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Treating a hypo with carbohydrates

B

be strong 2017

Member
Hi folks . After seeing my diabetic nurse today and discussing among other things my nurse stated that after having a low blood sugar in the morning 2.1 approximately, (type 1 diabetic) by the way . She told me that you don’t treat a hypo with carbohydrates after using glucose tablets. I have been diabetic from 1985 and have always done this as I was told years ago . I am now unsure as to what I should do or not do . Any help would be appreciated.
 
I swear in the hypoglycaemia manual thing that is available it's advised you do? So that you are able to stabilise your BS levels or something to stop them dropping further?
 
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Quite surprising and alarming advice from a nurse.. she obviously hasn’t done DAFNE where it states - treat with rapid acting glucose until levels are above 4 mmol/l then have 10g of carb, simply because you could drop again.
 
Personally I just use sugar to treat, and a temp basal on my pump if I suspect I will get low again later. But many people do eat sugar and a slower carb - in particular if they are on MDI since they don't have the option of a temp basal.
 
Hi, I'm another one who would advocate a longer acting carb snack as a follow up. Maybe a digestive biscuit in my case.

Nurses. I was advised by one prior to an eye procedure on testing at 4.2 to eat half the pack on jelly babies I had in my bag..(they wouldn't do the eye injection if lower than 4.8, or lol 14. Something, which I thought was generous.)

I told her I'd just do two & see her in half an hour.. What do I know? Only been at it for 41 years..
 
Depends a lot on how much active insulin on board there is. Sometimes a mere 5g will stop a slow slide with no need for follow up if there's little or no iob. If lots of iob, sure, a bit extra slow release is good.
 
I always treat a hypo with lucozade (or any sweet drink)) as it acts extremely quickly to raise sugar levels to be where they should be, but I would then have half a sandwich or something similar to ensure sugars do not drop again.
 
therower said:
@be strong 2017 . I think you've already answered your own question.
Diabetic since 1985 gives you far more insight and knowledge on how you treat hypos on a personal level than any nurse no matter how well informed.
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I was diagnosed 1990, so almost as much experience. ;)

I'd be inclined to agree with this for the most part, but medical science does move forwards. I have been to at least two courses/events where I learned new developments about how to handle my condition.

Now, that may or may not be true in this instance, and I think most clinicians would agree that the patient is the number one expert in diabetes management. After all, we are living with it 24/7.

I'm on a pump, so I only treat hypos with high-GI carbs, and don't eat anything else. If I do, I need to bolus with it.

For anyone on MDI, I think the advice in @Scarjaws screenshot is quite right.
 
I think treating a hypo with glucose tablets as suggested by the DN in the original post is totally correct.
Unfortunately the DN has failed to ask......
1. What caused the hypo?
2. What iob is there?
3. When was last meal?
4. When is next meal/ insulin injection due?
5. Is there any activity being undertaken to be considered?
There could be more things to consider.
The DN offered advice for the moment. Diabetes isn't momentary.
 
be strong 2017 said:
Hi folks . After seeing my diabetic nurse today and discussing among other things my nurse stated that after having a low blood sugar in the morning 2.1 approximately, (type 1 diabetic) by the way . She told me that you don’t treat a hypo with carbohydrates after using glucose tablets. I have been diabetic from 1985 and have always done this as I was told years ago . I am now unsure as to what I should do or not do . Any help would be appreciated.
Click to expand...
In a way you and your nurse are both correct. A reading of 2.1 does sound really really low however. I would expect you to be sparked out on the floor with this reading. It wasn’t 3.1?

Anyway; in answer to your question.

Carbs in food tend to labelled by the way your digestive tract handles them. All eventually end up in your blood stream as Glucose. There are 3 main kinds.

1) Glucose is the simplest of carbs. Nothing is done with this and ends up in your blood after about 40min


2) Table sugar and fruit juice sugar are known as a simple carbs. These take about 1 hour 10min to be broken down to Glucose


3) Foods like Quaker Oats and Corn Flakes are called a complex carbs. These take about 2 hours.


Because of this delay in processing Glucose tablets are the best option when you get really low readings but things like porridge will be useful mainly to maintain you above a reading of about 4.
 
If it took 40 mins for glucose taken by mouth to get into the bloodstream, I know I would be dead ! I have been type 1 for 54 years. What are you quoting from ?
 
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I wonder if she's thinking your type2 who need to watch too much carbs?
Even I've been told to follow with a sandwich or meal if due.

I don't think some nurses can keep up. They say because they're overworked. In other countries nurses are hugely more qualified or more acedemic than ours. However paid much much more.

Some are a mystery to me.
 
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