Glucose tablets likely better for easing low blood sugar symptoms

When people with diabetes experience a dangerous drop in blood sugar, glucose tablets might be a better option than a sugary food or drink, a study suggests.

People with diabetes can develop hypoglycemia, or low blood sugar, if they skip a meal, exercise harder than usual or take too much insulin or other diabetes medications. Low blood sugar can cause fatigue, anxiety, rapid heartbeat, sweating, mental confusion or even coma or seizures if not treated quickly.

For a new study, researchers pooled data from four papers in the medical literature that compared the effect of dietary sugars and glucose tablets on relieving low blood sugar symptoms, including three randomized trials, which are generally the most reliable kind of medical study.

As reported in the Emergency Medicine Journal, the adults and children in the studies had type 1 or type 2 diabetes. All of them were awake throughout their episodes of low blood sugar. Altogether, 515 low blood sugar episodes were treated with dietary sugar and 232 were treated with glucose tablets.

Across the four studies, different forms of dietary sugars were used, including Skittles candies, orange juice, Mentos candies, jelly beans, cornstarch, milk and glucose gels. In general, the individual substances were about as effective as the glucose tablets for getting blood sugar levels to rise.

When results from all four studies were combined, neither dietary sugars nor glucose tablets reliably returned blood sugar levels to normal within 10 to 15 minutes, according to the research team.

"Regardless of the oral (method) used to treat hypoglycemia, time is required for absorption before the measured blood returns to the normal range and the patient’s symptoms improve," the authors wrote.

However, people who used glucose tablets seemed to feel better faster. Patients who used sugary foods were 11 percent less likely to feel relief from their symptoms within 15 minutes. Glucose tablets are available in drugstores and online. Prices on Amazon.com range from about $5 for a pack of 10 tablets, to about $9 for a bottle of 50.

“Although the results lean toward glucose tablets, everybody reacts differently to low blood sugar,” said Susan Renda, a certified diabetes educator at Johns Hopkins Comprehensive Diabetes Center who was not involved with the study.

“We can’t say that this study controls for individual differences in low blood sugar, like measuring a patient’s glucose level or checking to see how they feel,” she told Reuters Health.

“We don’t want to discourage people from using dietary sugars,” said study co-author Dr. Jestin Carlson, an emergency physician at Saint Vincent Hospital in Erie, Pennsylvania. “Glucose tablets seem to work better, but if you’re using dietary sugar, that’s OK too,” he told Reuters Health by phone.

What’s most important is to treat low blood sugar right away, according to Renda. She said, “Whether it’s Skittles or glucose tablets, people should carry something with them at all times for whenever they feel a drop in blood sugar.”

As of 2014, approximately 29 million Americans - about 9 percent of the U.S. population – had been diagnosed with diabetes, according to the Centers for Disease Control and Prevention.