After hypo blood readings

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Isma1123

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I find that sometimes when after having treated a hypo, my blood sugar goes up to 11, 12 or 13, I treat a hypo very well and accordingly, so I have 15 grams of fasting acting carbohydrates, like 15 Skittles, or 5 dextrose tablets and then wait for no more than 15 mins and recheck, once I’m back in range, I will have a starchy carb snack of between 15 to 20 grams, to keep my blood sugar up, majority of the time, my blood sugars be in range, until my next meal, but sometimes they fluctuate above 10 to 13, is that expected and is it normal, or am I doing something wrong? I’m a slight tad worried
 
I don't think what you are doing is wrong, as such @Isma1123, but rather can you possibly make better use of your CGM to get maximum visibility of your BG behaviour before you even go hypo and then tune your response accordingly? I also don't think that "excursions" to 13 are particularly bad if infrequent and not very longlasting.

The rule of 15 has its origins in an era of when CGM was extremely rare. You already know with some 20 years of being T1 that before CGM you needed good hypo awareness and timely fps to even know you were going hypo. Today most T1s have the opportunity to use CGM. So if my hypo is relatively shallow and my phone CGM reading is confirmed by my finger prick test (if I should be in doubt) I will normally only take c.10 gms of fast carbs, rather than 15. But if the hypo is deeper I will start with 15gms as my response. Similarly I won't always take that secondary carby snack, trusting my CGM to guide me whether or when I need that second boost. My Endo also told me that a protein bar with 10-12 gms of carbs was far better than a carby snack of lower protein and I can see the logic, in that the extra protein is more enduring. Also, presumably for you and your gastroparesis problem higher protein would be better? I suspect your 2nd carby snack is excessive at 15-20 gms; 10 might be better for you. With the benefit of having CGM, perhaps you could experiment a little more rigorously to find a permutation of hypo responses and timings that work best for you - working from Alerts rather than Alarms.

When I had Libre 2 my low alert setting was at the upper limit for Libre of 5.6. This made it an Alert for me, rather than an Alarm. The readings, particularly along with the trend arrows, are far more informative than anyone can ever get from fps; you will, of course, know that far better than I could. So, since getting Libre 2 after one year with no CGM, I rarely go hypo to start with. My alerts tell me change is happening at 5.6 and I can often nudge that dropping BG back up with a smaller snack. We are all different. I think that I start, having no pancreas whatsoever and thus none of the pancreatic hormones that play their part in balancing my BG and slowing my BG changes, with a worst case scenario. I need Alerts, eg at 5.6, not Alarms at say 4.5 when nudging is no longer an option. Why depend on Urgent reaction when timely measured response is potentially an option.

So as well as making full use of the tech to reduce the incidence of my even having hypos, when they do occur I don't automatically also take that 2nd protein/ carb snack, but allow my CGM to guide me as to whether I need it.

[Slight digression: I don't understand why Abbott ever capped their low Alarm to 5.6 rather than something higher and why Libre 2 or 2+, or 3 hasn't raised that Alarm upper limit to make it a more usable Alert. My Dexcom G7 calls their warnings Alerts and allows an upper limit of 8.3 for the low Alert.]

However, I'm not clear whether your gastroparesis would change this thought process. Have you made some progress in managing that since last year? Have your frequency of hypos increased since your gastroparesis raised its head? Also, for you is that 2nd carby snack rendered less helpful because of your gastroparsis?

I'm retired and have more freedom to respond exactly as I choose; I do recognise that if I was holding down a full time job my decisions and responses might be slightly different. But I like to think that I still would want to do what is best for me and what gets me recovered as smoothly as possible, which would also be best for my work.
 
Morning and usual good detailed advice from Roland which I can’t really add to it apart from re-emphasise the idea of consider an earlier response to an impending hypo using the CGM.
Personally I am much more comfortable with treating getting close to or entering hypo Territory than I have been so I often just note the low alert and just watch and wait approach.
Plus I normally only take 2 dextrose tablets and check again in 10-15 minutes and if no response will take another two as I often find my BG level steadies and goes back up.
My point is we are all individual and have to experiment to find out what works best for us and particularly if we can in a safe environment to find out what works best.
Good luck
 
I find that I need different amounts of carbs to treat a hypo. The amount dependent on the rate of decent of my glucose levels, as shown on my sensor readings. There is a time lag in these so I know that I will be a it lower than it shows and will check with BG test.

I adjust what I take according to the hypo. I find juice works more quickly than JBs but find it a hassle to carry juice around with me. I use JBs if I am out. The hardest bit for me is to wait the 15 minutes before checking again. My sensor graph is helpful as I can see whether I have turned the corner.

For stubborn hypos I may need a second lot of JBs but with the warnings in the sensor I find that is rare now. I have an alert setting which enables me to head off the hypos most of the time.

Find what works for you. If you are going up above 10 try reducing the amount of carbs you use, a bit.
 
Like Sue above, I grade my hypo treatment to the hypo. A 3.8 and a level arrow only needs 1 Jelly Baby (JB) and I almost never use follow up, slower release carbs. A low 3s gets 2 JBs with no follow up slower carbs and anything below 3 gets 3JBs.

You cannot rely on Libre for your follow up 15 min check after a hypo as the way it works, it will almost always show you having dropped lower 15 mins after treatment due to the algorithm it uses, so always finger prick to check recovery, otherwise you will be at risk of over treating it.

I find that 5g carbs (1JB) will generally raise my levels by about 1.5mmols and 10g carbs (2JBs) by about 3mmols, so having 3 JBs and 10-15g of follow up carbs could easily put me into double figures for a mild hypo, hence I don't follow that general guidance. I think this guidance was to try to keep us safer when we were just finger pricking and didn't have CGM like Libre to see what was going on, but now that we can monitor our levels 24/7 a more graded response is possible.

You need to experiment and find what works for you.
 
Proud to be erratic said:
I don't think what you are doing is wrong, as such @Isma1123, but rather can you possibly make better use of your CGM to get maximum visibility of your BG behaviour before you even go hypo and then tune your response accordingly? I also don't think that "excursions" to 13 are particularly bad if infrequent and not very longlasting.

The rule of 15 has its origins in an era of when CGM was extremely rare. You already know with some 20 years of being T1 that before CGM you needed good hypo awareness and timely fps to even know you were going hypo. Today most T1s have the opportunity to use CGM. So if my hypo is relatively shallow and my phone CGM reading is confirmed by my finger prick test (if I should be in doubt) I will normally only take c.10 gms of fast carbs, rather than 15. But if the hypo is deeper I will start with 15gms as my response. Similarly I won't always take that secondary carby snack, trusting my CGM to guide me whether or when I need that second boost. My Endo also told me that a protein bar with 10-12 gms of carbs was far better than a carby snack of lower protein and I can see the logic, in that the extra protein is more enduring. Also, presumably for you and your gastroparesis problem higher protein would be better? I suspect your 2nd carby snack is excessive at 15-20 gms; 10 might be better for you. With the benefit of having CGM, perhaps you could experiment a little more rigorously to find a permutation of hypo responses and timings that work best for you - working from Alerts rather than Alarms.

When I had Libre 2 my low alert setting was at the upper limit for Libre of 5.6. This made it an Alert for me, rather than an Alarm. The readings, particularly along with the trend arrows, are far more informative than anyone can ever get from fps; you will, of course, know that far better than I could. So, since getting Libre 2 after one year with no CGM, I rarely go hypo to start with. My alerts tell me change is happening at 5.6 and I can often nudge that dropping BG back up with a smaller snack. We are all different. I think that I start, having no pancreas whatsoever and thus none of the pancreatic hormones that play their part in balancing my BG and slowing my BG changes, with a worst case scenario. I need Alerts, eg at 5.6, not Alarms at say 4.5 when nudging is no longer an option. Why depend on Urgent reaction when timely measured response is potentially an option.

So as well as making full use of the tech to reduce the incidence of my even having hypos, when they do occur I don't automatically also take that 2nd protein/ carb snack, but allow my CGM to guide me as to whether I need it.

[Slight digression: I don't understand why Abbott ever capped their low Alarm to 5.6 rather than something higher and why Libre 2 or 2+, or 3 hasn't raised that Alarm upper limit to make it a more usable Alert. My Dexcom G7 calls their warnings Alerts and allows an upper limit of 8.3 for the low Alert.]

However, I'm not clear whether your gastroparesis would change this thought process. Have you made some progress in managing that since last year? Have your frequency of hypos increased since your gastroparesis raised its head? Also, for you is that 2nd carby snack rendered less helpful because of your gastroparsis?

I'm retired and have more freedom to respond exactly as I choose; I do recognise that if I was holding down a full time job my decisions and responses might be slightly different. But I like to think that I still would want to do what is best for me and what gets me recovered as smoothly as possible, which would also be best for my work.
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Hi and thanks for replying, i find that some days after treating a hypo, i need a starchy carb slow snack after, as i tend to start dipping again, so do you think that maybe 10 grams of carbs should be ok, cos they do recommend 15-20, to be more safer, as hypos are more dangerous than high blood sugars. I usually have 15 skittles to treat a hypo, regardless of what number it is, as long as it’s under 4.0, after treating it, my numbers are back in normal range, what do you suggest, if my number is under the 4 mark, should I take less skittles and keep checking after every half hour to see wether I’m dipping again and should how much should I increase if my numbers are below 3.5
 
Isma1123 said:
Hi and thanks for replying, i find that some days after treating a hypo, i need a starchy carb slow snack after, as i tend to start dipping again, so do you think that maybe 10 grams of carbs should be ok, cos they do recommend 15-20, to be more safer, as hypos are more dangerous than high blood sugars. I usually have 15 skittles to treat a hypo, regardless of what number it is, as long as it’s under 4.0, after treating it, my numbers are back in normal range, what do you suggest, if my number is under the 4 mark, should I take less skittles and keep checking after every half hour to see wether I’m dipping again and should how much should I increase if my numbers are below 3.5
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Hi Isma
Our Hypos come in different ‘shapes and sizes’
The lower I am the more JBs I will have, ranging from 1 if I am just below 4, to 3 JBs if I am below three.
I think the advice on eating a slower release carb after you have reached normal levels following a hypo (I was told to do this at the start) stems from before we had sensors,where we can monitor what happens after our hypo.
It is definitely find out what suits you. If you are going higher than you want the. You need less carbs.
 
I am not medically qualified so I'm happy to say what I think but any advice from me is just me thinking out loud. You've been managing your D for a long time.

Yes, Isma, I do think that 10 gms for your second or follow up snack would be ample. As both @rebrascora and @SB2015 have each said I also think you could lean on your tech to relearn what does and doesn't work for you.

Certainly I believe hypos are more dangerous if you were to allow one to progress to a point where you became unconscious. But I think your tech should alert you well before that scenario should even start; indeed with well judged alert times I also believe you should never go hypo. You should consider running at least routinely above 5 and even close to or above 6; for you I wouldcsuggest you adopt a mindset that says TIR should start nearer 6, rather than 4. If you were to do that we could probably both kick this thread into some long grass!

One thing you haven't said is how strong and reliable your hypo warning signs are. If they happen to not be so great then by lifting your bottom of in range from 4 to nearer 6 you may well noticeably improve your hypo warning signs.

The other thing about lows in general they can (and usually they are expected to) lead to long term cognitive impairment. Neural damage from lows is accumulative and you are young enough for these to accumulate and become obvious in your later life!

However, you ducked my question about where have you got to with your gastroparesis? Is it better? The same? Or worse? You can't completely ignore this additional ailment, it may have a significant bearing on this discussion. I have no knowledge letalone experience with gastroparesis. But my intuition is flagging warning signs for you that if your digestion is impaired then carb counting and thus bolus dosing can only be affected. This could in turn explain why you have hypos in the 1st place?
 
Isma1123 said:
I find that sometimes when after having treated a hypo, my blood sugar goes up to 11, 12 or 13, I treat a hypo very well and accordingly, so I have 15 grams of fasting acting carbohydrates, like 15 Skittles, or 5 dextrose tablets and then wait for no more than 15 mins and recheck, once I’m back in range, I will have a starchy carb snack of between 15 to 20 grams, to keep my blood sugar up, majority of the time, my blood sugars be in range, until my next meal, but sometimes they fluctuate above 10 to 13, is that expected and is it normal, or am I doing something wrong? I’m a slight tad worried
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I got a bit frustrated with high BG after treating hypos with the recommended 15g, plus a starchy carb follow-up.

I know that hypos breed hypos, so you are statistically more likely to have another in any day that you've had one.

But the highs didn't help. And sometimes a frustrated correction some time later then led to a hypo!

So I gradually evolved a more instinctive and unofficial approach where I'd decide whether to follow up, or not, and whether to gently nudge incrementally based on a case-by-case basis, my understanding of what had caused the low BG in the first place, and what was happening next!

It's not something I can recommend to others, but dropping the "always follow up" seemed to help me. Especially now I can set a alarm to remind me if I'm still in the 4s 30-60 minutes later, and give myself another little 5-6g fast carb nudge then.
 
Proud to be erratic said:
I am not medically qualified so I'm happy to say what I think but any advice from me is just me thinking out loud. You've been managing your D for a long time.

Yes, Isma, I do think that 10 gms for your second or follow up snack would be ample. As both @rebrascora and @SB2015 have each said I also think you could lean on your tech to relearn what does and doesn't work for you.

Certainly I believe hypos are more dangerous if you were to allow one to progress to a point where you became unconscious. But I think your tech should alert you well before that scenario should even start; indeed with well judged alert times I also believe you should never go hypo. You should consider running at least routinely above 5 and even close to or above 6; for you I wouldcsuggest you adopt a mindset that says TIR should start nearer 6, rather than 4. If you were to do that we could probably both kick this thread into some long grass!

One thing you haven't said is how strong and reliable your hypo warning signs are. If they happen to not be so great then by lifting your bottom of in range from 4 to nearer 6 you may well noticeably improve your hypo warning signs.

The other thing about lows in general they can (and usually they are expected to) lead to long term cognitive impairment. Neural damage from lows is accumulative and you are young enough for these to accumulate and become obvious in your later life!

However, you ducked my question about where have you got to with your gastroparesis? Is it better? The same? Or worse? You can't completely ignore this additional ailment, it may have a significant bearing on this discussion. I have no knowledge letalone experience with gastroparesis. But my intuition is flagging warning signs for you that if your digestion is impaired then carb counting and thus bolus dosing can only be affected. This could in turn explain why you have hypos in the 1st place?
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My gastroparesis is under control and does not have an impact on my blood sugars. I only have mild symptoms and not to the point where I have severe abdominal pain and feel sick and throw up, i don’t know how having gastro triggers hypos, I usually have hypos due to physical activity and some occasions cos of a correction bolus overworking. I am aware that hypos can affect us in the long run and and am very worried. I do understand when you say that being between 4 and 5 can give a person warning signs, but I have no hypo awareness until im below the 4 mark or even 3.5 mark. But if I was to avoid having a hypo running between 4 and 5 and having a nudge with some carb, then wouldn’t that cause a spike in blood sugars, further than resulting in having to give a correction and then further hypoing which has happened to me before, sorry I know I sound like I’m quite clueless but I’m just worried that preventing a hypo happening can lead to a spike, but as diabetics we need to remember that going above range at least 15 to 20% of the time is expected aswell. Btw I don’t use a cgm, I finger prick cos I find these sensers innaccurate and I have severe anxiety about looking at blood sugars
 
Isma1123 said:
But if I was to avoid having a hypo running between 4 and 5 and having a nudge with some carb, then wouldn’t that cause a spike in blood sugars, further than resulting in having to give a correction and then further hypoing which has happened to me before, sorry I know I sound like I’m quite clueless but I’m just worried that preventing a hypo happening can lead to a spike, but as diabetics we need to remember that going above range at least 15 to 20% of the time is expected aswell.
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The trick is in having just a very small amount of hypo treatment to nudge your BG levels upwards.
I have several options in this situation. I know that 1 jelly baby (5g carbs) will raise my levels about 1.5 mmols, so if I am on 4.2 for instance, a single JB will nudge my levels up to about 5.7 which is still well in range but safer than running along at 4.2. I also use dried fruit like dates, figs, apricots and prunes in the same way. One prune or apricot is about 5g carbs but will act a bit slower than a JB. a large date or dried fig is about 7-8g carbs, so if I am 4.2 and levels are slowly dropping then I will have one of those instead of a prune or apricot. There have been the odd occasion when I have bitten a JB in half to just have 2-3g carbs where I was going to have a meal soon and wanted to nudge my levels up a bit but not spoil my meal or push levels too high before the meal.

Of course, if you don't have a CGM like Libre then you can't see what your levels are doing and take action like this with a very small carb snack to nudge levels up a bit until you are obviously hypo. I would encourage you to give CGM another go, but learn about it's limitations first and remember that it is a tool to help you not a judge of your diabetes management. I have gone through phases where I got chewed off with it and needed a break from it but after a week or so I come back to it, really appreciating how much easier it makes my diabetes management and as the years have gone on, I don't seem to get to that poit of needing a break any more.
 
everydayupsanddowns said:
I got a bit frustrated with high BG after treating hypos with the recommended 15g, plus a starchy carb follow-up.

I know that hypos breed hypos, so you are statistically more likely to have another in any day that you've had one.

But the highs didn't help. And sometimes a frustrated correction some time later then led to a hypo!

So I gradually evolved a more instinctive and unofficial approach where I'd decide whether to follow up, or not, and whether to gently nudge incrementally based on a case-by-case basis, my understanding of what had caused the low BG in the first place, and what was happening next!

It's not something I can recommend to others, but dropping the "always follow up" seemed to help me. Especially now I can set an alarm to remind me if I'm still in the 4s 30-60 minutes later, and give myself another little 5-6g fast carb nudge then.
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Sorry for the late reply, I’m aware I have yet to answer to you on another thread, yeah hypos can be very difficult and when you said that having to cprrect, following having a hypo is another issue also and trust me I’ve been there also where my correction has overworked and I’ve ended up dipping again. So what would you suggest if I’m running between 4 and 5 to avoid a hypo coming & how much carbs would you recommend to give that little nudge to avoid a big spike, that’s what worries me and makes me quite reluctant in doing, some people have said to me that I’m over treating a hypo if I’m having a follow up snack of 15 to 20 grams but that’s what is recommended though, I’d don’t know, I’m just fed up tbh and lost, but thank you for responding
 
I also meant to mention that I would be surprised if 15 Skittles is just 15g carbs. I would imagine that each Skittle will be more than 1g carbs. I would have expected 3 Skittles would be about 5g carbs so 9-10 would be about right for your initial quick release carbs.... but I stand to be corrected by those who use Skittles.
 
everydayupsanddowns said:
I got a bit frustrated with high BG after treating hypos with the recommended 15g, plus a starchy carb follow-up.

I know that hypos breed hypos, so you are statistically more likely to have another in any day that you've had one.

But the highs didn't help. And sometimes a frustrated correction some time later then led to a hypo!

So I gradually evolved a more instinctive and unofficial approach where I'd decide whether to follow up, or not, and whether to gently nudge incrementally based on a case-by-case basis, my understanding of what had caused the low BG in the first place, and what was happening next!

It's not something I can recommend to others, but dropping the "always follow up" seemed to help me. Especially now I can set a alarm to remind me if I'm still in the 4s 30-60 minutes later, and give myself another little 5-6g fast carb nudge then.
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That pretty much how I handle my affairs. If it’s a basal low? I’ll tickle it up in 5g increments. I might not know where it’s going, but I sure know how much 5 or 10g lifts. Then I would follow up. If a bolus low I’ll tickle it up but be mindful pending on when the low happened that what I bolused for could be kicking in a little later than the NR. So it could either be the timing or a miss calc? If I were to follow the “15 rule” on many occasions. It would be too much.

rebrascora said:
I also meant to mention that I would be surprised if 15 Skittles is just 15g carbs. I would imagine that each Skittle will be more than 1g carbs. I would have expected 3 Skittles would be about 5g carbs so 9-10 would be about right for your initial quick release carbs.... but I stand to be corrected by those who use Skittles.
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I don’t use Skittles. But I just looked them up? It does look closer to 5 skits per 5gs?

Skittles nutrition facts and analysis.

www.nutritionvalue.org www.nutritionvalue.org
 
rebrascora said:
I also meant to mention that I would be surprised if 15 Skittles is just 15g carbs. I would imagine that each Skittle will be more than 1g carbs. I would have expected 3 Skittles would be about 5g carbs so 9-10 would be about right for your initial quick release carbs.... but I stand to be corrected by those who use Skittles.
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No they are pretty much bang-on 1g of carbs each.

I have just double checked with our digital scales.

50 Skittles = 55g weight

Packet states 89g of carbs per 100g

55 x .89 = 48.95g of carbs

So 1 Skittle based on that sample would be 0.98g of carbs. Which is as near to 1 as makes no difference. 🙂
 
Isma1123 said:
So what would you suggest if I’m running between 4 and 5 to avoid a hypo coming & how much carbs would you recommend to give that little nudge to avoid a big spike, that’s what worries me and makes me quite reluctant in doing, some people have said to me that I’m over treating a hypo if I’m having a follow up snack of 15 to 20 grams but that’s what is recommended though, I’d don’t know, I’m just fed up tbh and lost
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I think you’ve got to listen to your body. And observe what results you get.

AND then be prepared to change and tweak your tactics as your diabetes inevitably changes its mind.

A hypo on any day statistically puts you more at risk of a second dip. But if you are finding the 20g of follow-up carbs is not just protecting you from a second dip, but is causing you problematic high BG levels for many hours, you could cautiously consider reducing the amount of follow-up carbs? But not if that reduction then increased your risk of further hypos (which are a cause of more immediate risk).

As for small nudges when above 4 but only just…I can’t offer you any advice for how to treat your own diabetes, but I sometimes consider small nudges of 5g or 10g of fast carbs rather than the full 15g. But I have to say those small nudges have often not been sufficient - and I have needed to retreat. It all depends on what direction my BG is headed, and whether I have insulin on board.
 
rebrascora said:
I would encourage you to give CGM another go, but learn about it's limitations first and remember that it is a tool to help you not a judge of your diabetes management. I have gone through phases where I got chewed off with it and needed a break from it but after a week or so I come back to it, really appreciating how much easier it makes my diabetes management and as the years have gone on, I don't seem to get tothat poit of needing a break any more.
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to add to this @Isma1123 if it was one CGM that you didn't get one with it might be worth trying another different sensors seem to work differently with different people. I was given the libere when first dianogused and found it be terrible they would fail all the time after about 2 days and ended up just slowing finger pricking because it was causing so much stress. I'm now dexcom one and find it works great for me I been since October and have only changed one early due to it going a bit funny(and could see why when I removed tje sensor) and u trust it way more than I did libre. In fact I trust it so much I easily forget to carry a meter with me sometimes(not recommended). But other people have had the opposite exercise and found libre to work better for them then dexcom
 
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everydayupsanddowns said:
No they are pretty much bang-on 1g of carbs each.

I have just double checked with our digital scales.

50 Skittles = 55g weight

Packet states 89g of carbs per 100g

55 x .89 = 48.95g of carbs

So 1 Skittle based on that sample would be 0.98g of carbs. Which is as near to 1 as makes no difference. 🙂
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This all depends on which skittles you are referring to ... there are Fruit skittles, squishy skittles, giant vegan skittles, vegan chewy skittles etc, etc. They are different sizes.
 
Isma1123 said:
I find that sometimes when after having treated a hypo, my blood sugar goes up to 11, 12 or 13, I treat a hypo very well and accordingly, so I have 15 grams of fasting acting carbohydrates, like 15 Skittles, or 5 dextrose tablets and then wait for no more than 15 mins and recheck, once I’m back in range, I will have a starchy carb snack of between 15 to 20 grams, to keep my blood sugar up, majority of the time, my blood sugars be in range, until my next meal, but sometimes they fluctuate above 10 to 13, is that expected and is it normal, or am I doing something wrong? I’m a slight tad worried
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What do you have as a carby starch snack, got my alarm set at 5.6 , when it sounds i usually eat a biscuit or something but usually I will drop into the 4s before it gets into my system. Thanks
 
Charl said:
What do you have as a carby starch snack, got my alarm set at 5.6 , when it sounds i usually eat a biscuit or something but usually I will drop into the 4s before it gets into my system. Thanks
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I am guessing that the Libre shows your levels dropping into the 4s before it comes back up but you haven't necessarily finger prick to check that and it may be that you don't actually drop that low?
The Libre algorithm continues to show levels dropping for 20-30mins after carbs have been eaten(or drank) simply because it takes time for it to realise that the trend has changed direction and levels are coming back up. If you are concerned about this, you could have faster acting carbs than a biscuit, like a couple of jelly babies. Personally, if I was 5.6 and dropping fast I would have just one jelly baby and give it half a hour to see if that levelled it out or came back up and have another one if it settled in the 4s. It depends if there were other slower carbs still in my system from an earlier meal which were still digesting and releasing glucose, before I ate the jelly baby and it was just that I had got the timing wrong and my insulin was kicking in faster than the food was digesting and I just needed something to slow down the insulin a bit. Or, if it was perhaps as a result of exercise where there were no other carbs digesting and my levels were dropping fast and I then I would probably have 2JBs. If my levels were 5.6 and just dropping very slowly I would not have anything but just monitor and if it got to 5 I might then have one JB or a date or a prune. I rarely have biscuits as I prefer dried fruit for slower carbs or JBs for fast carbs. Sometimes just 5g carbs is enough and your average biscuit is at least 10g. I have been known on very rare occasions, to snap a biscuit in half when I just needed 5g.
 
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