Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is hypoglycemia?
- Who is at risk for hypoglycemia?
- I thought high blood sugar was bad. Why is low blood sugar also bad?
- Can the body protect itself from hypoglycemia?
- What are symptoms of hypoglycemia and how low is too low?
- How is hypoglycemia treated?
- Is there anything else that should be done to manage hypoglycemia?
- Find a local Endocrinologist in your town
How is hypoglycemia treated?
The acute management of hypoglycemia involves the rapid delivery of a source of easily absorbed sugar. Regular soft drinks, juice, lifesaver candies, table sugar, and the like are good options. In general, 15 grams of glucose is the dose that is given, followed by an assessment of symptoms and a blood glucose check if possible. If after 10 minutes there is no improvement, another 10-15 grams should be given. This can be repeated up to three times. At that point, the patient should be considered as not responding to the therapy and an ambulance should be called.
The equivalency of 10-15 grams of glucose (approximate servings) are:
- Four lifesavers
- 4 teaspoons of sugar
- 1/2 can of regular soda or juice
Many people like the idea of treating hypoglycemia with dietary treats such as cake, cookies, and brownies. However, sugar in the form of complex carbohydrates or sugar combined with fat and protein are much too slowly absorbed to be useful in the acute treatment of hypoglycemia.
Once the acute episode has been treated, a healthy, long-acting carbohydrate to maintain blood sugars in the appropriate range should be consumed. Half a sandwich is a reasonable option.
If the hypoglycemic episode has progressed to the point at which the patient cannot or will not take anything by mouth, more drastic measures will be needed. In many cases, a family member or roommate can be trained in the use of glucagon. Glucagon is a hormone that causes a rapid release of glucose stores from the liver. It is an injection given intramuscularly to an individual who cannot take glucose by mouth. A response is usually seen in minutes and lasts for about 90 minutes. Again, a long-acting source of glucose should thereafter be consumed to maintain blood sugar levels in the safe range. If glucagon is not available and the patient is not able to take anything by mouth, emergency services (for example 911) should be called immediately. An intravenous route of glucose administration should be established as soon as possible.
With a history of recurrent hypoglycemic episodes, the first step in treatment is to assess whether the hypoglycemia is related to medications or insulin treatment. Patients with a consistent pattern of hypoglycemia may benefit from a medication dose adjustment. It is important that people with diabetes who experience hypoglycemia check blood glucose values multiple times a day to help define whether there is a pattern related to meals or medications.
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