Emergency care for low blood sugar for people taking insulin

This information is for people who may help you if you are too weak or confused to treat your own low blood sugar from diabetes. Make a copy for your partner, co-workers, and friends. If your child has diabetes, you need to provide a copy for teachers, coaches, and other school staff.

View a slide show of steps for preparing a glucagon injection and a slide show for giving a glucagon injection.

• Make sure the person can swallow.
  1. Lift the person's head so that it will be easier for the person to swallow.
  2. Give the person ½ teaspoon of water to swallow.
• If the person can swallow the water without choking or coughing:
  1. Give him or her 4 oz of liquid (juice or soda pop) from the list of quick-sugar foods.
  2. Check the person's blood sugar level using his or her blood sugar (glucose) meter.
  3. Wait 10 to 15 minutes.
  4. Offer the person more quick-sugar food if he or she is feeling better but still has some symptoms of low blood sugar.
  5. Or give the person a shot of glucagon if he or she is not feeling better. Follow the directions given with the medicine.
  6. Check the blood sugar level again.
  7. Offer the person a snack (such as cheese and crackers or half of a sandwich) if it is more than 30 minutes before a meal.
  8. If the person becomes more sleepy or lethargic, call 911 or other emergency services.
  9. Stay with the person until his or her blood sugar level is 3.6 millimoles per litre (mmol/L) or higher or emergency help comes.
• If the person chokes or coughs on the water:
  1. Call 911 for emergency care immediately.
  2. Do not try to give the person foods or liquids, because they could be inhaled.
  3. Give the person a shot of glucagon if one is available. Follow the directions given with the glucagon medicine.
  4. Check the person's blood sugar level using his or her blood sugar (glucose) meter.
  5. Stay with the person until emergency help comes.
• If the person is unconscious but not having a seizure:
  1. Call 911 for emergency care immediately.
  2. Turn the person on his or her side, and make sure the airway is not blocked.
  3. Give the person a shot of glucagon if one is available. Follow the directions given with the medicine.
  4. Check the person's blood sugar level using his or her blood sugar (glucose) meter.
  5. If the person becomes more alert, carefully give a quick-sugar food or liquid.
  6. Check the person's blood sugar level again.
  7. Stay with the person until emergency help comes.
• If the person is unconscious and is having a seizure:
  1. Call 911 or other emergency services immediately.
  2. Get the person in a safe position, such as lying flat on the floor. Turn the person's head to the side.
  3. Do not try to give him or her anything to eat or drink or put anything in the mouth.
  4. If glucagon is available, give the person a shot of glucagon when the seizure stops.
  5. Stay with the person until emergency help comes.

Author:	Alison Allen Caroline Rea, RN, BS, MS	Last Updated: November 14, 2007
Medical Review:	Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Matthew I. Kim, MD - Endocrinology & Metabolism David C.W. Lau, MD, PhD, FRCPC - Endocrinology & Metabolism
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