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Rule of 15, my ****.

Spiker

Well-Known Member
"In the event of a hypo, take 15 grams of fast acting carbs. Wait 15 minutes, then re-test."

I had:

Adrenergic hypo warning.
Confirmed by CGM 5.4 dropping.
Meter test showed 4.5

To stabilise me over the next 8-10 minutes took:

12 glucotabs x4 gCH = 48 gCH
2 Mars bars = 62 gCH
Half a bottle of Coke = 27 gCH

So a total of 137 gCH in under ten minutes. The first eight minutes were worsening toward critical. The last two minutes were stabilising but not out of the woods. CGM was showing a down trend the whole time.

Take15 gCH and wait 15 minutes to retest? I'd be in a coma in the back of an ambulance right now, instead of writing this.

Rule of 15, my ****. Who comes up with this *****?
 
I normally just react on a hypo by eating first. Then test while on the munch/drink.
Followed by another test 20 minutes later to check I'm heading in the right direction...

Where is this info from Spiker?
 

That's pretty terrifying really.

But pleased you managed to stay in character.
 
Whoever thought that rule up had obviously never dealt with the absolute panic of knowing you are about to go unconscious. I'd rather treat the resultant hyper any day. The only thing I count is how quickly I can get glucose down me.

Can't imagine the NHS/DAFNE ever adopting the rule of 137 "take 137g CHO and hope for the best". Glad you managed to save yourself Spiker.
 

I would hate to know what your blood sugar was after that binge.
If you felt you were dropping like a bomb then you should have drunk the coke first not touched the mars bars as they are full fat. Then tested every 5 mins if that worried about it. Just ignore the CGM in situations like that as it's 20 mins behind an actual finger poke reading. Liquid glucose is always a first defence when the double arrows appear and going down.
 
Yes it was glucotabs on the way to get the Coke. The Mars bars were probably overkill, and not my weapon of choice, but I struggle to get fat Coke down. Half the bottle was still on the table when the smoke cleared. However the Coke was not doing it for me so I wanted a plan B. Something about Coke doesn't get into my bloodstream very quickly. Maybe the coldness, the CO2, the acidity, who knows.

And yeah of course I wasn't watching the CGM. The CGM alarm and meter check served to get me to head asap to a place with more than the 96g of glucose I was carrying on me.

16.7, 4 hrs later, since you asked. Yes, the purpose of the Rule of 15 is to prevent rebound highs. I try to stick to 12-16 gCH to treat hypos, but if the situation is worsening rather than stabilising after 5+ minutes then I treat it aggressively. Because I know from bitter experience that I can go from fine to unconscious in that time frame. And I would rather have 100 bad rebounds than one coma.
 
feckin' hell. I had one of those last Tuesday but not quite so bad.

BG spike from a time trial, over corrected, hypo resulting. This was about 10pm when I really wanted to go to sleeep as I had to be up at 3:30am to get to Heathrow the next morning.

Biscuit - still dropping
Another biscuit - still dropping
2 jelly sweets, now about stable but <4
2 more jelly sweets, just about 5

Now half past 11
 
Jaylee said:
Where is this info from Spiker?
Click to expand...
Looks like the Rule of 15, aka 15-15, may be US in origin. It's ADA policy and also endorsed by Joslin, Mayo Clinic, and the NIH.

God knows how it infiltrated its way into the NHS.
 
Spiker said:
DAFNE, and it appears to be some kind of NHS orthodoxy.
Click to expand...

Cheers Spiker, I have to admit to being (without sounding like an arrogant, jaded individual with an inferiority complex.) a "school of lifer" on this.
I haven't done DAFNE. Also on MDI.
Working on a 30 year old theory of mine that the metabolism allows most drugs like aspirin to kick in in 20 minutes..?
Carbs peak in an hour'ish after intake but depending on the style of hypo I can be on the rise in 20...
I have had the odd one where I seem to go low, treat with Lucozade or coke feel the sobriety, then drop again within ten..? But put that down to the lack of longer acting carbs being used in conjunction...? Difficult to eat a digestive or Mars bar during a gig! But music is the only profession where you can get away with looking stoned... Lol

You will all have to forgive me for my heathen ways... Great thread by the way!
 
you could always drink beer.

Walked to the village pub's beer festival yesterday after dinner. Hypo of 3.0 on the way there, so I was scoffing my little box of ***** bears on the way.

90 minutes later after 4 interestng halves 12.7. My first corrective bolus for a while
 
Sounds like a hypo from hell, do you know why it happened Spiker?

The treat with 15g of fast-acting carbs is just a general rule, some need more and some need less, much depends on how much insulin is still active so the timing often determines how much glucose you need.

Personally 15g can be too much for me and 2, maybe 3 JB's is enough to get me out of trouble, if it's within two hours of injecting QA then I will have a follow-up snack such as a couple of oat crackers.
 
I always wait 30mins before massively od'ing on carbs. I thonk dvla say to wait 40mins and if intending to get behind a wheel this is the time I would wait before retesting.

There is no way I would have rebounds from od'ing..

I take into account if I've been working, any insulin still in me etc for treating my hypo's. I treat with maomi pinballs which stay good in any heat and are 5g per pinball.

It sounds like you were having a huge drop in levels. I would be more alarmed at the reasons for the huge drop than the 15g rule....
 
@noblehead and DD, I am glad that the hypos you have are comparatively mild / shallow. I agree I now need to understand what caused such a steep and aggressive hypo.

Noblehead I think your experience proves that the Rule of 15 is just as likely to be wrong in the other direction - too many carbs rather than too few.

It's ridiculous really that they make these simplistic rules and try to apply them to an entire population that is so diverse.
 
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