A nudge with some staying power

Anybody else ever use this “not real low but trending in that direction with some non-trivial insulin yet to act” kind of treatment? It’s an odd combination I don’t mind using once in a while. Works well when you suspect you need to add some staying power to counteract a slowly falling trend, like when you want to sleep.

Quirky, I know.


I don’t use protein for lows (or soon-to-be lows), but I think I should. I think it would help me have less of those times where I go low repeatedly within a short period of time.

If the BG is coming down quickly, a pure glucose tab solution is the best idea. But in some situations it’s nice to ride the often steady line after a little peanut butter.

This is a strategy employed by Camp Joslin. If memory serves me right, they sometimes use banana followed by peanut butter. Peanut butter crackers are also an advisable snack on their list.

I’ve always viewed it as a treatment suitable for injection therapy bc you can’t turn that long lasting insulin off. I’ve never used it. But I can see how with looping doing it in the mini version you depicted, makes a lot of sense. It also makes me think of times after a long day of activity when we fight persistent lows later, we could have deployed this. Thanks for bringing it up.

In Caleb’s case, we’d use soy bean butter, bc he’s allergic to peanuts. For all I know, that’s what you are using!

I should clarify that I used to use quick acting glucose plus slower-acting carbohydrates plus protein as a kid. But I stopped using this strategy when I started on Lantus in my 20s. I figured that the additional carbohydrates and protein were because NPH (or Toronto/regular, when I was using that) would often continue to peak or start to peak shortly after a low, and since Lantus (and the pump basal) don’t have these dramatic peaks, it wasn’t necessary. But there are still times that I have two or three lows in a row. The difficulty is probably telling when I’m going to have two or three lows in a row and when I’m going to just have one…

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What is that thing below the peanut butter?

It’s an orange-flavored glucose (dextrose) tablet. You’re not serious, are you?

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I use a reasonably low-carb (but not no-carb!) dark chocolate in that case – I find there’s enough sugar to catch the low and enough fat to sustain the fix. Peanut butter - even the full-sugar ones - doesn’t do much for my BG, so I use it more for an easy, no-worry snack than anything else. Glucose tabs have not been my favorite fix for anything in some time (I know, bad boy! :wink: )


Here’s the context where I used that tactic.

Just before 8:00 p.m. my blood sugar was falling steadily (sideways Dex arrow) following my post-dinner walk. I was around 80 (4.4) and my insulin on board was about 1.2 units. My Loop AP was already basal low-temping at 0.0 units/hour. I ate most of the glucose tab by itself and then followed it with the peanut butter. My BG responded well by bottoming out at 68 (3.8) and only rebounding to 99 (5.5) before slowly going down.

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Perfect! Wish I could put together a loop AP… just don’t have what I’d need to even try. Nice, though!

I definitely turned some kind of corner back on April 12. All of my numbers have taken a turn for the better. I remember some 14 and 30-day Clarity lines that you and others posted here. Those lines were flat, in-range, and skinny, kind of like a worm burrowing through soil. While mine looked more like a fuzzy caterpillar.

I never thought I could break through to that better level of control but now I’m seeing it. :joy:

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Ok. I have never used those. They seem kinda “mediciney”. For lows I just use food or drinks and stuff that I like.


hey eddie, I didn’t know what it was either!


I thought the same thing for a long time, and really didn’t use them until late last year (I think I tried those old BD tablets when I was first diagnosed, but forgot about them and they’ve been off the market for years). They taste better than you’d expect (grape is delicious). If I’m having a bad low they won’t be enough on their own, but I find it’s helpful to take 2-3 which brings me up fast (and takes away my craving to eat everything in my kitchen and shoot up to 20 mmol/L) and then eat something like a granola bar after to sustain it. I used to use orange juice or coke a lot but learned when I got a CGM that they are way too much sugar too quickly most of the time, leading to a high and then another low later.

I used to use glucose tabs, but switched to smarties (the US kind, which are different from Canadian), which are basically tiny, slightly better tasting (IMO) glucose tables in cellophane rolls. More precision in dosing, and easier to throw a few of the rolls in my pocket. Also you can buy bulk bags of smarties for much cheaper than the equivalent in glucose tabs.

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Oh yeah, we call those Rockets. I do use our version of Smarties for low blood sugars now and then, but they take a while to kick in of course and aren’t really the best idea (delicious though). I don’t think I’ve had Rockets since I was a kid, how many grams of sugar are in each tablet?

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6g per roll. My CGM taught me the whole 15g per low is usually WAY overboard for me, so I use anywhere between half a roll to 2 rolls usually to treat lows, depending on how bad they are.

Also, they take the same time as glucose tabs to kick in for me, which makes sense since they both are dextrose plus colors/flavors, with nothing else to slow it down.

I have gone back and forth with using glucose tablets versus candy/food a few times over the years. The biggest benefit for me is that they contains pure glucose, exactly what’s needed to treat a low, nothing more, nothing less. Did you know that even table sugar, sucrose, is half glucose and half fructose? Fructose follows a different metabolic path, via the liver, than glucose. I don’t know of any commercial candy that contains glucose or dextrose only.

Glucose tabs are measured amounts that my low-addled brain can understand. I’ve even taken to eating less than one tab to nudge a trending low with little power behind it. This way I less often over-treat my low, a more common problem with me using food.

I understand the convenience and taste preferences for things like Skittles. The ingredient list for Skittles, however, makes me pause.

Skittles’ ingredients are: Sugar, corn syrup, hydrogenated palm kernel oil, apple juice from concentrate, less than 2% - citric acid, dextrin, modified corn starch, natural and artificial flavors, coloring (includes yellow 6 lake, red 40 lake, yellow 5 lake, blue 2 lake, yellow 5, red 40, yellow 6, blue 1 lake, blue 1), ascorbic acid (vitamin c).

I don’t like to consume corn syrup, especially the high fructose corn syrup. Did you know that hydrogenated palm kernel oil is a trans-fat? Trans-fats have been associated with many bad health effects.

@Eric2, I just couldn’t imagine anyone with diabetes not recognizing what a glucose tab looks like. YDMV! The picture and setting may have contributed to the confusion. No, I don’t think the glucose tabs taste like medicine. But they’re not tasty enough for consideration if I want something sweet.

Smarties. That’s why I use them.

Thanks for that – I learned something new! Smarties are a better choice than Skittles from my perspective.