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The Rule of 15 for Diabetes

The rule of 15 is recommended by the American Diabetes Association to treat hypoglycemia (low blood sugar). Through this method, a person can safely increase their blood sugar levels when they drop dangerously low. 

The Rule of 15 says: if your blood sugar drops below 70 mg/dL (milligrams per decilitre), eat a snack that has 15 grams of rapid acting carbohydrates.

After 15 minutes, recheck your blood sugar. Did it increase to a safe level? If so, you’re in the clear. If not, have another 15 grams of carbs and wait another 15 minutes to recheck your blood sugar. 

Repeat these steps until your blood sugar is back in its target range.

How does the Rule of 15 for diabetes work? Here’s everything you need to know. 

The Relationship Between Blood Sugar, Hypoglycemia and Diabetes

Blood sugar, also called glucose or blood glucose, is the primary type of sugar found in the blood. Glucose travels through the bloodstream, fueling the cells and providing the body with energy. 

The body gets most of its glucose from the carbohydrate-rich foods we eat, such as corn, potatoes, rice, and fruits.

Insulin, a hormone created by the pancreas, works 24/7 to help regulate the amount of glucose in the blood and is responsible for the critical process that turns food into energy. 

When the body does not produce enough insulin naturally, produces too much insulin, or doesn’t use the insulin properly, this leads to a buildup of glucose in the bloodstream, which can lead to diabetes. 

The normal range for blood sugar is around 90 to 110 mg/dL. When blood sugar drops below the normal range and reaches 70 mg/dL, this is called hypoglycemia.

Signs and Symptoms of Hypoglycemia

Although anyone can experience hypoglycemia, it’s most common in people who have type 1 diabetes and those with type 2 diabetes who take insulin or other medications that control blood sugar. 

Hypoglycemia is a medical emergency. If you’re at risk of hypoglycemia, it’s essential to be aware of the early signs and symptoms of this condition, in order to treat it before it leads to organ damage, brain damage, seizures, and/or other serious complications. 

Know the early signs and symptoms of low blood sugar:

  • Shakiness 
  • Dizziness 
  • An irregular or fast heartbeat
  • Confusion
  • Fatigue
  • Skin turns pale
  • Anxiety
  • Sweating
  • Hunger
  • Irritability
  • Tingling or numbness of the lips, tongue or cheek
  • Nightmares and night sweats (if asleep)

If hypoglycemia goes untreated, symptoms may progress to:

  • Extreme confusion 
  • Inability to concentrate
  • Blurred vision
  • Seizures
  • Losing consciousness
  • Difficulty speaking
  • Muscle weakness
  • Possible death

It’s possible to have hypoglycemia unawareness, which means a person has low blood sugar but doesn’t notice the symptoms. People with hypoglycemia unawareness are at a greater risk of developing severe symptoms (like confusion, slurred speech, seizures and intense drowsiness) as they don’t recognize the initial warning signs. 

It may be best for a person with hypoglycemia unawareness to wear a continuous glucose monitor that measures blood glucose levels every few minutes to prevent hypoglycemia. 

Using the Rule of 15 to Treat Hypoglycemia

How does the Rule of 15 help to safely treat hypoglycemia? 

When you consume carbohydrates, the body breaks those carbs down, turning them into glucose. This increases the level of glucose in the blood, and therefore, raises blood sugar levels.

The symptoms of hypoglycemia are unpleasant, so a person who experiences them may want to eat a lot in a short amount of time to quickly raise blood sugar and alleviate the symptoms. 

Eating too many carbs too quickly can cause blood sugar levels to spike too high, leading to hyperglycemia (high blood sugar). The Rule of 15 safeguards a person against a blood sugar spike, by regulating the amount of carbs consumed (15 grams) and the amount of time to wait  (15 minutes) before rechecking blood sugar and eating another 15g of carbs if necessary.

Here’s what a snack with 15 grams of carbohydrates may be:

  • 4 glucose tablets (chewable tablets made of sugar)
  • 1 tube of glucose gel 
  • ½ cup of fruit juice or regular soda (not diet)
  • 1 tablespoon of sugar, honey, or corn syrup
  • Hard candies or gumdrops (see nutrition label for how many to consume)
  • 6 jelly beans
  • 5 lifesavers

If a person with diabetes has severe low blood sugar and is not able to be treated safely with the Rule of 15, glucagon is used. Glucagon is a hormone that helps regulate blood sugar. In cases of severe hypoglycemia, a person may inject glucagon into the affected person’s bloodstream. 

People who are at risk of severe low blood sugar are at risk of falling unconscious and not being able to inject themselves. It’s important to tell friends, family members and coworkers where the glucagon kit is located and how to use it in case of an emergency. 

What causes low blood sugar?

The are a number of reasons that may explain low blood glucose, including:

  • Having type 1 diabetes
  • Having type 2 diabetes
  • Taking insulin or other diabetic medications
  • Not eating enough, or skipping a meal
  • Getting more physical activity than usual
  • Drinking alcohol

While it’s possible to develop hypoglycemia without diabetes, it is most common in people with diabetes. 

We’ll help you prevent or manage hypoglycemia.

The best treatment method for hypoglycemia is preventative treatment. It’s important to minimize the risk factors associated with hypoglycemia, by living a healthy lifestyle, getting enough physical activity, and eating a protein-rich, balanced diet.

For a person who is at risk of hypoglycemia or has had hypoglycemia before, managing blood sugar levels is essential to preventing serious health problems, such as heart disease.

Whether you’re looking to prevent hypoglycemia or manage hypoglycemia, our experienced doctors at UCF Health are here to help you. 

One of our top-rated endocrinologists in Orlando will create a treatment plan that helps you manage your symptoms and/or prevent various risk factors. 

We understand how scary it can be to live with diabetes or to have experienced blood sugar readings below 70 mg/dL. We are by your side, here to help you maintain healthy blood sugar levels and advise you on precautions to prevent further complications.

The UCF Health diabetes program translates evidence-based medical science into a three-prong approach that focuses on medication, healthy diet, and exercise.

All of our doctors are focused on providing a comfortable, convenient patient experience, and offering the highest quality of healthcare services available.

Once you visit one of our healthcare providers, our new patient portal allows you to view lab results, send secure messages to your doctor, view statements and receipts, and manage prescriptions. If you’re managing the healthcare of a family member, you may be granted digital access to their record (with proper permission).

See our COVID-19 updates for patients, so you know your options and know what to expect when you visit us! 

Use our online scheduling tool to schedule an appointment with a leading endocrinologist near you today.

Sources:

  1. “Hypoglycemia (Low Blood Glucose).” Hypoglycemia (Low Blood Glucose) | ADA, https://www.diabetes.org/healthy-living/medication-treatments/blood-glucose-testing-and-control/hypoglycemia#:~:text=The%2015%2D15%20rule%E2%80%94have,at%20least%2070%20mg%2FdL. 
  2. “Hypoglycemia.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 13 Mar. 2020, https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685. 
  3. https://www.cdc.gov/diabetes/basics/low-blood-sugar-treatment.html#:~:text=The%2015%2D15%20Rule&text=Once%20it’s%20in%20range%2C%20eat,t%20get%20too%20low%20again.&text=If%20you%20have%20low%20blood,still%20below%20your%20target%20range.