Low Sugar, treat with rule of 15?

What do you do when you get a low blood sugar?

Well, you will see this all over the internet, the rule of 15.  This tells you the best ways to treat low sugars.  Then we will discuss reality as my patients tell me.

The rule of 15 calls for 15 grams of carbohydrates if your sugar is under 70.  Some examples of 15 carbs is 3-4 glucose tablets, 15gm of glucose gel, 1/2 cup of fruit juice or soda.

Wait 15 min and recheck your sugar.  If it’s still under 70, then give another 15gm carbohydrate and repeat the process.

Well, that is so nice and neat. I have NEVER seen a patient follow this rule.  Why?  Well, have you ever gotten a low sugar?  It ain’t pretty.  The entire house is upside down.  The fridge and the pantry are all devoured.  Especially if you have had a low before where EMS or hospitalization was involved.  Hypoglycemia is very scary!

Should you follow the rule of 15?  Yes, but….

I tell patients, “go ahead, eat the fridge” (they will eat it anyway regardless).  But, after they eat everything they can find and they start to feel better, I have them do an inventory of what they ate and take half the insulin for the carbs they just ate.

If you are not taking insulin, then it’s a little easier to follow the rule of 15, but because you are not on insulin, it’s rare to get low sugars in the first place.

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