I'd like to ask a couple of questions

I have two questions, for you type 1 diabetics (hopefully those who’ve been through this disease a bit longer, but any input would help) What should I really do if my blood sugar drops? Sugary foods help but further complicate my chances at living a health type 1 diabetic life (sugary foods further my risks at having health problems)

Why after eating a meal does my insulin work first? Which is to say, why does my blood sugar drop from insulin, rather than the food im eating act first? (The carbs in the food) My blood sugar drops low and I freak out a little and eat sugary things although i’m not supposed too.

Welcome to the balancing act that is life with diabetes.

Blood sugar that drops too low for too long can lead to severe medical complications, including death. That’s why current medical wisdom recommends treating (but not overeating) to bring a glucose reading under 70 mg/dl back to the target range (yours may vary, but usually 70-130 mg/dl). Depending on your body and how long you’ve lived with diabetes and how much injected or pumped insulin is active in your body, there will come a blood sugar low point at which you are no longer able to help yourself by eating or drinking something containing glucose. That’s called a severe hypoglycemic episode and is something that is good to avoid.

Sugary foods (in sensible quantities and in conjunction with a healthful, balanced eating pattern) in themselves do not further your risk of health problems–it’s the long-range affects of having blood sugars out of target for too long each day, for too many years. To keep blood sugars in range, many people with diabetes choose to limit sugar, but it’s not necessarily a complete no-no.

With meal-time insulin and food, there’s a time lag between when the blood sugar peaks from the digested food and when the rapid-acting insulin peaks (is most potent). This, unfortunately, can get quite complicated and depends on lots of things–how much insulin you take, how long before you take the first bite of food, and the composition and combination of foods you eat–fat and fiber can slow the emptying of glucose (made from the food you eat) into your blood stream, while something like a sugary Coke can be processed very rapidly by your body.

People tend to experiment with when they give the insulin to figure out what works best for them–some people need to give it 15 minutes before eating, others bolus during the meal. My routine varies a bit depending on my pre-meal blood sugar and what I plan to eat. There are lots of discussions about timing of boluses on this site.

Best wishes!

You might be in a honeymoon stage of type 1 thats what I’m in after I eat my BG levels go low and I use the 15 carb rule . eat 15 carbs and check my bg . that works sometimes.

My doctor is working on decreasing my insulin.

Chris, different foods have different rates of breakdown. More fatty foods, like pizza, usually take longer to break down the carbs. For me, a couple slices of pizza will take about 4 hours to break down. A bowl of chicken and rice breaks down in an hour and a half. This is something that is MUCH easier to control on a pump.

You can work on timing your insulin based on the food you eat. Sugary foods for a diabetic under control are just as healthy as for non-diabetics. The complications come from the high blood sugars. As long as you take the insulin for the carbs you are eating, that is all we diabetics can really do. I find eating a candy bar is much more predictable and easier to bolus for than say, an apple, even though the apple is much healthier, because the candy bar has nutritional information on it. But that is just a poor excuse.

So couple suggestions:

  1. When you get past any possible honeymoon period, which is usually within the first 9 months of diagnosis, talk to your doctor about a pump. Join a pump group here, meet someone on a pump, and talk to a local diabetic trainer.

  2. Talk to your doctor about a CGM. That is a Continuous Glucose Monitor. I think it is an essential tool that EVERYONE needs, but most insurance companies would disagree. It reads your sugars and reports them about every 5 minutes. it doesn’t replace regular testing though, just supplements it.

  3. Work with a diabetic trainer to figure out what your carb-to-insulin ratio is. They can also help you understand diets better. Be aware though that they are usually trained for Type 2 diabetics, and due to how rare Type 1 is they may give you Type 2 specific guidance that really doesn’t apply to Type 1’s.

  4. You are your best guide. It took me over 10 years to work out what is good advice for me coming from doctors and trainers and everyone else’s mom. If someone says “Should you be eating that?”, understand that they are trying to look out for you and as politely as you can, explain that you have worked it out with your doctor as to what you can or can’t eat.

If you aren’t familiar with the term “bolus”, that is what pump users call injecting insulin. Instead of having long acting and short acting insulin, pump users have really-short acting insulin being pumped in 24 hours a day usually. That is called a Basal. I have a low Basal rate overnight, a medium Basal during the day while I’m active, and a high Basal for evenings when I’m usually much less active. Then when I eat carbs, I’ll take a Bolus of insulin. Such as 10grams of carbs will be 1 unit of insulin.

I agree with all statements listed thus far. Really good info here!

Chris, just keep in mind that the advice to diabetics “Don’t eat sugary foods” is mainly targeted at Type 2’s. That is because sugar breaks down quickly and a Type 2’s pancreas can’t keep up, even with the oral medications they take. Type 1’s don’t have a functional pancreas at all, so it is much less of a concern.

Type 1’s, and Type 2’s who’s pancreas has crapped out completely, only need to worry about injecting insulin for the sugar you eat. I had some doctors and a camp nurse early on who told me that it was a bad thing to be injecting insulin ad hoc throughout the day to compensate for unplanned foods. But that I’ve come to find, especially now that I’m on the pump and that is EXACTLY what I do, that this was some really bad advice.

You should however not take insulin just for a BG that is high, because you may have some insulin that is still working in your system. Once you get a few years into it, you’ll know how long the insulin takes and how much insulin is needed for each mg/dl of BG that you are over your target. Just make sure you check your sugar a little more than you think you need to.

I’ve probably repeated some things that Kelly said, but I just wanted to reinforce the things I’ve learned in 18 years. Now I’m older, have a family, chase my little ones around the house, run in races, bike (30+ miles) a few times a month, and compete in triathlons. Living a great life. The athletic things all started 4 years ago, but before that I was healthy too. And I’ve been known to eat a few candy bars. Just not daily, and just not without knowing what it would do to my sugar levels.

If I pass on early, I suspect it will be more likely due to hereditary heart disease and heart attack in 30 years than to diabetes. or maybe I’ll go in a sky diving accident! :wink: The point is, be conscious of the consequences, but don’t let that stop you from enjoying life now.

One last bit of advice. Orange Juice. When my sugar is low, I drink some OJ. Preferably the kind with ONLY OJ in the bottle. This fixes me within 5 to 15 minutes most times.

8 oz of OJ is more than enough. That’s half of a regular sized glass. 1 measured cup.

also as long as we have adequate exercise and diet a small splurge every now and then keeps it interesting. Last night after a chicken salad for dinner my wife prepared fresh Peach Cobbler…totally hand made. Not one ounce of Splenda went into that bad boy. I enjoyed it very much…Then I over bolused and went low but that was my own stupid fault lol!!! Its all about enjoying sugary foods in moderation.

Mmmm, peach cobbler! I’m not a fan of Splenda at all. I’ll stick with the cancer-causing aspartame for now. :slight_smile:

You really only need 15 grams of carbs to get your blood sugar up. This is a small glass of milk…or a couple small cookies…or toast with butter. You should talk to your dr about adjusting your insulin…or get a pump. Its been invaluable to me and I’ve been diabetic for 38 years now…it really helps with eating.

I’ve been type one for 22 years and I’ll keep it simple for you… when you are low drink fruit juice…natural sugars are better and then eat protein to keep the sugar up… like cheese and crackers, peanutbutter… something…

For meals wait till after you eat you meal then bolus(take U’r shot)… This is what I do now because of the same issue…

I wish you the best!!!

I stick to all natural sugar when the occasion arises lol

I agree with everything so far: a lot depends on what you’re eating. You probably just need to adjust your dosing and timing.

If you start seeing a lot of lows, or if you find yourself eating a lot more than you did before diagnosis (including treatments for lows), then call your doc. Insulin can drive your hunger level up like nobody’s business. If you start ‘eating to your insulin’ rather than ‘insuling to your eating’ then you’re apt to put on too much weight rather than just putting back on what you lost. Your diet shouldn’t need to change tremendously – but it never hurts to make it better. The ‘diabetic diet’ is really just what everybody should be doing…

What should I really do if my blood sugar drops?
Learn first how far 1 gram carb raises your blood sugar (BG). It is weight related. Glucose tablets circumvent digestion and give you glucose quickly. Example: 6 grams raises me 40. Perhaps 8 grams would raise you that much. You look a bit heavier than I am. Try it out. Find out how far actual glucose raises you.
Then if you go low, you can quickly raise yourself by the number grams it takes to put you back to 100. And you can go on with your meal.
What you do for dropping BG also depends on why it’s dropping - what amount insulin you injected.
If you put in more insulin than the food requires, you go low, and it may be rapid. Raise it by using the medicine every diabetic loves to hate: glucose tablets. By using “medicine” to raise yourself, you don’t take sweets and overeat. You stick to the amount of medicine you need.
Why after eating a meal does my insulin work first?
Does your digestion take longer than the insulin you inject takes? A slow digestion may be a problem & it requires a doctor visit. Keep a record of the time you start eating a measured, small fast carb (such as fruit) and test a half hour later to see if your digestion of fast carbs is starting to raise your BG. If it is, you can time your shot. And of course fats slow it down. Protein’s change to glucose is slow.
A separate test by you can show you when, after you inject, the time your BG starts going low (20 minutes? 45 minutes?). Do this only when your BG is 130 or more. And don’t confuse it by eating at the same time. Simply use a unit of fast acting insulin, test at 20 min, 30 min, 40 min until you see the lowering. At 3 hours, you can see how far down one unit took you - if you don’t eat meanwhile!
I suggest Walsh’s book, Using Insulin, and Scheiner’s book, Think Like a Pancreas. They are somewhat old now, but take you through the processes you need for controlling well. Best wishes.

hi chris,

about the sugar thing… sugar for a type 1 diabetic isnt bad at all (except maybe for your teeth) as long as it is either bolused for with a rapid acting insulin or in case of hypoglycaemia. Whoever told you that you weren’t supposed to eat sugary things seems like a douche because if you dont eat a sugary food when you are low then it will take longer for your symptoms to go away and as you know low bg isnt pleasent at all.

As for the lows before meals, try eating a sugary pudding afterwards and bolus for it before. This will counteract the insulin that is causing low bg at first. Otherwise if you’d rather be more healthy try giving the bolus later on depending on how long the food takes to affect your blood sugar.watch out for foods high in complex carbs like pasta or high fibre, fat and protein meals as they generally have a lower glycemic index rating

good luck

btw, a recent study found that heart disease risk increases with more frequent low blood sugar (especially prolonged) which is why you must always treat it as quickly as possible with sugary foods

just curious - are there any other long term risks from more frequent lows (aside from the obvious risk of hypoglycemic coma) that you know of? i have found that the better my control, the more often i get lows. i have been fine with that trade since my a1cs are so much better and also b/c i wasn’t aware of any long-term risks that are as bad as the long-term risks from frequent highs.

Really? Well it’s been fairly close to a year(since I was diagnosed) , and to be honest my blood sugars (after what appeared to be the end of my honeymoon period) began skyrocketing alot more easily and I had to be more careful with what I ate, so I don’t think the honeymoon stage is what i’m in. 15 carbs? I’m glad someone gave me a more direct answer, thanks :smiley:

Thank you for the help, I really appreciate it. :smiley: