What's best for hypo?

[lilydawn]

Hi my partner just been diagnosed with type 1 and we are all trying to learn more about what to do in the day.
One thing I am particular scared about is hypo if insulin is too much. Apparently it can be very often and dangerous!

We wanted something easy to carry and works well l so found this thing called Glucogel on amazon and got a few, but I won't say that's the best tasting stuff.
There are some better flavouring stuff/ juice online but I am not so sure about.

I wonder what do people usually do for hypo (and also more manage the fear I would say as a patient or carer)? Thanks!

 

[Robin]

Hi my partner just been diagnosed with type 1 and we are all trying to learn more about what to do in the day.
One thing I am particular scared about is hypo if insulin is too much. Apparently it can be very often and dangerous!

We wanted something easy to carry and works well l so found this thing called Glucogel on amazon and got a few, but I won't say that's the best tasting stuff.
There are some better flavouring stuff/ juice online but I am not so sure about.

I wonder what do people usually do for hypo (and also more manage the fear I would say as a patient or carer)? Thanks!

I use jelly babies or fruit pastilles, because they’re easy to carry. I know a lot of our forum members also use them, and a lot also use glucose or glucojuice, I think.
Hypos are only dangerous if you don’t get good warning of them, (and at the start of the diabetes journey, awareness is usually quite good), or if you haven’t got anything to treat them with at the first sign, so quite right to think about something easy to carry. Also, keep something in every room in the house, especially by the bed. There’s nothing worse than feeling hypo, and having to traipse downstairs to treat it.(I usually trip over my own feet when I’m hypo anyway)

 

[Deleted member 25429]

Hi my partner just been diagnosed with type 1 and we are all trying to learn more about what to do in the day.
One thing I am particular scared about is hypo if insulin is too much. Apparently it can be very often and dangerous!

We wanted something easy to carry and works well l so found this thing called Glucogel on amazon and got a few, but I won't say that's the best tasting stuff.
There are some better flavouring stuff/ juice online but I am not so sure about.

I wonder what do people usually do for hypo (and also more manage the fear I would say as a patient or carer)? Thanks!

I use full fat coke ...

 

[rebrascora]

Hi and welcome
It is great that you have found this forum and come here to support your partner.
Hypos are scary and particularly the first few, but as with anything, once you get used to them and you learn how to deal with them, the fear diminishes and you gain confidence.
Many people carry jelly babies or dextrose tablets to deal with hypos. I use my empty test strip pots to contain a 3-4 jelly babies or 11 jelly beans or 3 dextrose tablets. They are a convenient means of carrying the appropriate amount to treat a hypo and I have pots in every room of the house including by the bed and in the bathroom, so that they are easily to hand as well as in my coat pockets and handbags. Some people use cartons of orange juice or small cans of "full sugar" coke.

If your partner is very lucky he will have very few, but I think having them more often has helped me become much more confident in dealing with them and they are more of a short inconvenience now rather than a scary occurrence. That said, I also follow a low carbohydrate eating plan so that I am unlikely to make a significant error with my insulin injections because I rarely inject more than 4 units at a time. If you are injecting 10 or 12 units, it is easy to be 2 or 3 units wrong whereas if I inject 3 or 4 I am only ever likely to be 1 unit out.

I hope that makes sense and provides you with some reassurance. I think what I found most scary was my unreaslistic expectation that I might only have 2 or 3 a year and when I had 2 in a week in the early days I was really worried. Once I spoke to people on this forum and found that normal can range from several times a day to almost never, it helped me to cope.

 

[Bruce Stephens]

I used to use dextrose tablets, and I've still got lots of those (I keep a tube in my pocket), but usually I use some kind of sweet (jelly babies or fruit pastels, typically). (I think optimally you want glucose and random sweets tend to have more of a mixture of sugars, but I get enough warning of a hypo that it's not critical. Almost always I'm eating one or two sweets in order to avoid quite going hypo.)

If your partner's ever unconscious (or nearing that) then glucogel and similar can work better in that case (can be used while you wait for the professionals to arrive).

 

[Bloden]

Hi there.🙂 A 15ml carton of orange juice fixes a hypo nice n quick for me. I also use Jelly Babies to correct a low BG reading that isn’t heading for hypo. Those gels are rank!

 

[Deleted member 25429]

Hi and welcome
It is great that you have found this forum and come here to support your partner.
Hypos are scary and particularly the first few, but as with anything, once you get used to them and you learn how to deal with them, the fear diminishes and you gain confidence.
Many people carry jelly babies or dextrose tablets to deal with hypos. I use my empty test strip pots to contain a 3-4 jelly babies or 11 jelly beans or 3 dextrose tablets. They are a convenient means of carrying the appropriate amount to treat a hypo and I have pots in every room of the house including by the bed and in the bathroom, so that they are easily to hand as well as in my coat pockets and handbags. Some people use cartons of orange juice or small cans of "full sugar" coke.

If your partner is very lucky he will have very few, but I think having them more often has helped me become much more confident in dealing with them and they are more of a short inconvenience now rather than a scary occurrence. That said, I also follow a low carbohydrate eating plan so that I am unlikely to make a significant error with my insulin injections because I rarely inject more than 4 units at a time. If you are injecting 10 or 12 units, it is easy to be 2 or 3 units wrong whereas if I inject 3 or 4 I am only ever likely to be 1 unit out.

I hope that makes sense and provides you with some reassurance. I think what I found most scary was my unreaslistic expectation that I might only have 2 or 3 a year and when I had 2 in a week in the early days I was really worried. Once I spoke to people on this forum and found that normal can range from several times a day to almost never, it helped me to cope.

I also follow the low carb diet , less insulin , less chance of hypos . This is the advice I was given by my consultant. Eating snacks that are low carb means I don’t have to keep injecting/ working out how much insulin I already have in me . With me if I’m unhappy my sugar levels fall so I try and let things go over my head . I had a very bad hypo the day after I came out of hospital following a DKA , they had neglected to tell me I could adjust my insulin levels . Most important thing for me was ensuring my underlying insulin was correct . I do still have to be careful about timing of my novarapid , I have to eat immediately . We are all different and we all find our own ways of managing this condition.

 

[Kaylz]

I use lift glucose chews these days, in the past I started with jelly babies but had a prolonged hypo and couldn't stomach them any longer, mini bags of drumstick squashies was my last treatment before I switched to the glucose chews (despite the name they aren't chewy and are the same texture as dextrose tabs) xx

 

[Amity Island]

Hi lilydawn,
It's also very important to know the cause of the hypo as this determines the course(s) of future methods and ways to avoid other hypos occuring. I find sweets high in glucose work quickest as there is no need for the body to convert it to use it.

These are some of the reasons a hypo might occur in someone using insulin. I'm sure others can add to this list.
Sudden unplanned excercise e.g running for a bus or to a meeting.
You've done more excercise than you've allowed for in extra carbs or insulin reduction.
Miscalculated the amount of insulin required for a meal.
Didn't eat as much as you planned.
Meal was late.
Alcoholic drinks.
Basal insulin dose is too high.
Overlapping insulin.
Increased sensitivity to bolus insulin due to exercise. Excercise can literally half the amount of insulin required for meals for up to 48hrs.
Pancreas can still be "helping" especially soon after diagnosis.
Mis-timed mealtime insulin, most of the time I take meal time insulin 15mins or more before eating a meal with carbs. But sometimes I take insulin after the meal if it's a bit meaty or fatty. Some people split their dose for a meal.

For me the most dangerous hypo is one that occurs just after eating a meal high in fat and or meat. Known as a stubborn hypo. Any glucose or sweets taken take ages to act and I need way more glucose than usual just to keep blood sugar up into range, but then hours later a great spike happens which then needs insulin to bring it back into range.

I've also had a stubborn hypo after getting increased sensitivity due to excercise. I've taken a standard amount of insulin for a meal and then realised I only needed to have taken half the amount! Meaning double the amount of insulin available.

 

[DaveB]

Dextrose (glucose). Low-cost, small, dissolve quickly and available in different flavours. Simples.

 

[trophywench]

Depends whethe he loses his ability to chew when hypo cos it's no good giving someone who can't chew anything like fruit pastilles!

 

[Thebearcametoo]

What’s best for hypo treatment is what you have to hand so having a good idea of what works means you have more chances of getting something for him to treat his hypo IYSWIM. Glucose/dextrose tabs are faster absorbed than sweets but not always to hand. Don’t mix fat with the sugars as it slows down absorption (so sweets are ok, chocolate isn’t). Liquids will help faster absorption so juices, full sugar coke, lucozade sport are all good treatments. And if you’re having sweets or glucose tabs having a drink with them will speed up absorption. The gels are good if he has trouble chewing or swallowing. If he’s unable to treat himself you can smear gel on the inside of his cheek and it will absorb that way. You should be able to get gel and glucojuice on prescription but they’re pretty rank for day to day treatment (flavoured hand sanitiser is how my daughter describes it). And he should also be prescribed glucogen to keep in the fridge - this is an in emergency treatment and you should always call an ambulance alongside its use. Having an array of choices in the house, especially something by the bed and something like tabs or sweets in with his testing kit when he’s out and about is the basic cover for hypos.

 

[leonS]

I would just add that it is essential to have hypo treatment available at all times. Do not be tempted to pop to the shop in the belief that a hypo will not occur.

It is a good idea to keep hypo treatment in a bag together with insulin and a BG meter so that it can be taken when even a short trip is planed (it might turn out to be much longer that expected).

Complex sugars consist of glucose units. These are quickly broken into glucose in the stomach, so anything which contains sugar will quickly treat a hypo. There is no "best" or perfect answer, just use what suits you most.

 

[Kaylz]

Complex sugars consist of glucose units. These are quickly broken into glucose in the stomach, so anything which contains sugar will quickly treat a hypo.

not 100% accurate though, a mars bar or the likes of other chocolate bars etc or even some I see use milk they all contain quite a bit of sugar but isnt the best as the fat slows the absorption of the sugar taking longer to fix a hypo

 

[leonS]

I too have heared this myth! I believe it to be nonsense for two reasons:

The sugar is not chemically bound to the fat, so the fat makes little difference to the speed at which the glucose goes into solution in the stomach acid.

Second - treatment with these sorts of things worked very well thirty to forty years ago, with no desernable difference to the speed of recovery. They were generally recommended then too.

Fats tebd to melt in a pocket too, so are less convenient than they would otherwise be. Many years of avoiding sweet things means that Mars, for example, tastes far too sweet to me. A hypo is not pleasent, so you might as well enjoy the treatment if possible.

That is just my view, By all means avoid fat + sugar if you want to follow modern wisdom.

 

[Kaylz]

I don't think its myth at all, I know at least 1 personally that has been Type 1 since we were at primary school when it was still believed that mars bars worked has switched because they discovered it does in fact take much longer to work and then produces a much higher reading later whereas a few glucose tabs sorted it and didn't cause that later high, there are many that have had hypo's based on their pre bolusing and the fact there was a higher fat content in the meal meaning the insulin hit first, if you think about it the mars bar taking longer follows that

 

[trophywench]

@leonS - also depends how low you are and how quickly your BG has dropped to that level. Not every hypo any person has is caused for the same reason hence its effects on the persons body will be different.

I have never really enjoyed Mars Bars anyway even when I was little (well before T1 hit) but I have always enjoyed orange 'pop' hence full sugar orange Lucozade was always my standby. Not tempting to drink as a drink otherwise really though as it ain't good for your teeth and gums and they're in a bad enough state already chez moi!

 

[Deleted member 27273]

I prefer to treat hypos with juice boxes, orange or apple because they raise my blood glucose quickly and enable me to maintain good blood glucose control afterwards I also hate the taste of jelly babies!

 

[SB2015]

I carry Jelly Babies with me all the time and have pots of these around the house, so that they are readily available anywhere. For a big hypo And Libre showing steep reduction in BG I tend to use fruit juice as it seems to get active more quickly. Jelly babies are more compact and I am able to adjust the number I eat, whereas a juice once opened it is all or nothing. The only problem I had with JBs was in heat in the car, when the bag changed to a jelly blob after melting!!!

 

[Deleted member 27273]

I carry Jelly Babies with me all the time and have pots of these around the house, so that they are readily available anywhere. For a big hypo And Libre showing steep reduction in BG I tend to use fruit juice as it seems to get active more quickly. Jelly babies are more compact and I am able to adjust the number I eat, whereas a juice once opened it is all or nothing. The only problem I had with JBs was in heat in the car, when the bag changed to a jelly blob after melting!!!View attachment 13325

Coagulated jelly babies!!