Hypoglycemia (low blood sugar) is an emergency that must be treated immediately.
Without treatment, a low blood sugar may progress to unconsciousness and convulsions.

Reducing the Risk of Hypoglycemia

The key to managing an episode of severe low blood sugar (hypoglycemia) is to be prepared.

Provide extra snacks for extra activity (consult exercise guide and/or dietitian)
Eat immediately after taking insulin if the blood sugar is less than 100 mg/dl (5.5 mmol/l)
Eat an extra snack of carbohydrate and protein if the blood sugar is less than 120 mg/dl (6.7 mmol/l) at bedtime
Replace carbohydrates in the meal plan with things like regular soda, regular popsicles on sick days
Use an insulin pump or Lantus instead of a traditional Regular/NPH insulin regimen
Treat blood sugars that drop below 70 mg/dl (3.9 mmol/l)

Symptoms Treatment

Fast heart rate
Pale skin
Quick-acting Sugar

15 Grams of carbohydrate
See Guidelines for Treating Lows by Age
If not better in 15 minutes, repeat treatment
If the next meal or snack is more than 30 minutes away give an extra snack of
carbohydrate and protein


Poor coordination
Inability to cooperate
Slurred speech

Instant Glucose or Cake Frosting Gel

Insert tube between gum and cheek
Administer appropriate amount
If no response in 15 minutes administer glucagon
If the next meal or snack is more than 30 minutes away give an extra snack of carbohydrate
and protein



Administer Glucagon as directed
(see Mini-Dose Glucagon Rescue for Hypoglycemia in Children With Type 1 Diabetes)
Call paramedics
Phone diabetes doctor on call
Feed as soon as possible after awakening
Review expiration date and instructions in the Spring and Fall






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If it happens, loss of consciousness may occur and
you may be physically unable to eat or drink a rapid-acting source of sugar (glucose).
If you need a Glucagon shot,
a family member, friend, or another adult will need to be ready to give it to you.



Glucagon: Be Prepared

Make sure you always have a Glucagon emergency kit with your other diabetes supplies when you’re away from home. Ask your doctor for a prescription that includes three kits and consider keeping one at school, at work, with close relatives, and in places where you or your child spends a lot of time. Close friends, coworkers, family members, school nurses, and coaches should know where your kits are and how to use them.

Ask your doctor about prescribing more than one Glucagon kit. Your insurance plan may allow you to receive more than one kit with only one co-pay. Check with your insurance company to find out how many kits you can get for a single co-pay.

Places to Keep Glucagon: Adults

At the Workplace
With You When Traveling
At the Homes of Close Friends
In Your Dorm Room

Places to Keep Glucagon: Children

In The School Nurse’s Office
At Daycare
With the Sitter
With the Coach
At the Homes of Relatives



A severe elevation in blood glucose level can be life-threatening.


Hyperglycemia, or high blood sugar (also spelled hyperglycaemia or hyperglycæmia) is a condition in which an excessive amount of glucose circulates in the blood plasma. Hyperglycemia represents a medical emergency like diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic syndrome (HHNS, also referred to as hyperglycemic hyperosmolar state). Hyperglycemia caused by insufficient insulin can lead to diabetic ketoacidosis, a very serious situation that requires emergency medical treatment. Hyperglycemia can also be caused by eating too much food, which requires treatment to lower blood sugar levels, but which does not lead to DKA. The only way to determine between the two situations is through ketone testing.

If your blood sugar is high, check for ketones.
You should be checked anytime your blood sugar is above 240 mg/dl (13.3 mmol/l) or any time you are sick. This includes any minor illness such as a cold.


Several factors can contribute to hyperglycemia in people with diabetes, including food and physical activity choices, illness, nondiabetes medications, or skipping or not taking enough glucose-lowering medication.

It’s important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as a diabetic coma. In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves and heart.

For diabetics, glucose levels that are considered to be too hyperglycemic can vary from person to person, mainly due to the person’s renal threshold of glucose and overall glucose tolerance.

Causes of Hyperglycemia

Eating Too Much Food Relative to the Amount of Insulin Injected
Missing An Insulin Injection
Blockage In Insulin Pump Tubing
Disconnected Insulin Pump Infusion Set
Illness or Stress

Symptoms of Hyperglycemia

Hyperglycemia symptoms appear when glucose values are significantly elevated — above 200 milligrams per deciliter (mg/dL), or 11 millimoles per liter (mmol/L). The longer blood sugar levels stay high, the more serious the symptoms become.
Some symptoms include:

Blurry vision
Dry mouth
Shortness of Breath
Fruity Odor to the Breath
Confusion, Fatigue, or a Decreased Level of Consciousness
Dehydration Due to Glycosuria and Osmotic Diuresis
Acute Hunger / Thirst