Comment by Lila on December 5, 2012 at 1:31am

I use pre-measured 15g doses of carb. So for example, my fridge is filled with mini cans of Coke which come in at 15g carb. When I have a low, I down a can, go away and wait 15 minutes, and then come back and test.

BTW, Kit Kats are great but not really the best thing to use for a hypo. The fat in the chocolate will delay the absorption of the carbs so you won't see your blood sugar go up for a while, by which time you might have eaten enough to spike your blood sugar the other way.

Comment by Jenni Haveman on December 5, 2012 at 3:23am

Jessica, this has been the HARDEST THING for me!!! If I get low enough, I feel panicky AND hungry, and I'll eat anything that's not tied down-- especially in the middle of the night, and ALWAYS starting with the chocolate! (I used to go with a peanut butter and jelly sandwich; it seemed a good choice, because of the sugar AND the protein-- but I can "second" Lila's comment-- the fat prevents the sugar from being absorbed quickly).

I buy grape juice in the little bottles and keep them in the coldest part of my fridge, because I like them and can't otherwise drink grape juice without a resulting high. (My endo wants me to take glucose tabs-- they work, but ICK!-- or orange juice, so I'm trying to compromise!) I start with that, but keep my options open if it doesn't entirely solve my low. (I feel your pain on this!)

Comment by Mike on December 5, 2012 at 7:35am

Hi Jessica,

I use glucose tabs, exclusively. I keep a roll of 10 tabs with me at all times. If I'm low and the brain is fuzzy, I can eat enough tabs to bring my blood glucose levels back up (2-4 tabs usually are enough to do the trick). And if I'm really fuzzy, I can always count my remaining tabs once I've gotten my BG levels up. For example, if I've got 3 tabs left in the roll, then I know I've eaten 7 tabs, or 28 g carbs (7 tabs * 4 g carb/tab).

Like Lila says, Kit Kats are a poor choice for treating a low. Chocolate sugars and fats will be slow to digest, so you'll stay low longer, and you'll want to keep eating b/c your blood is still craving sugars. Once the delayed sugar onset comes along, you'll likely have a ton of it coming down the pipeline. Glucose tabs, smarties, or skittles would all work better for treating lows. Faster sugar release/response to get your BG up quicker.

Cheers and good luck, Mike

Comment by jbowler on December 5, 2012 at 8:17am

Bolus for what you eat, correcting for the low blood sugar. That's easy on a pump (I'm using the Omnipod). The sugar goes through faster than the insulin, but I still wait until my blood sugar is at least 70 (and clearly going up) before delivering the bolus. Glucose tablets will send my blood sugar up in a few minutes, but I hate them. Bread/bread products are very fast and more satisfying.

There's nothing wrong with eating the food, just so long as it is possible to deliver a bolus for it. That gets difficult for a big sugar load. Berstein observes that bolusing more than 5IU at once seems not to work (the insulin is not adsorped in proportion to the dose), so boluses for large amounts of carbohydrate don't work; this is my experience.

John Bowler

Comment by Elizabeth on December 5, 2012 at 9:25am

What I do often is, I bolus for the food but set the pump to "square bolus" so that insulin infuses slowly. I don't know how that would work if you're on MDI though. I think what you would have to do is eat your carbs and wait 15 min to 30 min and then give yourself a bolus, subtracting some of the insulin depending on how low you were.

Comment by Brian (bsc) on December 5, 2012 at 10:58am

Those of us with diabetes are just set up to have difficult relationships with food. Binging is something that I think many of us can relate to, and it doesn't just happen, it reflects our feelings about food and how messed up we can feel when it comes to good. I am right now reading a new book by
our fellow member Ginger Vieira entitled "Emotional Eating with Diabetes." You might find this book really helpful.

Comment by Jessica on December 5, 2012 at 7:52pm

Thanks for all the great advice! I am on a pump and I do bolus for the extra carbs but I know that's way too many to eat at once. I keep juiceboxes that are 15-18 carbs on hand at all times, but when I am low treats sound so much more appetizing.
@Brian
Thanks for the info about the book! I am sure emotions have a lot to do with it. I have been having major problems with fatigue that none of the doctors can figure out :( Also it's finals week ...

Comment by Black Llama on December 5, 2012 at 7:59pm

Wow, 2 to 4 tabs?? Kit kats! I'm with Jenni. Depending on the severity of the hypo I ether take :

5 skittles
1 glucose tab (or a half if it's not too bad)
8 measures oz of OJ

Yes, it's hard to resist that "I must eat everything nom nom nom" feeling, but the highs afterwards aren't worth it.

If I need a lift, or I'm having a bad day, I will totally skip a meal or snack and bolus for the 30 grams of cabs in a candy bar :D Only if I'm under 100 though, and I'm not like ravenously hungry.

Comment by Elizabeth on December 6, 2012 at 6:50am

Jessica, are you having lows only, or highs too? Because usually, stress brings on highs, and what may be happening is, you're over-correcting for the highs and winding up stacking yourself into a low.

Another possibility, if you're having fatigue + frequent lows without highs, is you may be developing adrenal insufficiency. Has anyone checked your ACTH/cortisol levels? If not, it's an idea to consider. Cortisol is one of those hormones that pushes BG higher, and if you're suffering from low cortisol output, it could explain the lows. Talk to your endo.

Comment by Jessica on December 6, 2012 at 12:21pm

Hmm... Good idea Elizabeth :) I just had a huge panel of bloodwork done but I can't remember if they tested for that. I do have highs too, I had huge marriage issues a couple of months ago and am just finally getting them back close to normal as of about a month ago. But I have had the fatigue for about 13 years- ever since I got mono in the seventh grade. I have since been positive for mono- not just epstein's barr- six times! I appreciate any ideas!

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