What do you do when you are going low? Do you carry a juice? A sugar sachet, sweets, or glucose tabs? I remember as a child when my dad was going hypo we’d dissolve a bunch of white sugar in hot water and make him drink that, and from what I’ve learnt from working with others with diabetes that’s what many are told will do, some sugar, some juice, some sweets. But did you know there is a much better way to deal with lows? What if you could take something that worked fast, was predictable and you could take more or less take just the right amount to bring you back up to your target range?
The absolute best thing for treating a low is pure glucose.
This is what your body needs when you are going low. In its pure form as a single molecule it’s absorbed instantly, it does not have to go through any additional steps to become free glucose that gets absorbed into your bloodstream. If we compare it to table sugar, glucose is bound to another molecule called fructose, combined they are called sucrose. The body needs to break these molecules apart before it gets the glucose part, the part that will bring your blood sugar back up again. the fructose part bypassed glucose metabolism and goes to the liver. The same applies to sweets and juices, they are not pure glucose. You cant reliably calculate how much glucose is in your sugar sachet, fruit juice or sweets.
If you don’t want to be dealing with a high after a low, you want to be able to calculate how much glucose you need.
To calculate how much glucose, you will need to buy sone pure glucose tabs, 99% is good enough. Most of them come in tabs with 4g glucose, but you can buy some online that can be broken into 4 pieces, containing 1g of glucose each. Then you want o ts the effect 1g has on your bg, you need to do this in a fasted state (not having eaten for 4-5 hours), and not when there are any other factors that could affect your blood glucose, like exercise, stress, illness and so forth. Take 1g and test every 30mins for the next 2 hours. record then how much 1g of pure glucose raises you. Tip always keep your glucose separately from your testing kit, you don’t want to accidentally get glucose on anything which could give false readings, also remember to clean you finder after touching anything sweet.
Ideally, you will already be following a low carb diet.
Following a low carb diet will make it much more effective and predictable when you’re not using a large amount of insulin. When you have large amounts of insulin on board the result will be less predictable. So if you already are low carb then the next time you are experiencing a hypo you can use this formula to work out how much to take. Say for example you test and you are 3.5mmol/l (63mmol/l) and to feel safe you would like to bring your reading up to 5.5mmol/l (100mg/dl) and you learnt that 1g of pure glucose raises you by 0.3 mmol/l (5mg/dl) you might want to take 1 & 3/4 of a tab. And then test every 15mins.
Don’t like glucose tabs or have gastroparesis?
Maybe you find it difficult to chew on a glucose tab when you’re feeling hypo, or if you have gastroparesis (delayed stomach emptying) from years of poorly controlled blood glucose, which results in it taking longer for the glucose from foods to reach your bloodstream, you can purchase glucose gel.
And one last thing, this does not constitute as medical advice, always discuss any changes with your healthcare provider.