Managing hypos effectively

Status
Not open for further replies.
P

Paul Crown

Member
Relationship to Diabetes
Type 2
Hi all, need some advice please, I’m a type 2 taking gliclazide and metformin and had my first hypo last night (2.8) which I managed with orange juice and a couple of biscuits. My bloods were 14.4 this morning and was looking for some tips to avoid the spike as for the previous week bloods consistently in the normal range. Thanks in advance
 
The advice for people with Type 1 is
  1. take 15g fast acting carbs such as orange juice, jelly babies or dextrose tablets
  2. wait 15 minutes
  3. test BG again. If still hypo (less than 4.0), return to point 1 above (take 15g fast acting carbs and wait 15 minutes)
  4. eat 15g slow acting carbs such as a biscuit
  5. keep a close eye on BG for the next 24 hours
I assume the same would work for type 2.
 
How much orange juice? 15g would typically be around 150ml, so quite a small glass, but check the label of yours.

Did you have hypo symptoms? If not I would have retested just in case it was a false reading.
 
I find Dextro glucose tablets easier to control the amount @Paul Crown They work quickly and that in itself helps stop the panic. You might only need one biscuit as a follow-up. It’s all a case of experimenting a bit. Don’t beat yourself up about the 14.4. It was your first hypo and they can be scary and unpleasant.
 
RBZ5416 said:
How much orange juice? 15g would typically be around 150ml, so quite a small glass, but check the label of yours.

Did you have hypo symptoms? If not I would have retested just in case it was a false reading.
Click to expand...
Thanks too much orange juice I think and definitely had symptoms (sweating and feeling like going to pass out) re tested after 15 mins and was 4.7 then 5.4 15 mins after that
 
Inka said:
I find Dextro glucose tablets easier to control the amount @Paul Crown They work quickly and that in itself helps stop the panic. You might only need one biscuit as a follow-up. It’s all a case of experimenting a bit. Don’t beat yourself up about the 14.4. It was your first hypo and they can be scary and unpleasant.
Click to expand...
Thanks, now got some and hopefully this will be isolated
 
Glucose tabs are good but i find that fruit juice works quickest....i use apple juice as its nearly 10 carbs per 100 which makes it easiesr to calculate
 
Are you aware re carb counting? Hypos are going to be more likly if you have a low carb meal (eg meat, eggs, many salads, cheese)
 
Tdm said:
Are you aware re carb counting? Hypos are going to be more likly if you have a low carb meal (eg meat, eggs, many salads, cheese)
Click to expand...
I mean, you will need to eat enough carbs to give your glycaside enough to work on. Low carb may be ok, but the carbs you eat need to be matching with the carbs needed by your glycaside
 
Paul Crown said:
Hi all, need some advice please, I’m a type 2 taking gliclazide and metformin and had my first hypo last night (2.8) which I managed with orange juice and a couple of biscuits. My bloods were 14.4 this morning and was looking for some tips to avoid the spike as for the previous week bloods consistently in the normal range. Thanks in advance
Click to expand...
Did you wash your hands before testing this morning? Did you eat anything else after the biscuits.
 
Tdm said:
I mean, you will need to eat enough carbs to give your glycaside enough to work on. Low carb may be ok, but the carbs you eat need to be matching with the carbs needed by your glycaside
Click to expand...
Tdm said:
I mean, you will need to eat enough carbs to give your glycaside enough to work on. Low carb may be ok, but the carbs you eat need to be matching with the carbs needed by your glycaside
Click to expand...
Thanks, I’m not at the moment as just diagnosed however thanks for the heads up and will look into
 
If I had a small carton of orange juice and 2 biscuits for a hypo, I would expect to end up in the teens. 15g carbs is 3 jelly babies but I almost never need more than 2 for a hypo, often just one and no follow up slow release carbs. 10g carbs (2JBs) will raise my BG by 3mmols, so a carton of juice at nearly 20g carbs plus 2 biscuits ie another 20g carbs would raise my levels by 12mmols, so if my hypo was at 3mmols, that lot would take me up to 15 and that is without any contribution from my liver, which mostly these days leaves me to deal with hypos. 2JBs (10g carbs) will raise my levels from 3mmols up to a nice 6mols which is a level I am happy with. Of course, this is just what works for my body and you have to find what works for you, so next time try 4-5 glucose tablets and just 1 biscuit and see where that leaves you. Even when my levels are dropping fast like when I am mucking out my horses and my Libre alarm goes off and gives me a reading of 3.8 with a vertical downward arrow, I can eat 2 JBs and continue working and they will bring me back up to 5, particularly if I chew them well as they absorb through the cells walls in the mouth.
 
Please bear in mind that diabetes management takes some trial and error to work out what works for you.
The usual guidelines (15/15/15) is a good start and it is useful to read what works for others.
But I would recommend lots of testing and making notes to find out how the guidelines work for you and then using other people's experience to guide where you may want to tweak things.
Hopefully, being on glic results in less hypos than insulin so your notes and tweaking may grow slowly.
 
Sorry to hear about your hypo @Paul Crown

Treating them effectively, not getting a rebound high, but also not risking a ‘double dip’ into a second hypo later can be a delicate balancing act. “Hypos can breed more hypos” is a phrase I’ve heard from a hypo-specialist professor/endo. Once you’ve had one on a day, you are statistically more likely to have another.

Along with the ‘15 rule’ suggestions and other helpful tips you’ve had already, you might find some information here:

What is a hypo (hypoglycaemia)?

A hypo is when your blood sugar level, also called blood glucose level, drops too low. This is usually below 4mmol/l. A hypo, also called hypoglycaemia, can happen quickly. So it’s important to always have hypo treatments with you. It's also important to know what the signs are and how to treat...
www.diabetes.org.uk www.diabetes.org.uk

The advice always used to be to ‘follow up’ the fast acting carbs with something starchy and longer acting, to guard against a second dip, but I got frustrated with rebound highs and have settled into mostly treating only, and only ‘following up’ when I know I have extra ‘insulin on board’, or have been more active than usual.
 
Status
Not open for further replies.
Back
Top