Overdoing the sugar after a hypo

I am guilty of doing this too, especially during the first week or so after being diagnosed. I think it just comes with experience. In the example you've given, it's probably the hobnobs which did it. The Lucozade would probably have been enough to raise your BG but then you should follow up with a slow acting carb - I usually go for a couple of slices of [wholemeal] toast.

I know cakes and things aren't really advised, as they are often slow acting too, but I have been known to counter a hypo with apple pies. Mmmm!

Bernstein recommends you find out before you need to know, by how much a glucose tab will raise your BG. then when you need it you can take the right amount. There's a table on page 311 of my edition of Bernstein, which gives an average amount. Thus for a 140 pound (10 Stone ) peson, a gram of pure glucose will raise the BG by about 1/4 of a mmol/l. So to raise your sugar by 1, you would need to take 4g glucose. (If you weigh 10 stones)
It's always a risk that you will go too far, because of the delay in taking the sugar and feeling better. acron, it isn't necessary to take a slow carb afterwards. BG is BG, whatever its source.

HI

I was told 100mls coke and less if its lucozade cause of sugar content/
Or 3 spoonfuls of sugar. I would love to drink coffee with sugar for hypos but cant get it make quick enough

I was told to take slow carbs after to help bottom out sugar spike - but have usually just taken half an oatcake if not due lunch. Its scary waiting 15 mins and praying that its up again so I think its only natural to over correct than risk dropping further. Like everything with diabetes -trial and error.

More of a problem for me is being quite low before tea time (near 4) and then having to inject and wait half hour. My bg can drop quickly (on premix) so Im sure that by time I get my dinner sometimes i am in hypo land. Any suggestions? Sometimes Ijust nibble something low carb (veg, slice cheese etc) between times

The "classic" treatment is 15g fast carbs (glucose tabs or similar, or orange juice etc.) wait 15 minutes and test again.

IME it's more complicated for Type 2s who still have some insulin production and often a tendency for the liver to overreact, that would overshoot me and set my system oscillating. I tend to do 5 - 10g fast carbs then add some slow carbs mixed with fat as a stabilising influence, but for those with less active livers that would not be such a good plan.

Plan A is to preload with sufficient carbs that the hypo never happens.

hanadr said:

acron, it isn't necessary to take a slow carb afterwards. BG is BG, whatever its source.

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Both my DN, and the literature I have, instructs to take a slow acting carb after a hypo, as lilibet said, to ensure the BG remains up, rather than just plummeting again.

If you are type 1 you MUST take slow acting carbs after hypo correction unless you are due to eat a meal otherwise you most certainly will come crashing down again.

Caitycakes x

Hi Sarah

Thats with having a snack mid afternoon at any rate. Was taking bit fruit and some nuts but have had to give in and have ryvita or oatcake to ensure getting enough to stop low. If low 4's before injection then am snacking after injecting but not enough to put me high.

As it is I am tending to find that despite small complex carbs (which I do need to eat some of due to insulin - have tried less, hypo guaranteed) my bg is much higher than I'd like pp. I can only conclude that my 30 of the 70/30 mix is not enough to cover meals though the 70 seems fine to keep me between meals.

Lilibet

If I go low such as 3.1 I take a square of scottish tablet and 10 mins later im about 4.6 and then have some fruit and this keeps me steady till next mealtime.
My 30 day readings are 4.7 weekly 4.8.
Joe

Hi guys,

Before I read Berstein and started eating low carb I used to bounce from hypo to hyper and back again. My standard hypo solution was to drink a bottle of lucoade but that just meant my bs went too high afterwards.

Since going low-carb I now use lucoxade tablets and I know from vigorous testing that one tablet will raise my bs 0.8mmol. So when I get a hypo I know that exactly 1 or 2 or 3 tablets will take me back to to an acceptable level of 5-6 and not any higher. Also, I absolutely do not have to eat any slow acting carbs as because of the 'law of small numbers' (Bernstein), I know that I don't have excess insulin circulating around which will make me go hypo again and that the small amount of sugar from the tablets will be enough to stabilise me until I inject and eat again.

Everyone treats their diabetes slightly differently and I've found that the only way to stop the swings and roundabouts of bs levels is low carbing (and therefore less insulin). What I am most grateful for is that I din't have to lug around 2 bottles of lucozade in my handbag all the time and that if I get a hypo in the night I know that munching a couple of tablets will stabilise me and my bs levels will be okay in the morning. Hooray for Bernstein!

Katie.

davehunter said:

Whats scottish tablet?

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Concentrated sugar in a tasty square block.

Or put another way:
http://www.scottishrecipes.co.uk/tablet.htm

Interestingly advice is changing with regard to following up fast acting carbs with slow acting.

On DAFNE they give different advice depending on how close the next meal is.

The treatment needed depends what has caused the hypo and how long ago the last bolus was.

If I've gone swimming after breakfast, and have a hypo when I test afterwards, I know that I need to cover the remaining bolus that still has to act by eating something longer acting as well as the hypo fix. I could take it all as fast acting, but that would give me a spike.

If I'm just a bit low and there is no circulating bolus, then because my basal insulin is correct, I don't need any slow acting carbs.

Another complication is when you're on a slow acting insulin which is causing hypos. As it can take up to 3 days for the effect of a a change in basal insulin to take full effect, the hypos have to be treated with extra carbs in the meantime.

Am I the only one who quite likes hypo's cause its the only time I get to eat some sugary goodness? Doghnuts ahoy ha ha ha

Scottish tablet is a variation on fudge. It has a harder texture. When it is just right it melts in the mouth. You make it with condensed milk, sugar and butter. It is quite tricky to get just right. Many families will have a secret recipe. I don't. My attempts in the past have not given the right texture.

The biggest problem with it is that it is very hard just to have one bit. I avoid it for that reason.

I used to love scottish tablet before I was diagnosed. I admire anyone with the self control to eat only one piece. Even the smell of it makes me salivate (the kids still eat it!). For me the only way to treat a hypo is dextrose tabs as they taste rubbish and so there is no temptation for me to over indulge. I used to have a bar of chocolate but it doesn't really work quickly enough and I found that although I used to loooooove chocolate I didn't enjoy treating a hypo with it as I never had the luxury of savouring it (had to eat it too quickly). The worst thing about diabetes for me has always been hypos, I hate the out of control feeling. Fortunately, since low-carbing I haven't had a single significant hypo, only lows that I could treat with a little slower acting carbs!!!

Caitycakes x

l0vaduck said:

Interestingly advice is changing with regard to following up fast acting carbs with slow acting.

On DAFNE they give different advice depending on how close the next meal is.

The treatment needed depends what has caused the hypo and how long ago the last bolus was.

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This is probably happening because the old school advice was based on mixed insulin regimes (i.e. two mixed injections a day). So you had a fair bit of insulin working away regardless of the time, and regardless of your intake. Nice to see things moving with the times.

Noone seems to have mentioned the effect of the liver reacting to the hypo with a shot of glycogen which will make the BG go up very high - on top of whatever you take to treat the hypo. Shame the liver is so slow to do this, otherwise we wouldn't need glucose tabs at all. I don't know of a way round this - apart from restricting hypo treatment to 15g. But even then , there's always at least a bit of a spike.

My daughters (aged 14 and 7) are both on pumps. We have been told not to add slow acting carbs after a hypo, only to treat with the correct amount of fast acting glucose. This can be difficult when they are starving and are desperate to stuff their faces! So we try and remember to test again after half an hour and give some extra insulin to deal with the excess carbs.
Sue