The effectiveness of glucose, sucrose, and fructose in treating hypoglycemia in children with type 1 diabetes

Pediatr Diabetes. 2010 May;11(3):154-8. doi: 10.1111/j.1399-5448.2009.00558.x. Epub 2009 Aug 3.


Objective: There is a lack of evidence regarding the most effective treatment option for managing naturally occurring hypoglycemia in children with type 1 diabetes. The objectives of this study were (i) to determine if sucrose and fructose are equally effective as glucose in the treatment of spontaneous hypoglycemia in children with type 1 diabetes; and (ii) to determine prestudy and poststudy hypoglycemia treatment preferences.

Methods: Thirty-three subjects [aged 5.4-15.5 yr and average duration of type 1 diabetes of 3.1 yr (SD = 2.3)] participated in a randomized, crossover design. The main outcome was the effectiveness of treatment as defined by a blood glucose meter reading that was > or = 4.0 mmol/L 15 min after treatment. Each subject treated five hypoglycemic events with each treatment type: glucose (BD Glucose Tablets), sucrose (Skittles), and fructose (Fruit to Go).

Results: There was a significant difference between the effectiveness of the three treatments [Wilk's Lambda F(2,28) = 8.64, p = 0.001]. No significant difference between treatment with glucose and treatment with sucrose was noted, but the treatment effectiveness for fructose was significantly lower than sucrose [F (1,29) = 16.09, p < 0.001] and glucose [F (1,29) = 15.64, p < 0.001]. The preferred treatment choices before the study were as follows: 36% glucose, 18% sucrose, and 33% fructose sources. Poststudy, 52% of children preferred the same treatment, which was effective (glucose or sucrose), followed by 35% who changed their preference to an effective treatment.

Conclusion: Skittles are as effective in treating hypoglycemia as more expensive BD Glucose Tablets in children with type 1 diabetes.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Candy
  • Child
  • Child, Preschool
  • Cross-Over Studies
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Dosage Forms
  • Female
  • Fructose / therapeutic use*
  • Glucose / therapeutic use*
  • Humans
  • Hypoglycemia / complications
  • Hypoglycemia / drug therapy*
  • Male
  • Sucrose / therapeutic use*
  • Therapeutic Equivalency
  • Treatment Outcome


  • Dosage Forms
  • Fructose
  • Sucrose
  • Glucose