15/15 Rule: Do You Know It?

By GabbyPA Latest Reply 2016-04-24 07:03:37 -0500
Started 2012-10-29 13:24:00 -0500

Another discussion brought this to my attention, that maybe we don't know this general rule for treating a low episode.

Here is how it works:
If some one is experiencing a low test first.
If it is below 70 or dropping give them 15 grams of a fast acting carbohydrate.
Wait 15 minutes and test again.
If it is not going up, administer another 15 grams of a fast acting carbohydrate.
Wait 15 minutes and test again.
Repeat this until numbers begin to rise.

If things are not turning around by the third time, you may want to call 911 or find out if there is a glucagon kit. http://www.diabeticconnect.com/search?query=+...= A glucagon kit should be used ONLY as a LAST resort. Read and follow the directions carefully.

What is a low?
It will be different for different folks. So ask the person how they are feeling and what they personally consider a low. Some people can handle lows into the 50's, but a general rule is 70 or less.

What is a fast acting carbohydrate?
One that is simple sugar such as a soda, orange juice, glucose tabs or hard candy. Nothing chocolate, nothing sugar free and nothing with fat or fiber in it. Too often we reach for the wrong thing to raise the levels and it takes too long and we "overdose" them and give them a slow but lasting spike.

The goal is to get the levels to rise to at least 70 and get someone to eat a "normal" snack or meal that they would eat to help stabilize the rise.

Call 911 if the person is not responsive or if you really don't know what to do. It is always better to err on the side of caution. Just because someone is diabetic, doesn't mean that their condition is sugar related. We are susceptible to so many other things.

43 replies

Luis65 2016-04-22 09:14:12 -0500 Report

I just checked the carb count on the glucose tabs I carry. Each is 4 grams. I carry 3 with me especially when on a bike ride. I guess I should have at least 4 to reach 16 grams. In my bag I have a 6 pack of peanut butter crackers which is a total of 19 g carb, 9 g fat and 4 g protein.

Thanks for this info, Gabby. I replaced the 3 tabs with the whole tube of tabs which is 9 total. I carry this when I am out of the house and especially on bike rides.

Yesterday I was out of town and realized that I was out of test strips. I saw a tiny meter by NiPro called True2go. It has a memory but no date or time. I got it for $10 plus 10 strips. It is a pretty neat package. The meter snaps onto the strip container. There is an elastic sleeve that holds the strips and a small lancet device. So this goes into my to go pack with me while my larger meter stays at home.

GabbyPA 2016-04-24 07:03:37 -0500 Report

I bet after your low the other day, getting that to go pack together was paramount. We don't think about it until we need it sometimes.

cahos64 2015-04-21 10:24:53 -0500 Report

I keep juice boxes near my bed and in the car. I look for "low sugar" ones that only have about 13-15 grams of carbs, because normal ones are as high as 24 grams or more. They don't need to be refrigerated and are easier and quicker to drink than to chew on a glucose tab in the middle of the night and have all that sugar stuck in my teeth when I go back to sleep.

GabbyPA 2015-04-21 13:13:06 -0500 Report

Good point on the chewing tabs. I never really thought of that.

mysteria7130 2015-04-21 17:26:51 -0500 Report

If you have a food processer, you can make peanut butter, cashew butter, pecan butter. just put in the nuts. process it on high. when it forms a ball stop. break it up. process again. keep redoing till smooth. put in jar with lid and store in refridgerator. do not add oil or sugar or anything else. just nuts.

Panda99 2015-05-13 13:07:18 -0500 Report

Nuts are protein and fats, not a good choice for a low BG. This is a time you need a fast acting carb snack.

lilleyheidi 2014-10-13 03:31:20 -0500 Report

I have been having some 50's and 60's recently, I've been apparently not treating them properly. Today, when i stop at the grocery store, I'm going to pick up some orange juice juice boxes to have on hand for just such an emergency. Thanks for the information.

jayabee52 2014-10-13 03:38:06 -0500 Report

Please make sure you have a protein like peanut butter on hand so that when you are up to 80 + you want to eat some protein so as not to fall back into the hypo and do the BG roller coaster ride. The protein will digest slowly and provide your GE tract a slow, steady stream of nutrition.

God's best to you


lilleyheidi 2014-10-13 03:48:57 -0500 Report

thanks again James, yes, PB is always on hand, that is what i was using to treat the lows, a PB wrap. now i know to go for a juice first and bring it up, and then once it is up to 80 or so, have some PB to keep it level. thanks so much for all your help.

Msbasha 2014-08-25 18:29:59 -0500 Report

Thank you for this information! I will share this with my family so they will know how to help if I ever get to the point of not knowing what I'm doing! I also think it's good for the family to learn how to test your sugars. It might come in handy one day!

GabbyPA 2014-08-26 08:41:01 -0500 Report

It is vital that the family knows what to do. You never know. I used to never have lows and never took this too seriously, until I started to have them. OMG. It was scary and a lesson to the family came right after my first one.

niteow1947l 2014-06-05 14:53:40 -0500 Report

Thanks Gabby, I had never heard of the 15/15. Being a diabetic is very scary for me. I don, t know if others feel this way, or if this is part of being a diabetic. Thank you for your help, God Bless

onafixedincome 2015-05-30 13:12:59 -0500 Report

Yep, it's scary. And I have a quasi-medical background! Hang in there, and keep learning—I am finding that the more I know, and the more questions I ask, the safer I feel with the whole insulin/diabetic thing. :) Never give up!

jayabee52 2014-06-05 15:02:18 -0500 Report

Anything new and strange is scary no matter what one is talking about, diatetes or other subjects.

15/15 rule (aka "the rule of 15s" is one of the best ways to bring up a hypo without starting on the Blood Glucose roller coaster.

stacydalton 2014-06-05 21:31:08 -0500 Report

Mine used to drop to <20. Seizures, fainting, weirdness all around. I had a hard, fast lesson on how to keep that from happening. I wish I would have listened to my doctor's suggestion all those many years ago to keep myself healthy.

funnygirl98 2014-06-05 18:06:40 -0500 Report

I'm hypoglycemic and just last week because of being on the antibiotic bactrim for my foot ulcer my blood sugar had dropped all the way down to 25 a couple times… talk about totally freakin out to raise my bs b4 i passed out;-(

TopazDee 2014-04-04 03:32:36 -0500 Report

Thanks Gabby for the Info and jaybee for giving me the link, I have glucose tablets all over the place just in case but very relieved that my readings have stabilised dramatically, just have to get hubby to accept the just in case routine.
Stay Safe xxx

sherryleigh 2014-02-13 08:01:08 -0600 Report

Thanks Gabby, I didn' know this either. One of my lows was 33, I get really shaky and glittery and it wakes me up from sleep

GabbyPA 2014-02-13 08:55:02 -0600 Report

Glad to help. I have had a low of 49, and that was bad enough. I cannot imagine a 33. That has to be really scary.

jojowm 2013-05-30 13:18:20 -0500 Report

Just read this. Wasn't aware of this rule as I am fairly new to T2. Glad you posted it. Thanks Gabby!!!

Graylin Bee
Graylin Bee 2012-11-14 03:56:05 -0600 Report

Thanks for the reminder, Gabby. I need to show this to my hubby. Last week there were a few occasions I dropped into the low 70's. Made me think that I had better explaun this to him, in case I go lower and need a clearer head to remind me what to do. Once I was in the mid 40 range and didn't make the wisest selection. Would be nice to have him be able to redirect me when it happens.

ConnieMarie 2012-11-02 08:30:39 -0500 Report

great reminder…we keep canned orange juice, grapefruit juice and mini regular soda for emergency lows. they are great in a pinch

love to laugh
love to laugh 2012-11-01 23:42:44 -0500 Report


disablednursemarybeth2011 2012-10-30 23:41:11 -0500 Report

I started having lots of lows after starting new insulin humbling R U-500 insulin 5 times concentrated as reg u-100 insulin but works well
So I started keep oh in my little fridge by my bed and crackers and peanut butter on the go small little packets of peanut butter candy blood sugar machine glucose tablets, gel and glucagon kit at bedside with note on wall with insulin dose and what to do with symptoms to watch for emergency numbers and if I don't respond to treatment to call 911 and tell them I'm a insulin dependent type 2 diabetic all by bedside with care plan All drs names and numbers my diagnosis my meds my allergies family to call all medical info anyone may need anyone who has come to help me is so thankful for having all this right there and accessible they r able to help me faster especially if I'm alone at the time.

love to laugh
love to laugh 2012-11-04 16:16:37 -0600 Report




GabbyPA 2012-11-01 12:02:07 -0500 Report

This is a great way to plan ahead and give your helpers all the information they need. Sometimes we just need to know what to do to help. That is fantastic.

disablednursemarybeth2011 2012-10-30 23:26:59 -0500 Report

Yes gabby great reminder what's lowest anyone has ever had I sometimes am alone sometimes my 13 yr old son is here and knows exactly what to do if I start vomiting and it's under 50 I take glucagon kit

GabbyPA 2013-05-30 08:42:23 -0500 Report

My lowest low so far has been 48, but I have read here that others have been in the 20's. That would be so scary.

BrendaMarie68 2013-05-30 09:37:04 -0500 Report

I went to 31 a couple of days ago. The GOOD thing was that I was in the doctor's office when it happened (she was amazed I was still conscious). 3 glucose tabs and a small can of soda later I went to 83. It WAS scary. I was sweaty and disoriented… just "out of it"… I always have to remember to EAT.

jayabee52 2012-10-29 17:04:59 -0500 Report

Great reminder Gabby.

Like Joyce and Nick I didn't know about the "rule of 15s" (as I like to call it) UNTIL I had been on DC for a while. It hadn't been covered in my diabetes education classes or in my monthly diabetes support group.

One thing I would add is: once the Blood Glucose (BG) level is brought up and it is not yet time to eat a meal, I would suggest eating something containing a protein — like something with peanut butter in or on it. That would keep the BG from falling again when the "mini spike" from the 15 gm of carbohydrates drops off'

Nick1962 2012-10-29 14:35:07 -0500 Report

I guess I didn't know it was a rule (learned something new again here!). The way it was explaing to me was "small doses at intervals" until numbers recover. The D education I recieved early on was, let's say "adequacy challenged".

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