Treatment of Hypoglycemia with Dextrose

First-Line Treatment Options

For a person with suspected hypoglycemia who is awake and able to swallow, the American Heart Association recommends 15-20 grams of oral glucose in the form of dextrose tablets to treat hypoglycemia 1
Glucose tablets are preferred over other forms of dietary sugars when available for treating hypoglycemia, as recommended by the American Heart Association 1, 2
The recommended dose of 15-20 grams of oral glucose can rapidly restore blood glucose levels, according to the American Heart Association 1
Blood glucose and treatment should be repeated at 15-minute intervals until blood glucose levels return to normal (≥70 mg/dL), as suggested by the American Diabetes Association 3, 4

If glucose tablets are not available, alternatives containing at least 15 grams of simple sugars can be used, including 1 tablespoon table sugar, 6-8 oz apple or orange juice, 6-8 oz regular soda, 1 tablespoon honey, or 15-25 jellybeans, gummy bears, or hard-shelled candies, as recommended by the American Heart Association 1, 2

For children with suspected hypoglycemia who are awake but unwilling or unable to swallow glucose, it may be reasonable to apply a slurry of granulated sugar and water under the tongue, according to the American Heart Association 1
Sublingual glucose administration may be considered for children who may be uncooperative with oral glucose administration, as suggested by the American Heart Association 5

Oral glucose should not be administered to people who are not awake or not able to swallow, as warned by the American Heart Association 1
Emergency medical services should be activated for a person with hypoglycemia who is unable to swallow, has a seizure, or does not improve within 10 minutes of oral glucose administration, according to the American Heart Association 1
For severe hypoglycemia in patients who cannot take oral glucose, parenteral options include glucagon for intramuscular injection, as recommended by the American Diabetes Association 3

After initial treatment, blood glucose should be rechecked at 15-minute intervals, as suggested by the American Diabetes Association 3
If blood glucose remains <70 mg/dL, treatment should be repeated, according to the American Diabetes Association 3
Any episode of severe hypoglycemia requires reevaluation of the diabetes management plan, as recommended by the American Diabetes Association 3, 7

Glucose tablets have demonstrated better resolution of symptoms at 15 minutes after treatment compared to dietary sugars, as found by the American Heart Association 1