When I go low I take Glucose (often liquid) followed by a Danactiv. The Danactiv has 14 carbs (don’t get the Light for a low, good for other times), 3 g. protein and probiotics. I really prefer liquids, because when I’m low I have difficulty swallowing. I have a small fridge in my bedroom so that I can find something quickly at night without bumbling around the house. Best luck in going forward with your new lifestyle.
Gosh, JeanV, your story has me thinking…I’ve been waking in the middle of the night with sweats, etc, and I’ve been exercising hard and eating less. I’m still newish to this (LADA), and I thought that my estrogen was too low from exercise - which can happen. I haven’t been testing in the middle of the night because my husband is exhausted from getting up at 5:30am. I have so many aches and pains that the last thing that I want to do is get out of bed, sit up in the bed, or reach over and grab anything to test. This, of course, is worse with exercise…
More and more as I read this forum, I’m realizing that T1s and T2s have a lot of differences. My brother is a Type 2 and doesn’t have to be as strict as I have to. He thinks I’m absurd.
You are far ahead of me on the hypo thing, but I eat high fat plain FAGE yogurt everyday for various purposes, which includes convenience. It would seem to me that that may work. I think it only has 6-7 carbs.
When I first started exercising, my bg would go high because I’m told it would dump from the liver. Whatever the process, your body will acclimate to exercise after a period of time, but in my experience, exercise seems like another hormone. It eats up HRT, raises cortisol, and affects bg.
I still produce insulin.(Someone told me about Dr. B. at the very beginning of symptoms, and it has helped preserve function.)
The problem with testing at 5 minutes and finding you’ve gone up 1 mg/dl is that that is well within the margin of error for the meter, and therefore doesn’t mean anything. I know how hard it is to wait the 15 minutes (feels like a couple of hours, at least!), but that’s about the soonest you can get a reliable result.
When I have a bad low (which is rare, now, with my CGM and LC diet), I just stretch out on the couch, and pet my cats and try to think about anything but the low. And then I get up and pace, and somehow, I make it through.
Keep on trying! 
Thats another good point. If Im super low and my body is telling me I need to eat or Ill die, I break out diet soda and the lowest carb things I can find and munch away. Im grateful this doesnt happen often.
I think the anxiety is directly correlated to the amount of adrenaline my body dumps out during a hypo. I am blessed (ahem!) with an abundance of this hormone and am prone to panic attacks at the best of times (i.e. I can have a panic attack when my bg’s are pretty much anywhere on the map).
I have a huge dump of counter-regulatory hormones when I go hypo. It’s my understanding that many long-term diabetics lose this – aka hypo unawareness.
I’m the polar opposite of unaware; I feel like I’m going to have a heart attack from the pounding heart, I’m drenched in sweat (like I showered in my clothes), I’m shaking so bad I can hardly get the blood onto the test strip (I’ve had to poke twice to do it), I have flashing bands of light in front of my eyes that make everything more difficult. It’s not garden variety anxiety – it’s an adrenals-orchestrated melt down.
I know that it will pass (intellectually) but I’m literally suffering through the whole thing. Once I awoke out of a dead sleep with such severe muscle cramps in my thighs that I thought, “Oh, if my heart goes into spasm like this I’ll die.” At the same time that I was arching in pain from the cramps, I was so sad that I was dying there in my bed because I knew it would make my mother so sad. The cramps were so severe that I couldn’t get up and open the drawer to take out the glucose until they passed. Now I keep the glucose in a baggie right where my hand can reach it, next to the bed.
I’m sorry, but the idea of having a couple of glucose tabs, testing myself and going back to sleep while I’m like that is just…impossible to comprehend. For one thing, I’ve got to change my clothing, dry my hair, change the bedclothes, bundle up somewhere and wait while my body burns off the adrenaline (which takes time). For another thing, I’m terrified that it’s going to happen again because there’s never a clue as to what caused it in the first place – none of my doctors have ever been able to piece it together with me later, even though I keep meticulous records.
The question is not, “will I over-treat?” but rather “what’s the minimum I can over-treat, with the healthiest possible foods”?
I’m sorry, but if I’m at 36 and I eat protein and go back to sleep, you might as well start arranging the funeral.
I don’t understand what you’re saying. I’m not talking about being in the 70’s. I’m talking about a crash-and-burn hypo.
I haven’t been on Bernstein that long, and I struggle with my compliance (big time), but goodness, even he treats his hypos with dextrose tabs. Eating fat/protein is for after you get up into a survivable range, not when you’re headed into a coma.
You should definitely test if you’re waking up in the night with symptoms. You could be dangerously low. Most of the long-term diabetics I know will test any time they wake up in the middle of the night, even if they get up to go to the loo.
I do live alone, so I don’t worry about waking anyone. I keep everything laid out on my desk so it takes only about 30 seconds to test after I wash my hands in hot water. I can be back to bed in under a minute.
I’ve never heard of estrogen being too low from exercise (unless you’re a super-skinny Olympian, as a long-term result of having very little body fat) but if you’re diabetic and waking in the night feeling sweaty and shaky, it’s quite likely it’s a hypoglycemia episode. It’s a prime time to go hypo: several hours after eating, several hours after our night-time long-acting insulin injection, at a time when our bodies are fairly insulin sensitive, before the dawn phenom starts to kick in.
Sounds like you’re in a place where you just have to endure, because I don’t think there’s any way to moderate the kind of symptoms you’re experiencing. 
Making sure you don’t have a rebound low is important, and I think onesaint’s idea of munching on low-carb stuff is a good one – if your mouth is busy, then it might help take your mind off the other stuff.
Meanwhile, all I can do is hope this eventually settles down, and becomes more manageable!
Hugs!
I agree with the glucose tabs, and somehow, I’m not worried that you’re going to turn over and go back to sleep – I know I never can when I’m having symptoms!
I know it’s a waste of a good night, but I think you need to monitor carefully for several hours after a bad low. I do NOT think your lows are typical, and therefore, I think you need to be more careful!
Soon after starting insulin I had a few hypos after exercise. One consumed about 90g of carbs. I think I have what is called Late-Onset Hypoglycemia. It can happen 1-36 hours after exercise, but will hit me around 2 hours afterwards. The thing that worked best for me was to follow up my exercise with a quick protein shake and then have a meal within two hours. I believe that part of the argument is that exercise depletes your glycogen and you body will at certain times seek to replenish those stores and you body becomes a huge glucose sucking monster. If you take in postworkout nutrition, you can preempt that and load your body back up, it doesn’t take much, but 25-30 g of carbs should help.
To treat a low, follow the rule of 15. When you’re low (check your blood sugar to be sure you’re really low), take 15g of carbohydrate (your dextrose tabs). Wait 15 minutes and re-check your blood sugar. If it’s still low, take another 15g or carbohydrate (I’d use dextrose tabs again). After another 15 minutes have gone by, re-check. I’d continue to use the dextrose tabs every 15 minutes UNTIL YOUR SUGAR IS NORMAL. If you’re hungry after your sugar is normalized, eat RAW UNSALTED ALMONDS. They are a great blood sugar stabilizer. Any kind of protein - a tuna packet, a piece of chicken, etc. will also keep your blood sugar stabilized. But I think it’s important to keep using the dextrose tabs until you get your blood sugar in its normal range. Good luck and take care of yourself! Check out this link:
Diabetes Self-Management Treating HYPOGLECEMIA
THANK YOU bsc. I can’t thank you enough. I’ve tried to talk about this with my doctors, but sometimes I think they went to Barbie & Ken’s Malibu Beach College of Surfing!!!
I could kiss you, but your icon is excellent kiss-repellent (what? me worry?) ;0)
The 15-15 guideline doesn’t hold water for everyone & can lead to over-treating a low.1 gram glucose raises me 10 pts. Fifteen grams would raise my BG 150 pts, so I don’t use glucose tabs. It can also take up to 1 hour to know the full effect, so taking another 15 grams in 15 minutes could over shoot the mark by a lot. People need to know the effect 1 gram glucose has on them. I tested using only 1 gram when I just a bit low to figure it out. Easy.
JeanV, I don’t use insulin. So far, for 1.5 yrs now, since I went Dr. B., I’ve managed to keep a 5.5 A1c with diet and exercise, and some of my exercise is pretty intense, like Zumba. Even my ballet class will have me in a sweat after jumping and leaping across the floor several times, and I know a lot of people think it’s gentle exercise… It’s a well known fact that exercise will lower circulating estrogen, and since I had a hysterectomy, I’m relying on HRT. Twice a week, I have two exercise hours a day plus going up and down the stairs all day doing laundry. It is possible to go too low, especially if my patch is stale. I am no longer thin, but people consider me a normal weight on visual inspection. However, I’ll have to figure out how to test in the night without waking my dh. I’ve never been lower than 69, but I get you that I could be going low in the night. How, likely is that if I still make insulin and am not taking any oral medication?
That may be an overgeneralization, which is common in medical advice. It really depends on how low you are, WHY you’re so low, and how sensitive you are to carbs. Also, the liver might be sensing the glucagon you are putting out (unless you’ve lost glucagon function, too) and getting ready for a dump, which would raise you greatly.
Each person needs to experiment to find their own tolerances for hypo treatment – just like treatment for highs, it can vary greatly. The rule of 15 is probably a good starting place when you’re new to diabetes, but as time goes on, you’ll have to figure out your own body’s reaction. They don’t say YMMV for nothing, ya know!
If you’re not on insulin or oral diabetes medications, then I think it would be fairly unlikely. I used to get reactive hypoglycemia (years before diagnosis) but that’s usually in response to a big carbo load, which you won’t get if you’re following Dr. B’s guidelines.
It could be a variety of a hot flash due to hormones.
It wouldn’t hurt to test once or twice, however, just to be sure.
That’s because your body works like a beautiful clock, Gerri. Mine works like a raging hippo from outer space.
I marvel at the “just take x to achieve y” discussions among T1’s. It’s like watching someone describe the biology of a rare, exotic phoenix or a gryphon.
My body is more like this: "At some point, something will happen, but there’s no predicting what, why or when."
Here’s a great example: Dinner last night? Steak and lettuce. Period. Nothing but water since then. My bedtime bg was 185 mg/dl. Not great but I’ve seen worse. Stayed up too late reading and plunking around on the interwebs. Woke up late this morning (feeling drained) and tested at 235 mg/dl. Oh, darn. Well, that’s to be expected as I overshot my morning Lantus. Inject 48 IU of Lantus, take my Synthroid with water, no food because I have to wait an hour for the Synthroid to digest. Curled up in the bed because I’m FREEZING today and can’t get warm. Drifted off to sleep. Woke up at 2:30 p.m. – wow guess I was still tired. Tested at 253 mg/dl.
So to recap: protein and lettuce for dinner. Woke at 235 mg/dl. Injected 48 IU of Lantus. SEVERAL hours later my blood glucose was up, to 253 mg/dl.
So what did the Lantus do, exactly? Raise me? Not possible. Lower me? Nope. Hello? Am I getting sick? Maybe. Is it hormones? Maybe. Who the heck knows?!?
I injected Novolog with my eggs, celery and almond butter…I guess we’ll just see. It could drop me 10 points. It could drop me 100 points. I have no way of predicting. None.
Does this sound like clockwork to you? This is the nightmare I live in every day. Everyone tells me that if I just do x then I should see y result. My doctors tell me. My friends tell me. People writing learned articles tell me. People writing best-selling books tell me. But it never, ever, ever, ever works that way in my body.
@Natalie – YMMV indeed!!!
Thanks, Natalie. I wish I had a cat to pet during a hypo. Or a doggie. That would probably help me calm down.
You’re right about the testing. Five minutes seems like an eternity. I know I’m wasting the test strip, but waiting fifteen minutes seems impossible. Maybe I’ll make it a game and give myself a prize if I can make it to fifteen. A new DVD or something.
OK, now I’m on a roll reading about late-onset hypoglycemia. Thanks BSC!!! It sounds like replenishing my glycogen during that “window” right after exercise – as well as avoiding evening exercise – are both important to avoiding going hypo in my sleep.
Health Shorts: Beware of late-onset hypoglycemia
Thursday, March 27, 2008
Diabetic patients should be aware of the risk of an exercise-induced hypoglycemic attack, not only during a workout but also several hours later. In fact, late-onset hypoglycemia can occur as long as 48 hours after exercise.
To avoid problems, athletes are advised to check their blood sugar both before and after exercise and to be alert to symptoms such as shakiness, excessive perspiration, nausea, anxiety, changes in gait or coordination or difficulty thinking or seeing clearly.
Diabetics, particularly those on intense therapy, are advised not to exercise at night because of the risk of hypoglycemia during sleep.
(SOURCE: Peggy Kraus, “Working with diabetic clients: a look at the exercise implications and contraindications when working with clients who suffer from type 1 and type 2 diabetes, hypoglycemia or hyperglycemia,” IDEA Fitness Journal, November-December 2007)
http://live.psu.edu/story/29749
I don’t have a body that works anywhere close to a beautiful clock. I have gastroparesis & it’s nightmare attempting to time insulin to uncooperative digestion. I never know if food will hit in 4 hours or 8. I get less than 5 hours sleep waiting to head off the spike. I’ve had staggering lows from insulin peaking before food. Truly, it’s a crap shoot. I’ve got a convoluted bolus regiment that’s an ever-changing combination of Regular & Aprida. If I eat slightly too much fiber, food digests the next day.
I can relate because I also have no way of predicting results.