15 rule for hypos

[MaryPlain]

I was just wondering why there is this rule of 15g carbs and wait 15 minutes. Thinking about it, how much carb you need depends on how sensitive you are to carbs and how low you are.

If I have a low of above 3.5 (and it's not sinking fast) I find that 15g can put me up too high. On the other hand if I'm at less than 2.5 and I know there's insulin on board then I would start with 20g.

Does anyone know how the 15g rule was arrived at?

The other thing is that I find that after 15 minutes I'm still on the up and I need to wait 20 before re-dosing otherwise I'll end up sky high!

What is other people's experience?

 

[Adrienne]

Hiya

I think this is a non negotiable rule (the 15 Rule) when you are first on the road to diabetes. I know for children with t1 and parents its the best way to get them to start dealing with things. It is a set and hard rule for school staff or family or friends looking after these children.

However as you say as you move on through the diabetes journey you find things out for yourself. We know that if Jessica is in the 2's she needs around 30 cho so she has 200 ml ish of lucozade or two small cans of coke straight away. However if she is 3.7 or above then just a couple of gulps of lucozade with do the trick.

However if she is left in anyone elses care they follow the 15 rule to be on the safe side.

 

[everydayupsanddowns]

I guess it's easy to remember, useful for most people in most circumstances and that the 15 mins can restrain people caught up in a Eat All The Things hypo panic

 

[Pumper_Sue]

As a small child it was always 1 sugar lump and as I got older it was 2.

I have no idea why people insist on giving small kids 15 carbs then more to follow, as this for little ones is almost a meal in it's self. End result a massive high at the end of it.

For me any more than 10 carbs to treat a low means basal is out and it needs sorting.
Certain times of day it's a case of 3 carbs and that's enough.
In 47 + years of type 1 I have never ever followed up with a carby long acting snack.

 

[everydayupsanddowns]

Me neither Sue (well at least I stopped immediately I saw what happened to my BGs with follow up vs without), but I know that others find that hypos-breed-hypos and can slip back under 4 after an hour or so without. As ever YDMV

 

[Monica]

When Carol was first diagnosed (aged 10)I was told to give her 3 dextroenergy tablets. That equals to 9g carbs. About a year later I discovered the glucotabs, which are 4g each. I asked the DSN what to do, as 3 tabs equal 12g carbs. She suggested breaking one in half. I never bothered though, she just had 3 tabs anyway. Now, fully grown she still only has 3 glucotabs or a can of coke (which is 15g carbs). Only occasionally do I tell her to have 4 tabs.

 

[Twitchy]

Very unscientific this, but I get mini bottles of coke (from a certain supermarket which just sponsored the paralympics ) and if I'm feeling very hypo or it feels like a 'fast & hard' one, I glug the lot, give it 15-20 mins & try & remember to check & correct by topping up with more if necessary, or for more 'mundane' hypos 🙄 it's a calibrated glug...over time I've got to figure out what amount works quite well. Still looking for a decent hypo treatment for night time hypos that doesn't involve either caffeine, tablets that are pure bleugh or any form of undiluted ribena or lucozade etc in any form (shudders with memories of childhood hypos & stomach bugs...!) I guess it's a case of finding what works best for you, & not being surprised when it changes over the years. I tried jelly babies for a bit, but I either lost all self discipline with the hypo-hamster-munchies & woolfed the lot, or they went all stale & hard & yukky... (such a fusspot, I know...) 🙂 All good fun really...

 

[MaryPlain]

When Carol was first diagnosed (aged 10)I was told to give her 3 dextroenergy tablets. That equals to 9g carbs. About a year later I discovered the glucotabs, which are 4g each. I asked the DSN what to do, as 3 tabs equal 12g carbs. She suggested breaking one in half. I never bothered though, she just had 3 tabs anyway. Now, fully grown she still only has 3 glucotabs or a can of coke (which is 15g carbs). Only occasionally do I tell her to have 4 tabs.

Is it a very small can of coke? I only ask because a standard can is 36g carbs.

 

[Adrienne]

Is it a very small can of coke? I only ask because a standard can is 36g carbs.

Yes Monica is talking about the party cans you find in the mixer aisles in supermarkets. THey are 150 ml and are 15 cho each.

I have done experiments with this 15 minute wait and the majority of times I got the same outcome which is why we wait 15 minutes every single time.

If you test at say 10 am and are hypo and treat, if you test at 10.05 your number could be lower than at 10 am. If you test at 10.10 then the level could be the same as at 10 am but by 10.15 am you will be higher.

We found that Jessica was obviously still going down and the quick acting has to start so she would keep going down till it kicked in. If this happens to others (which is does) then if you test 10 mins after the initial hypo then you could give more quick acting as you would assume that nothing has happened and this is one case where people over treat and numbers rocket 😱

 

[Monica]

Is it a very small can of coke? I only ask because a standard can is 36g carbs.

Oh sorry, I didn't explain that properly. Yes, as Adrienne said, it's a small can of coke 150ml. I think they are perfect, as no measuring out is involved.

 

[MaryPlain]

Yes Monica is talking about the party cans you find in the mixer aisles in supermarkets. THey are 150 ml and are 15 cho each.

I've only ever seen those on planes! Mind you I've never looked for them as I can't stand coke.

If you test at say 10 am and are hypo and treat, if you test at 10.05 your number could be lower than at 10 am. If you test at 10.10 then the level could be the same as at 10 am but by 10.15 am you will be higher.

That's just it - many times I've tested at 15 minutes and am very rarely higher, but at 20 minutes I'm usually back to normal. I was caught out a few times by this and over-treated. In fact I have to admit that since having my pump I rarely get serious hypos any more so I often don't re-test any more (always do if driving or if I still feel low) because it's so rare that the initial treatment doesn't work. Just goes to show we are all different!

 

[Monica]

I've only ever seen those on planes! Mind you I've never looked for them as I can't stand coke.

You could buy Sprite instead, that's 15g too. You can buy mixer cans at almost any supermarket. I think Shiv has also bought Vimto at Wilkinson's 🙂

 

[MaryPlain]

You could buy Sprite instead, that's 15g too. You can buy mixer cans at almost any supermarket. I think Shiv has also bought Vimto at Wilkinson's 🙂

I've never liked fizzy drinks - I find the bubbles hurt my throat! It affects how quickly I can swallow too so not a good choice for me for hypos. Somehow the bubbles in Cava don't have the same effect - maybe the alcohol acts as anaesthetic! Not very good as a hypo fix though.....

 

[Northerner]

I've never liked fizzy drinks - I find the bubbles hurt my throat! It affects how quickly I can swallow too so not a good choice for me for hypos. Somehow the bubbles in Cava don't have the same effect - maybe the alcohol acts as anaesthetic! Not very good as a hypo fix though.....

I'm the same - never really liked fizzy drinks although I have forced myself to tolerate beer and lager...😉

I have tried using Powerade to treat a hypo but it feels like I haven't had anything - I prefer something to eat 🙂 I also tailor my treatment to the level of hypo and whether I have much circulating insulin on board - it's only on rare occasions that I check after 15 minutes.