Baqsimi is used under the same circumstances as injected glucagon and with similar effectiveness.

Side effects tend to be mild and include headache, nasal congestion, cough, runny nose, watery eyes, nausea, vomiting, and itchy nose, throat, or eyes.

When to Call 911

If someone you know falls unconscious due to a hypoglycemic event, act quickly if you are unable to provide emergency treatment yourself (such as giving a shot).

Call 911 immediately if the person is unresponsive or their blood sugar stays persistently and extremely low (below 50 mg/dL) and/or they have certain symptoms despite treatment:

  • ConfusionDizzinessNausea or vomitingShortness of breathTremors or chillsExtreme anxietyIrritability and changes in behaviorProfuse sweatingPale, clammy skinRapid heartbeatExtreme fatigue or sleepinessLoss of consciousnessSeizures

As you await emergency services, the 911 staff can provide you step-by-step instructions for how to deliver a glucagon injection if an emergency kit is available.

In emergency situations, glucagon may be delivered intravenously (into a vein) to rapidly elevate blood sugar. Emergency medical personnel also commonly use intravenous dextrose, a form of sugar, until blood sugar levels are fully normalized. Once the individual is stabilized, oral glucose or sucrose is administered to help replenish glycogen stores.

Never try to give an unconscious person food or drink, since this can cause choking, vomiting, or asphyxiation.

A Word From Verywell

Prevention is the best strategy for keeping hypoglycemia at bay if you have diabetes. Proper diabetes management involves more than just monitoring your blood sugar. It demands you recognize the early symptoms of hypoglycemia, control your intake of carbs, and take your medications as prescribed to help keep your blood sugar within the optimal range.

If you don’t have diabetes, your healthcare provider will need to identify and treat the underlying cause of hypoglycemia. Until you are able to pinpoint the cause—whether it is diabetes-related or not—you may find yourself hard-pressed to prevent future episodes. Don’t ignore the symptoms; see a healthcare provider as soon as possible.

Frequently Asked Questions

  • What are fast-acting carbs?
  • These are foods that contain sugars that can quickly be released into your bloodstream in about five minutes in order to balance your blood sugar during a hypoglycemic attack. Foods containing glucose or sucrose are the most effective types of fast-acting carbs.
  • When is it necessary to give a glucagon injection?
  • The injection should only be administered if a person’s blood sugar is severely low (less than 54 mg/dL) or they are having severe symptoms, including:SeizuresConfusion and disorientationInability to feed themselves or drink on their own
  • How do you treat reactive hypoglycemia?
  • You can manage immediate symptoms by consuming fast-acting carbs. However, you need to identify if there’s an underlying medical issue, such as an enzyme deficiency or a tumor, that is causing the drop in blood sugar. If so, that cause must be treated. You also may need to make lifestyle changes that prevent hypoglycemia from recurring.

These are foods that contain sugars that can quickly be released into your bloodstream in about five minutes in order to balance your blood sugar during a hypoglycemic attack. Foods containing glucose or sucrose are the most effective types of fast-acting carbs.

The injection should only be administered if a person’s blood sugar is severely low (less than 54 mg/dL) or they are having severe symptoms, including:

You can manage immediate symptoms by consuming fast-acting carbs. However, you need to identify if there’s an underlying medical issue, such as an enzyme deficiency or a tumor, that is causing the drop in blood sugar. If so, that cause must be treated. You also may need to make lifestyle changes that prevent hypoglycemia from recurring.

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  • Zegalogue (dasiglucagon) injection. Prescribing Information.
  • Food and Drug Administration. FDA approves first generic of drug used to treat severe hypoglycemia.
  • Food and Drug Administration. Information for the physician: glucagon for injection.
  • MedlinePlus. Glucagon injection.
  • Lilly USA. Baqsimi (glucagon) nasal powder.
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By Elizabeth Woolley

Elizabeth Woolley is a patient advocate and writer who was diagnosed with type 2 diabetes.