Evidence-based|Sources: NIH, WHO, AHA, AGS clinical guidelines|Updated 2026
! Emergency signs ā€” act now ā–¾

Call emergency services if the person is unconscious, having a seizure, cannot swallow, or cannot safely take sugar by mouth. If you have a prescribed glucagon product, use it as directed while someone calls for help.

  • Severe confusion, slurred speech, or extreme sleepiness
  • Seizure or loss of consciousness
  • Very low meter/CGM reading and unable to take oral sugar
1 What counts as ā€œlowā€ and common symptoms ā–¾

Many clinicians treat <70 mg/dL (3.9 mmol/L) as low. Some older adults may use a slightly higher safety threshold if thereā€™s fall risk or unawarenessā€”confirm your personal plan.

Body signalExamples
EarlyShaky, sweaty, fast heartbeat, hungry, anxious
ThinkingFoggy, irritable, hard to focus, headache
SevereConfusion, slurred speech, seizure, fainting
Hypoglycemia unawareness: Some people (often after many lows) feel few warning signs. CGM alerts and a slightly higher target may helpā€”discuss with your clinician.
2 Fast treatment: the 15ā€“15 rule ā–¾
  1. Check your blood sugar (meter/CGM). If you canā€™t check but have clear symptoms, treat anyway.
  2. Take 15 grams of fast-acting carbohydrate: glucose tablets (per label), 4 oz (120 ml) regular soda or juice, or 1 tablespoon sugar/honey. Avoid chocolate/fatā€”works slower.
  3. Wait 15 minutes, recheck. If still low, take another 15 g and recheck.
  4. Once back to normal and the next meal is far away, eat a small snack with carb + protein (e.g., crackers + peanut butter) if your clinician advises.
On certain medicines (e.g., sulfonylureas) or insulin: Lows may last longer. Keep glucose sources handy and inform your clinician after a significant event.
šŸ“„ Printable: 15ā€“15 Wallet Card šŸ§° Build a Low-Sugar Kit
3 Why lows happen (fix the root cause) ā–¾
  • Meals: skipped/late meals, smaller portions than usual, vomiting/illness
  • Activity: more walking or exercise than usual, yardwork, housework
  • Medicines: insulin timing/dose mismatch; some pills (e.g., sulfonylureas) increase risk
  • Alcohol: especially without food; lows may show up hours later overnight
  • Kidney/liver issues: can change how long medicines last
4 Prevention (day & night) ā–¾

Daytime

  • Eat on a steady schedule; keep a portable carb in your bag/pocket
  • Match insulin/med timing to meals; verify dose with your plan
  • Check before driving; if low, treat and wait until normal

Activity

  • Carry quick sugar and ID
  • For longer walks, plan a small carb beforehand if advised
  • Check again after activityā€”lows can be delayed

Night

  • Avoid heavy evening alcohol; take medicines exactly as prescribed
  • Consider a small balanced snack if your clinician recommends
  • Use CGM alerts if available; keep glucose tabs by the bed
5 Caregiver & family plan ā–¾
  • Know where glucose tablets/gel and the glucagon are stored; learn how to use them
  • If the person canā€™t swallow safely: donā€™t give food or drink; use glucagon if prescribed and call emergency services
  • After recovery, note time, suspected cause, and actions taken; share with the clinician
6 Special situations (driving, illness, appointments) ā–¾
  • Driving: Check first. If low, treat, recheck, and wait until normal and you feel clear-headed.
  • Illness: Vomiting/poor intake? You may need a simplified planā€”contact your clinician.
  • Clinic days: Bring meter/CGM and a short log: times, readings, meals, activity, and any lows.
šŸ–Øļø Printable Hypoglycemia Log šŸ“± Track Lows on thevitatrack.com
7 Myths to ignore ā–¾
  • ā€œChocolate works fast.ā€ Fat slows sugarā€”use glucose tabs, juice, or regular soda first.
  • ā€œIf I feel okay, Iā€™m okay.ā€ Some people feel few signsā€”use a meter/CGM and routines.
  • ā€œOne low doesnā€™t matter.ā€ Repeated lows increase risk and can blunt warning signs.
8 FAQs ā–¾

What number is an emergency?

Any low with severe symptoms (confusion, seizure, fainting) or inability to swallow is an emergencyā€”use glucagon if prescribed and call for help.

How can I stop nighttime lows?

Avoid heavy evening alcohol, review medicine timing, ask if a small balanced snack is right for you, and use CGM alerts if available.

Should I change my dose after a low?

Donā€™t adjust on your own. Record what happened and contact your clinicianā€”doses or timing may need to be personalized.

Educational content only. Always follow your clinicianā€™s advice.

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Medical DisclaimerThis article is for educational purposes only and is not a substitute for professional medical advice. Always consult your doctor before starting supplements or changing medications. Learn about our editorial process.
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