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Hypoglycemia correction points

Use the 15-15 rule for most conscious adults with mild to moderate hypoglycemia:
  • If blood glucose is <70 mg/dL (3.9 mmol/L):
    1. Take 15 g fast-acting carbohydrate
    2. Recheck glucose in 15 minutes
    3. If still <70, repeat 15 g and recheck in 15 minutes
    4. Once corrected, eat a snack/meal with carb + protein if next meal is >1 hour away

Fast-acting carb equivalents (about 15 g)

  • 3-4 glucose tablets (depending on brand)
  • 1 tube glucose gel
  • 4 oz (120 mL) fruit juice
  • 4 oz regular (non-diet) soda
  • 1 tbsp sugar or honey

Severe hypoglycemia

  • If confused, unconscious, seizing, or unable to swallow:
    • Do not give oral food/drink
    • Give glucagon (nasal or injection) if available
    • Call emergency services

Common “correction points” to remember

  • Treat at <70 mg/dL
  • Recheck every 15 min
  • Avoid overtreating (which causes rebound hyperglycemia)
  • Identify cause: missed meal, excess insulin, exercise, alcohol, renal impairment, etc.
If you want, I can give this as a quick bedside checklist or pediatric-specific version.

Hypoglycemia correction

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severe hypoglycemia glucagon dextrose intravenous treatment

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hypoglycemia levels classification 15-15 rule oral glucose repletion

Hypoglycemia correction (quick protocol)
  1. Confirm low glucose
    • Treat if <70 mg/dL (3.9 mmol/L) or if classic symptoms with no immediate test available.
  2. If patient is awake and can swallow (mild/moderate)
    • Give 15 to 20 g fast-acting carbohydrate (glucose tablets/gel, juice, regular soda, sugar/honey).
    • Recheck glucose in 15 minutes.
    • If still <70 mg/dL, repeat.
    • Once corrected, give a longer-acting carb snack or meal to prevent recurrence.
  3. If severe hypoglycemia (needs help, altered, unconscious, seizure)
    • No oral intake.
    • If no IV access: give glucagon
      • 1 mg IM/SC or 3 mg intranasal.
    • If IV access available: give IV dextrose 10 to 25 g
      • e.g., 20 to 50 mL D50W over 1 to 3 min.
    • Call/emergency support and observe closely.
  4. After recovery
    • Recheck glucose repeatedly for recurrence.
    • Identify trigger: excess insulin/sulfonylurea, missed meal, exercise, alcohol, renal dysfunction.
    • Adjust treatment plan to prevent repeat episodes.
Source support:
  • Hypoglycemia in Adults (p.24): Level 3 treatment doses for glucagon and IV dextrose.
  • Diabetes Management in Wilderness Athletes (p.11): glucose repletion principles and severe hypoglycemia definition.
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