Treating Low Blood Sugars Quickly

Treating Low Blood Sugars Quickly

Unless you are eating a meal right away, the best treatment for lows is a combination of simple and complex carbohydrates plus some protein. Quickly treating lows lessens stress hormone release and lowers the chance of the blood sugar going high after a reaction. You'll feel better if the body is quickly resupplied with the fuel it needs. Your brain, muscles and other cells will thank you for not prolonging their misery.

Treatment Plant For Hypoglycemia
  1. Eat 15 to 20 grams of fast acting carbohydrates immediately.
  2. Consider how much unused bolus insulin may still be active. Decide whether complex carbohydrates and/or protein are needed to keep you stable until you eat your next meal.
  3. Test your blood sugar 30 minutes later to make sure it has risen. Repeat step 1 if necessary.
  4. After a moderate or severe low blood sugar, wait 30 to 45 minutes before driving or operating machinery. A return to normal coordination and thinking is slower than the return to a normal blood sugar.

You may need to eat more than 20 grams for a low:

  • when you took a carb bolus for a meal but never ate it.
  • when it has been only an hour or two since your last injection of rapid insulin.
  • when you have been more physically active.

Glucose is the "sugar" in blood sugar and may also be referred to as dextrose on labels. It comes in tablets, such as Dex4 or BD Glucose tablets, and in certain candies like Sweet Tarts. Glucose breaks down quickly and reaches the blood as 100 percent glucose, which makes it the best choice for raising the blood sugar quickly. Another good product for raising your glucose is Glucolift Glucose Tablets.

Table sugar consists of one glucose molecule and one fructose molecule, so when it breaks down in the stomach, only half is immediately available as glucose. Fruit juices, like orange juice, contain mostly fructose and are a relatively poor choice for quick treatment of serious hypoglycemia because they take so long to raise the blood sugar. For mild lows, these differences may not be vital, but if a low is serious, you want to choose the fastest carb available to get you back on your feet quickly. Choose high glycemic food for a quick rise of the blood sugar.

Quick Carbs
Each has 15 grams of quick carbs:

1 tablespoon of honey
3 BD Glucose Tablets
3 Smartie® Rolls (in cellophane)
4 CanAm Dex4® Glucose Tablets
5 Dextrosols Glucose Tablets
5 Wacky Wafers®
6 SweetTart® (3 tabs/packet)
7 Pixy Stix
8 SweetTarts® (3/4" Lifesaver size)
14 Smarties® (3/4" diameter roll)

How much glucose is needed? A good rule of thumb is that 1 gram of glucose raises the blood sugar 3, 4, or 5 points for body weights of 200 lb., 150 lb., and 100 lb., respectively. For example, a 5-gram glucose tablet raises the blood sugar about 20 points at 150 lbs.

Use 15 to 20 grams of quick carbohydrate for all low blood sugars. Check to see how many grams are in each glucose tablet you use so that you actually get 15 to 20 grams. The quick carbs listed below should rapidly raise the blood sugar between 45 and 80 mg/dl (1.7 to 4.4 mmol) depending upon your weight. Test your blood sugar again in 20 to 30 minutes to ensure the low has been corrected.

Thinking and coordination remain abnormal for 30 minutes after you treat a major low blood sugar. Wait 30 to 45 minutes after the blood sugar has returned to normal before driving a car or operating machinery.

Once you have eaten simple carbs and your thinking is no longer impaired, consider your situation. A recent injection of Humalog or Novolog, extra exercise, or a missed meal will all require more than 15 to 20 grams of carbs for treatment. At bedtime, in particular, add an additional 10 to 20 grams of carbohydrate, such as a glass of milk or half an apple. Raw cornstarch, a complex carbohydrate that breaks down very slowly, is available in special bars to help prevent overnight lows. An alternative to raw cornstarch is to have a high fat and protein food, like cheese or peanut butter, or part of an athletic bar. Protein and complex carbohydrates help keep the blood sugar from dropping for several hours.

Don't Overtreat A Low

Don't go too far. A panic overdose of orange juice with sugar, a box of chocolates or the entire contents of your refrigerator makes your goal of stable blood sugars hard to achieve. These panic attacks come from the release of stress hormones during lows. If your blood sugar frequently goes high after a low, you are overtreating them.

Prepare for the panic. Have premeasured quick carbs handy at your bedside, in your pocket or purse, at your desk, in the glove compartment, and where you exercise. Memorize that it takes only a little carb to counteract most lows. A low does not mean unlimited treat time. Keep glucose tabs or another quick carb handy and use them automatically. Allow time for them to correct your blood sugar before eating food. Your intense hunger will disappear as you recover, and you will be glad later that you did not indulge.

Variable Blood Sugars
  • Frequent or severe low blood sugars
  • Erratic eating (different amounts, different times)
  • Skipped meals
  • Insulin doses change a lot each day
  • Exercise that varies in time, length, or intensity
  • No exercise at all
  • Irregular sleep or work hours
  • Stress
Choose a correction:
  • Regulate your lifestyle, exercise, and stress for a more recognizable pattern to your charts; less insulin is often needed.
  • Discuss with your physician for an insulin regimen that is more adapted to your lifestyle.

Lows When Blood Sugars Are Variable

When your readings rise and fall frequently, either you are on too much insulin in one of your doses (suggested by a pattern, such as frequent lows on waking), too much total insulin (suggested by frequent lows, which can be followed by high readings), or too much sliding scale insulin (suggested by highs followed within 2 to 5 hours by a low). Here are some other things to consider when your readings are out of whack:

Lows Before an Injection

When a low blood sugar occurs near the time an injection will be given, should you reduce the dose? After eating fast carbs to treat the low, it may be wise to reduce the rapid insulin given as a carb bolus to lower the risk of another low.

However, basal doses are very different from rapid insulins in their timing. Compared to the rapid action of Humalog and Novolog, basal insulin has no immediate effect.

Humalog and Novolog begin to lower the blood sugar about 20 minutes after an injection, but insulins like Lente, NPH, Ultralente, and Lantus have no effect on the blood sugar for at least 90 to 120 minutes. But if a basal dose is reduced, the reduced insulin activity continues to affect the blood sugar over the following 14 to 24 hours. This means that lowering a basal dose for a low blood sugar makes little sense. However, a reduction in the basal dose may make a lot of sense as a way to eliminate a particular pattern of lows over the following days.

Adapted from Using Insulin © 2003. Walsh, Roberts, Varma, Bailey. Click here to order.

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