Hi everyone,
I am wondering if anyone has tips on resisting that overwhelming urge to majorly over-treat lows. When I get low enough (40s or 30s) I find it almost impossible to stop eating. I usually end up doing a huge bolus after these “hypo binges” and then still ending up high. I find this is particularly a problem if I wake up in the middle of the night with a low.
Thanks
Laura
i totally know what you mean! it’s hard to stop eating when you’re not feeling better. i treat with a pouch of capri sun (about 30g). it acts fast, and the fact that it isn’t an endless bag of food (or jug of juice, for that matter) kind of helps.
good luck!
I use smarties. One roll is 6 grams of carbs so I usually take 2 or 3 depending on how low I am. They are also cheaper than glucose tabs. I find it’s easier to use something measurable like juice, soda, glucose tabs or smarties. I also keep them by my bed so I don’t get up in the middle of the night in search of something to eat. Like Faye said, it’s not an endless supply of food and food actually takes longer to bring your sugar up which means you feel compelled to eat until it does. Take 15grams of fast acting carbs then wait 15 minutes… retest then take another 15 grams if you are still low. I believe this is referred to the rule of 15. If you are having too many lows you should discuss that with your doctor…you may need to tweak your insulin/carb ratio.
15 grams , 15 minutes
1 mini juicebox = 15 grams, 4 glucose tablets… and so on. Do not treat with food. Have you tried this?
I did this. I also used the 15 grams, 15 minutes, test, 15 gram repeat if needed…
Then I learned that the amount of grams to use is dependent on your weight.
I cut 4 gram glucose tablets. in half.
For my weight, 3 half tablets, 6 grams, raises me 40 mg/dl. 15 minutes. test. repeat if needed.
If you’re 150 lbs, you can use the 15 grams.
I ALWAYS went high if I ate food.
As others have stated here, “15 grams of glucose tablets or gel, wait 15 minutes, test, repeat if needed” really works.
Yes, you may need to adjust the 15 grams. If you don’t have much insulin on board and your low is on the high end, 60-70, you may need only 1 or 2 glucose tabs to bring it to a sensible level.
The “old” advice was to follow the glucose with a snack, preferably with protein remember peanut-butter/cheese crackers?). This usually isn’t necessary (as long as you can continue to check bg to see if it’s rising), unless you have rapid-acting insulin still active in your body (it’s been less than 4 hours since your last shot or bolus) or have been exercising.
I’ve had better control since I promised myself I’d use glucose tabs whenever possible to treat lows. Still, I had a bad low at 3 a.m. last week and in my sleepy haze managed to consume some chocolate chips … some cereal … and a few Pringles. The wake up number was NOT pretty.
Although food or drink can be used in a pinch, I find that treating a low with something that is more “medicinal” helps me better differentiate between the brain-about-to-blank-out “hunger” of a low versus true hunger before a meal. Good luck! Let us know what works for you.
The hard part is waiting 15 minutes for the symptoms to go away after eating something.
Try picking something you know will work. Many good suggestions above, like Capri Sun drinks. Keep it available in single servings and keep just a few, not a big supply, in various places where you might need it. After you take it, go someplace where there’s no food to snack on. The bathroom, the living room, the bedroom. Just get away from the other food. Set a timer for 15 minutes and test when it goes off.
I particularly like Kelly’s advice to view treating a low as medical treatment rather than satisfying hunger.
Good luck,
Terry
This is such a great site. Thanks everyone for your advice. I will pick up some glucose tabs or gel and make a genuine effort to think of it as medicine rather than food.
Yes, waiting 15 minutes is the key. I always tell myself (yes, quite literally talk to myself) and just say, my blood sugar is going up, even though I still feel low.
I am sure to treat with things in small units-- smarties, glucose tabs, pixy stix, or my favorite: milk with a little nesquik. The point is that I do not go over 15-20g.
IF I do overtreat, then I give insulin for all the carbs over the 15-20g immediately. Fast-acting insulin takes 15-20 minutes to start working. So if I overtreated, taking an injection is the best way to prevent the follow-up high. BUT the best solution is to not overtreat (easier said than done for me!!)
It’s funny! I’ve been battling lows all night last night. The funny thing is … I’m in the hospital! ha ha ha They really tend to overtreat with food! Last night I had a low – treated with ice cream & 4 half portion graham crackers. 1/2 hour later, I wenr down a couple points! More ice cream & grahams. 1/2 hour later – up a bit but way below the bedtime limit of 100. More food and a juice this time. I must have cionsumed at least 12 graham crackers, two ice creams and at least 8 oz. of OJ. Finally got to 101 and safe BG level. They had finally called my endo’s office and were told to reduce several of the basal rates. When I woke up I was 190. Well, I guess I need to look at my track record and make some adjustments.
Take heart … you’re not alone in this.
Lois La Rose
Milwaukee, WI
Hi Laura,
I use to do that too. What worked for me was switching what I ate to treat a low. In the old days, I’d drink juice, chocolate milk, eat bars, or eat/drink anything sugary I could get my hands on. I can recall making chocolate milk by adding chocolate syrup to white milk, but making it SOOO thick that it was more like a sludge than a drink. My hypo mind was saying “Make sure there’s enough chocolate in there to bring me back up.” And then low and behold, I would have a nasty hyper high event not too long after.
Now, I use glucose tablets exclusively. They have a consistent number of carbs in them (4g per tablet, I use the ReliOn brand I can get cheap at Walmart), which makes it easy to know how many to eat, or more importantly, WHEN to stop eating them. Whenever I go low, I usually start with 4 tabs (16g total carbs) and see how it goes. If I’m getting better, I stop. If not, I retest and then do another 4 tabs if necessary. By that point, I’m almost always back to where I need to be.
If my mind is really wonky, all I have to do it count how many I’ve had, then do the math later to figure out how many carbs I ate. Works a lot better than guessing if I drank 10 or 20 ounces of orange juice, or trying to guess how thick the chocolate sludge was.
Cheers, Mike
Dave,
My problem with chocolate milk is a (lack of) self-control issue and not an effectiveness issue. Choco milk has no problem bringing me back, to be sure!
I like your Skittles idea, but I would run into the same problem. I’d be sitting there with a vial of yummy Skittles just waiting to be eaten. And they wouldn’t have to wait long…
If I have the chalky, tums-like glucose tabs, they’ll sit there undisturbed until they are, in fact, absolutely needed.
Cheers, Mike
I also use smarties and find that it works great. I put a few around the house where I am most likely to have a low, and put the rest of the bag away, so I am not tempted to eat more than I should.
Laura,
I agree with taking glucose tablets or candy in a pre-measured amount. Liquid does work faster than solid food. I usually “chase” my glucose tablets with a glass of water.
One thing that no one has mentioned yet is that the body’s defense against low blood sugars contributes significantly to high BGs that follow low BGs. The liver releases sugar in any low BG emergency. The body also responds with counter-regulatory hormones to fight the high insulin levels in the body by disabling it.
I’ve found that if I catch and treat low BGs quickly then I can prevent the liver and the counter-regulatory hormones from getting involved too much. If my low BGs extend for hours, like when I’m asleep, then I find I lose control of my BGs for eight hours or more after I treat the low BG. That loss of control persists even if I give plenty of insulin to metabolize any immediate and subsequent carbs.
When I wake up low (<70 mg/dl) I sometimes skip breakfast (after treating the low BG) because I know that eating, even if I give insulin, will drive my BGs higher than 200, sometimes as high as 300.
My doctor has told me that to start to gain control of blood glucose the first thing one has to do is eliminate any lows. My doctor thinks that anything under 80 mg/dl is low.
It’s a bit complicated but the more you know the better you can adjust.
Good luck.
Terry
Now that we have cgms, I have found we started to overtreat lows. When you see two arrows going down and cover the insulin on board and she drops lower even ten minutes later, you can panic. One way I can think of is to use glucose tabs, smarties or skittles… those are the fastest. Another way is to look at insulin on board when low and cover that so that you are assured of coming back up. Then again, you can give yourself a reasonable limit of fast acting carbs, but you can err on the high side. If 30 or 40, I would err on the high side and give maybe 30 grams of fast acting sugar. When you have come up, I would have some peanut butter, something to keep the sugars up. If overnight, I would run your sugars a little high, maybe 130 to 140, if you had run so low in the first place.
For most people with Type 1, the chocolate in Hershey’s syrup, could slow down the recovery from a low, maybe even substantially. Milk also takes 20 or more minutes to digest. Glucose tabs, smarties, skittles, juice, in that order, would make more sense for most. Be careful what you use to treat a fast acting low; you have to beat the clock.
orange juice or cherry juice =)
also Kaleb has the dawn phenomenon effect where he gets lower at night; and even though Orange Juice is usually a ‘no no’ haha he drinks a small glass before he goes to bed so he doesnt wake up low; like he had been a lot lately; he even got his lantus lowered 2 units; the 0J or Cherry Juice works without over doing it unless you just drink a whole lot haha and it works pretty quick so you dont feel like you have to keep eating to get it up =)
the BD brand of square orange flavored glucose tabs are preferred by my b/f he said they’re awesome; ha they even taste good. i ate one before; im not dx as anything but mine tends to run on the lower side; it was 50 one time when i was sick but the thought of food and i would have gotten sick so he gave me the glucose tab instead; so i, too, can vouche is tasty =)
I was told by a nurse that after you correct a low, it is important to have a protein so that you don’t crash again. I hope this helps you. (I have a hard time resisting eating too much as well)