The standard recommendation for treating hypoglycemia involves 15 g of simple carbohydrates with glucose reassessment after 15 minutes. Evidence supporting this practice largely derives from two small studies of intravenous insulin-induced hypoglycemia in adults with type 1 diabetes mellitus (T1DM). A systematic review published in Diabetes, Metabolic Syndrome and Obesity evaluated whether different oral carbohydrate doses resolve non-severe hypoglycemia (3.0-3.9 mmol/L) at the first glucose reassessment.

The review searched MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials for full-text studies evaluating oral treatment of hypoglycemia in individuals with T1DM. Two reviewers independently screened studies and extracted data. The analysis included seven studies assessing hypoglycemia management in individuals using multiple daily insulin injections, non-closed-loop insulin pumps, or closed-loop pump systems.

Among studies involving multiple daily injections or non-closed-loop pumps, more than 50% hypoglycemia resolution at first glucose re-check occurred in two analyses. In one exercise-induced hypoglycemia study, 20 g of glucose resolved 60% of episodes at 15 minutes. In a real-world patient-recorded study, 0.2 g/kg, 0.3 g/kg, and 15 g glucose tablets achieved resolution rates of 61%, 71%, and 63%, respectively, at 10 minutes. Among closed-loop insulin pump studies, 16 g glucose tablets achieved 58% resolution at 20 minutes, while 10-30 g sucrose achieved 79-100% resolution at 15 minutes.

These findings indicate that the amount of carbohydrate required to resolve hypoglycemia at the first glucose reassessment may vary depending on the cause of hypoglycemia and the insulin delivery system used in people with T1DM.