Treatment of insulin reactions in diabetics

JAMA. 1984 Dec 28;252(24):3378-81.


Using a modification of the glucose clamp technique, we have studied the efficacy of commonly used foods to correct hypoglycemia in insulin-dependent diabetics. After lowering the plasma glucose level to 55 mg/dL at a steady-state plasma free insulin concentration of about 50 microU/mL, patients were fed 20 g of carbohydrate as milk, orange juice, or D-glucose or 40 g of carbohydrate as orange juice. The data indicate that 20 g of carbohydrate as D-glucose corrects hypoglycemia without rebound hyperglycemia. In an outpatient setting, this treatment also proved effective in spontaneous episodes of hypoglycemia. We conclude that (1) the D-glucose content of the ingested carbohydrate is an important determinant of the glycemic response, and (2) at times of moderately severe hypoglycemia, ingestion of 20 g of D-glucose provides an effective glycemic response for periods of at least 40 minutes. In view of these data, a table is provided listing some common sources of 20 g of D-glucose.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Animals
  • Beverages
  • Citrus
  • Diabetes Mellitus, Type 1 / blood
  • Dietary Carbohydrates / administration & dosage*
  • Female
  • Glucose / administration & dosage
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / diet therapy*
  • Hypoglycemia / etiology
  • Insulin / adverse effects*
  • Insulin / blood
  • Male
  • Middle Aged
  • Milk
  • Tablets


  • Dietary Carbohydrates
  • Insulin
  • Tablets
  • Glucose