Hypo Treatment

Dillinger

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Hi,

I think that treating hypos correctly is one of the hardest elements of diabetes control; your brain is not working quite right, you are hungry and can be anxious so tend to stuff yourself with glucose/carbs/anything you can find...

I've recently changed my strategy for treating hypos and I think it's working.

Previously I would take 9 grams of glucose tablets (Dextrose) when I was hypo which is 3 of the tablets.

The problems with that is as it is a modest amount in response to a hypo I would often find I would in addition eat something else in response; so would as often as not 'overtreat' the hypo and end up with a high blood glucose level.

Also Dextrose tablets are frankly disgusting.

What I've decided to do is to decide, when hypo, whether I have active insulin on board (with me that means am I hypoing within 4 hours of injecting my bolus dose) or not. If I do I eat a running/sport energy gel. These come in little packets and are about 20 grams of carb.

If I do not have active insulin on board I would treat as normal with Dextrose tablets; boo hiss.

The benefits of this is that the energy gel things get into the blood very quickly are tasty and are very generous in the amount of glucose which stops pretty much any hypo (unless some real mistake has been made). That means that I don't over compensate any more and avoid excessive rebound highs.

The downside is that the running gel things are more expensive than Dextrose tablets and I'm dreading one bursting in my pocket.

Does anyone else use them; does the above sound like a plan?

Best

Dillinger
 
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Engineer88

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Have you tried hypostop? its on script and is a gel (flavorless) which works well.

I don't have the patience you do and tend to change hypo by hypo. general rule of thumb is a drink though as thats quicker than anything else.
 
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CarbsRok

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Gluco tabs 4 gms each x 3 and the Raspberry flavour does the trick for me. If you want to use a gel look in the cake making dept of a supermarket liquid glucose is available for just over a pound. in tubes. It tastes 100% better than the hypofix gel.
If you want to use the sport/running gel then perhaps consider having it in a plastic bag in your pocket.
 
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Dillinger

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Have you tried hypostop? its on script and is a gel (flavorless) which works well.

I don't have the patience you do and tend to change hypo by hypo. general rule of thumb is a drink though as thats quicker than anything else.


Hypostop is EVEN WORSE, if possible, than Dextro tablets ! Also, there's too much of it as I recall; I assumed it's for really serious blood glucose crashes?

I like the idea of cake gel @CarbsRok, I can't be doing with plastic bags in my pockets so I'm going to just have to risk it!

Best

Dillinger
 

AndyOD

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Hypostop is EVEN WORSE, if possible, than Dextro tablets ! Also, there's too much of it as I recall; I assumed it's for really serious blood glucose crashes?

I like the idea of cake gel @CarbsRok, I can't be doing with plastic bags in my pockets so I'm going to just have to risk it!

Best

Dillinger
I try to do something quick like glucogel then a chewybar which at work I have in my draw. On occasion I'm out walking snickers in my jacket pocket (long acting when walking) and get my Mrs to carry glucogel in her bag, or sometimes when I'm alone in my other jacket pocket I would suggest that if u get something in and sit down wait for 10 mins before doing anything as u can overshoot if u go mad. End up wildly up and down over correcting. 20 grammes of carbohydrate works for me but then I like to run in the safe zone.
 
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CarbsRok

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Hypostop is EVEN WORSE, if possible, than Dextro tablets ! Also, there's too much of it as I recall; I assumed it's for really serious blood glucose crashes?

I like the idea of cake gel @CarbsRok, I can't be doing with plastic bags in my pockets so I'm going to just have to risk it!

Best

Dillinger
The hypo stop in individual tubes is about 10 carbs (from memory) You can have a bigger bottle and it does measured doses. No matter which way you look at it, it's disgusting :(
The liquid glucose is just that but very thick with a screw top on it.
If you want something that is smaller how about the individual tubes of cake icing. Just make sure you are not too hypo and end up with blue or red lips :D I know the Americans are in great favour of this method of treating hypos. Just pick your colour carefully.
 
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jojogirl

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Thank you for bringing this one up. I struggle with this one too. The brain goes in panic mode and is confused between the messages telling it to eat everything, and the messages of memory telling it that you'll go high! Sometimes if I have panicked and over-treated, I then immediately give a bolus for what I shouldn't have eaten! curves the huge spike, and lets you stuff your face. Only problem is weight issues!

Jelly babies are tasty, but I always end up wanting the whole packet, not just 3 of them! Would like somebody to present us with a whole list of possible 'portable' hypo treatments, and next to that a list of how many carbs they are, and then how many we should take!
 
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Bazzza

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I have those dextrose tablets. But I always keep a bottle of coke in the gaff to treat my hypos. I used to overeat when treating these and to be honest couldn't give a **** how it would spike my bg. The way I saw it was, eat now or go into a coma. Carb counting and rationality went out the window...it was pure survival and getting sugar into the brain as fast as I could.
 
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tim2000s

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So here's an interesting point about your approach. You had already stated that your brain was struggling with the hypo, so you have decided to do something that requires higher brain function to make a decision. Surely it would be sensible to simply have a strategy to deal with a hypo. Full Stop.

And on that note, either, just take the gel, or just take 4x glucose tablets. There it is, the routine, bang, done. No questions, no decisions, no thinking. No hypo.

It's easier to react to a mildly high blood sugar than to sit there and worry where you are in the day and when your next shot is when you are low.
 

Dillinger

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So here's an interesting point about your approach. You had already stated that your brain was struggling with the hypo, so you have decided to do something that requires higher brain function to make a decision. Surely it would be sensible to simply have a strategy to deal with a hypo. Full Stop.

And on that note, either, just take the gel, or just take 4x glucose tablets. There it is, the routine, bang, done. No questions, no decisions, no thinking. No hypo.

It's easier to react to a mildly high blood sugar than to sit there and worry where you are in the day and when your next shot is when you are low.

That's the problem though - the glucose tablets are better for minor lows, and you know when you are having those, so to opt for the gel isn't too cerebral. I think it works for me. Also as a low-carber I seem to be able to function on lower blood sugars more easily; I'm still aware that something is wrong but I'm not stumbling around.

But essentially what I'm saying is that I've swapped from a smaller amount of carbs for hypos (the glucose tablets) to the higher caliber glucose gel unless it's just a little dip under where it ought to be.

@jojogirl - have a look for Gu Glucose Gels - they come in lots of flavours, aren't vile, and seem to do the job. They are a bit expensive but I figure money is no object when your brain is starting to fail..!

Best

Dillinger
 

tim2000s

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That's the problem though - the glucose tablets are better for minor lows, and you know when you are having those, so to opt for the gel isn't too cerebral. I think it works for me. Also as a low-carber I seem to be able to function on lower blood sugars more easily; I'm still aware that something is wrong but I'm not stumbling around.

But essentially what I'm saying is that I've swapped from a smaller amount of carbs for hypos (the glucose tablets) to the higher caliber glucose gel unless it's just a little dip under where it ought to be.

@jojogirl - have a look for Gu Glucose Gels - they come in lots of flavours, aren't vile, and seem to do the job. They are a bit expensive but I figure money is no object when your brain is starting to fail..!

Best

Dillinger
That's fine, and as a low carb eater as well, I understand that your brain functions pretty well at low levels (down to <3mmol/l) as it is able to run off fats as well.

But be careful on approaches, as many aren't low carbing and putting themselves in a position where they need to make a decision at a point in time where that is difficult may not always be the right approach. If you aren't getting decent brain function at low sugar levels (i.e. the majority) then having a very simple approach that you know works is much more important.

As it stands, I've tended to find that just eating more of the glucose tablets has the desired effect, but I'd also say that "in basal" and "out of basal" isn't an effect I've noticed as having a direct impact on a low. I've tended to find that hypos are incurred either as a fast hypo due to bolus or a slow hypo from basal. Generally the fast hypo requires more glucose treatment.
 
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noblehead

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Never used the running energy gel but did once use the Glucogel Hypostop, never again as it tastes awful and the end of the tubes break off easily in the pocket.

I find Jelly Babies work fine for hypo's, if bg is plummeting fast then I have some party-sized tins of coke on standby.
 
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janeliz

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Asda and Morrisons sell a mini packet of bassets jelly babies for about 30p. Each pack has 5/6 jelly babies in it and fit easily into your pocket or bag. No danger of eating the whole of a large bag and over treating the hypo.
 
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noblehead

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Asda and Morrisons sell a mini packet of bassets jelly babies for about 30p. Each pack has 5/6 jelly babies in it and fit easily into your pocket or bag. No danger of eating the whole of a large bag and over treating the hypo.


Good to know, I use an old Glucotab container that fits 4 JB's at a squueze, it's great as the tub is quite robust and they don't go too soft when left in a trouser pocket.
 

Diamattic

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I have kinda found that too..

Most of my hypos are because I injected too much before a meal without realizing. When this happens i know it around the 2 hour mark, but also know that the 'hunger' can't be real because i just ate so i typically just try to pick a candy or something around 14g of carbs. That brings me out of it without loading up on extra calories or over treating.

As of right now my favorites are tootsie rolls - 6g of carbs, 20calories per small roll

And Airheads candies - 14g of carbs, 60calories per candy.
airhead_xlarge.jpeg


The airheads cost about 25cents in bulk each, and are very small and easy to carry around in your pocket or bag, they are pretty much all sugar so they work just about as well as Dex tabs (i can't notice a difference)

If i am hypoing for reasons like - working out, walking alot, forgetting to eat, or something else i will eat (just like you) about 30-40g of carbs, usually in the form of a sports nutrition bar (like a cliff bar) or a protein bar. If my sugars are severe i will have a dex tab or two AND half of the sports bar to get them started back up fast.
 
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alaska

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I find that low carbing means I'm much less likely to have a sudden crash down to very low sugar levels but all the same, I don't want to be letting my sugar levels go low for any longer than I need to.

The longer you spend at hypo levels, the more chance you have of losing hypo signs.

In my higher carb days (years back now) I had poor hypo awareness from too many hypos, too often, for too long periods and sugar levels that would sometimes go much too low into the 2s.

I'll sometimes use a couple of sugar cubes to treat a hypo (about 4g per cube) but it takes the best part of 15 mins to raise sugar levels from a mild hypo so will generally favour glucose tablets. Old glucose tablets can taste weird but fresh don't taste bad to me. I quite like the orange ones.

Ed
 

phoenix

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It sounds reasonable provided that you actually need that much because I know from reading some people absolutely do.
Is this hypothetical ie have you tried it and what does your meter tell you? ie how high would 20g of carb take you in this situation. I know for me that amount of fast carb would almost never be necessary .
.
If not hypothetical and you are getting hypos with bolus insulin on board then the question has to be why?
It seems a bit contrary to eat a meal at which you are presumably dosing for fewer than 20g of carbohydrate but later having to use 20g to remedy a hypo. That suggests that you have taken too high a bolus , your basal is too high , or you have been doing something that creates and extra glucose demand that you can't supply.

Actually, I know that you have been considering the Libre. This has been really good at showing me what happens to me. These two hypos, at the same time, on subsequent days were exercise (just walking) induced , both were at about 3.5 hours post bolus so at that point it's influence is waning. Just one dextrose in both cases . I would have only needed more if I was going to carry on exercising and not going to eat dinner for several hours.
I know you are thinking of getting one and I would recommend it to experiment and just to see what is going on .
hypo snip.JPG
 
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smidge

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@Dillinger - you are very good using dextrose tablets and energy gels and things like that. I use a Celebration or a Hero usually. Each one is about 6g carb and usually corrects my hypos quickly. The Libre showed a Snickers Celebration hitting my BG almost instantly. Mind you, my BG seems pretty slow moving in either direction and tiny amounts of sugar seem to be all that's needed to get me out of the mild hypos I tend to have. I also seem to function very well at lowish levels and can make reasonable decisions on treating my hypo. At least, I think I can!

If I've got active bolus on board and I hypo or if I have a scary night time hypo I tend to use half a small carton of orange juice - except that I don't seem able to only have a half carton, so I finish the carton and end up spiking high, injecting to correct and ruining any chance of sleep! So I don't recommend that.

I guess in a way I use a similar strategy to you when treating a hypo - small chocolate for levels just into hypo territory and orange juice for lower levels or when I feel really quick acting carb would be prudent - only I use nicer things LOL

Smidge
 
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LittleFragge

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I usually have 4 raspberry gluco tabs, but will have a snack. At times tho I over eat and I don't mean to, especially if its through the night I will eat anything, then my husband moans at me for over doing it. I eat until I feel better which is not good, at times i need to be a detective to know what I have had (hunt the wrappers and crumbs ) I'm better in the day, but do need a better system.
 
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ElyDave

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Hi,

I think that treating hypos correctly is one of the hardest elements of diabetes control; your brain is not working quite right, you are hungry and can be anxious so tend to stuff yourself with glucose/carbs/anything you can find...

I've recently changed my strategy for treating hypos and I think it's working.

Previously I would take 9 grams of glucose tablets (Dextrose) when I was hypo which is 3 of the tablets.

The problems with that is as it is a modest amount in response to a hypo I would often find I would in addition eat something else in response; so would as often as not 'overtreat' the hypo and end up with a high blood glucose level.

Also Dextrose tablets are frankly disgusting.

What I've decided to do is to decide, when hypo, whether I have active insulin on board (with me that means am I hypoing within 4 hours of injecting my basal dose) or not. If I do I eat a running/sport energy gel. These come in little packets and are about 20 grams of carb.

If I do not have active insulin on board I would treat as normal with Dextrose tablets; boo hiss.

The benefits of this is that the energy gel things get into the blood very quickly are tasty and are very generous in the amount of glucose which stops pretty much any hypo (unless some real mistake has been made). That means that I don't over compensate any more and avoid excessive rebound highs.

The downside is that the running gel things are more expensive than Dextrose tablets and I'm dreading one bursting in my pocket.

Does anyone else use them; does the above sound like a plan?

Best

Dillinger

For a minor low i.e. not hypo, but <4.5 I tend to use half a cereal bar or similar, 9-bars, nature valley, NAKD etc which does the trick.

For the serious ones, I too use the running gels Hi-5 are about 20g, or I also carry around the fun-sized packs of haribos (2 packs = 20g) which wont burst in the pocket, but can turn into one big squidgy sweet if they get too warm.

In terms of cost, look here http://www.discount-supplements.co.uk, or other online bike and running type shops, you can often find decent discounts f you are prepared to buy in bulk
 
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