Low Blood Sugar


Hypoglycemia (low blood sugar) can occur in students with diabetes mellitus who are using insulin. The level below 60 mg/dl is considered to be true low blood sugar. However, the treatment for low blood sugar is recommended when the level is below 70 mg/dl* to avoid a dangerously low level. The common reasons for low blood sugar are missed meals, a smaller portion of food than expected, exercise, illness such as vomiting and wrong insulin dose.

(* certain patients may need to keep blood sugar higher than this level due to the underlying medical condition such as seizure. Please consult with the healthcare provider regarding the optimal blood sugar range)


Symptoms of low blood sugar include hunger, feeling shaky, sweaty, mood changes, light-headedness. When a student complains of one of these symptoms, blood sugar should be checked and receive treatment if low blood sugar occurs.

Disorientation, confusion, loss of consciousness or seizure are symptoms of extremely low blood sugar and require immediate attention!

Treatment of low blood sugar

If a student experiences mild symptoms and is still able to eat, the best way to treat low blood sugar is to give fast-acting blood sugar. Use the rule of "15", give 15 grams of sugar and recheck blood sugar 15 minutes later, and if the level is still below 70 mg/dl, repeat the same process.

Examples of fast-acting sugar: 4 ounces of juice, 3-4 sugar tablets ( 4 grams each tablet), glucose gel or cake decorating gel.

Regular snacks do not act fast enough to raise blood sugar so it is not recommended for treating hypoglycemia.

If a student experiences severe symptoms of hypoglycemia such as loss of consciousness or seizure, use glucagon immediately. Blood sugar should rise within 10 to 15 minutes. If any of these symptoms occur, consider consulting with the healthcare provider for immediate care recommendations. If the student fails to respond to the treatment, call EMS.


Glucagon is a hormone that has an opposite action to insulin. It increases blood sugar level rapidly and is recommended for treating severely low blood sugar. Previously, it is only available in an injectable form. New forms of glucagon (prefilled pen and nasal spray) are now available. Please see the instructional videos below.

Hypoglycemia Management.pptx

Slides from 2020 School Diabetes Management Webinar

Glucagon Emergency Kit Video (Cincinnati Children's Hospital)

Gvoke : Glucagon Pen

Baqsimi : Glucagon that can be given via nose