Hi All,
I’m on MDI. When I go low during the night (I have my CGM set to alarm at 80), I drink fruit juice- but it often continues to drop & frequently takes my CGM 30-60 minutes or more to reflect that my sugar is back to a safe (over 70) range. If I drink more than 3-4 ounces of juice, it still takes forever and my sugar ends up going too high. Same result with glucose tablets. Question- What do people us to treat lows ?
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hi @Jophilly I use juice or glucose. Juice is tastier… but glucose is the fastest sugar absorption of all kinds of sugar and its easier to calculate the amount. I DO NOT use my cgm,. it lags reality by a very long time. I use my finger stick meter. 4-8-12 grams glucose tab (1 tab raises my bs by 20 mg/dl) , 15 minutes, when I see a rise… on the bs meter… then I go back to bed. if it’s juice, then its about 1 gulp = 30 mg/dl rise… much less precise! now the amount 1 glucose tab or x ounces of juice will raise your BS, is a number you have to figure out for yourself by experiment. good luck
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Hello @Jophilly ! I empathize with the delay in the CGM, I have to keep my finger stick monitor next to my bed for when the lows come during the night and I need to monitor my bg in a more timely manner. To treat the lows when I’m trying to sleep, I opt for Newtons of the Fig variety which often come in a pack of 2 “cookies”. For one cookie, the fig filling packs around 12g of sugar to bring my glucose up from a low, and the whole grain of the carbs is around 20g which keeps my numbers at a good level so I can sleep a few more hours until breakfast time, or until it is time for the other cookie in the pack of 2 Newtons! This is just what works for me, but I hope it helps you out some. All the best to you!
I find the best controlled way is the glucose tabs. Juice spikes me way up as well. It takes 15 minutes to start to rise with the finger stick. The CGM is 15 minutes more delayed - so that’s 30 minutes minimum. It’s frustrating that the alarm keeps going off all that time. It’s hard to be patient but not much we can do.
If I have IOB it takes 3 tablets for me. If my IOB is 0 I can usually go with 1 or 2 ( if the arrow isn’t straight down)
The middle of the night while trying to sleep is the worse. I try to not be too low when I go to bed hoping I make it (although then sometimes I end up high 
). I always check when I wake up in the night so I can adjust accordingly hoping for no alarms.
Good luck!
I use peanut butter and chocolate granola bars. If I gotta eat I might as well enjoy it. They do require some liquid to get the sugar into the digestive tract faster.
When I have lows in the middle of the night I’ve found it best to get up, walk downstairs and stay awake for 20ish minutes. Otherwise my digestive system stays asleep and I have a similar problem to what you describe.
Please forgive me if I’m confusing you with another user but I think I saw you post about the Libre and Libre 3. I used to use the Libre 14 day and found it was making wild guesses for blood sugars below 80. The smoothing algorithm Abbott uses also makes it take longer to show a rapid change. CGMs have limitations.
The error bars for the Dexcom G6 I use now get bigger below 70. To deal with this particular limitation I know exactly what one or two or four granola bars will do to me at night if I’ve been at my desk working all day. I’ll treat as described then go back to sleep. It’ll beep again if there is still a problem in 30ish minutes. If I’ve been out having fun or eating strange food I might do anything from ignoring the alarm to doing the dreaded watching for each new reading for an hour.
Hi @Jophilly am on MDI, i used to correct my lows with juices but few hours later i will experience hypos again, i found that these simple liquids takes short time to be digested and absorbed! (And that’s good because it helps with hypos) the problem is fews hours later you will have hypo again, i do prefer to take a small amount of juice to take me to near normal then have something to eat ( i do prefer nuts) which takes long to be digested and absorbed to the system and this will stabilize my BS for hours, this works for me I recommend you do research and find what works the best for you!
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100 seems to be my tipping point. Even with a CGM and smart pump making adjustments, when I get there my numbers usually start to 
or 
. And while the truth is in the meter, some years ago I noticed that it was taking longer for me to start to feel normal as my numbers rose.
There was a time when, as I was waiting… and waiting… and waiting… I would keep downing juice, soda or whatever looked tasty - hoping it would help. Of course that sent me skyrocketing, but it didn’t seem to speed things up, at least as far as how I felt physically. And even if my numbers are in a safe range, I don’t want to, say, get behind the wheel to drive if I’m not feeling right as well - so I try to avoid getting there in the first place.
They say “an ounce of prevention is worth a pound of cure.” Have you considered setting your low alert a bit higher - maybe 100 rather than 80 - so you could have a small snack before things start to go south?
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I use 1 sugar tablet (washed down with some water to get it moving faster) then I eat 1-2 peanut butter crackers. I find that the sugar tablet gets me out of the low but the fat in the cracker keeps me steadier over the next few hours. Sometimes, I will eat a few spoonfuls of yogurt before bed and that keeps me from going low - the carbs and the fat work well together. Good luck!
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Good Morning!
I’ve been using a fast-acting glucose energy liquid called “Glukos” at night for the last couple of years - 16 carbs, and electrolytes including15 mg of sodium. It works really well in 15-20 minutes an allows me to go right back to sleep with no worries.
That or a 6-ounce apple juice box always work quickly for me.
Our bodies and our T1D are all different.
I do understand this all too well, but thought I would share in case it can help someone else.
Jodi
Hi Jodi, Thanks so much, this is helpful. Question 1- Is Glukos a liquid or a gel ? 2- Where do you buy it ?
Thanks again, Joanne
I use Smartees candies. A nutritionist who I saw and who has T1 suggested them. There are many small tablet like pieces in one roll and I find I don’t over treat using them. One roll has 6g of sugar and it’s just sugar like a glucose tablet. I always panic and over treat and these solve that problem
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Hi,
Here is my routine, though, of course, you need to figure out what works for you.
I have found gummy candy to be the best, fastest, easiest way to treat low BS. I use gummy strawberries (we order it online). If wrapped tight with plastic, these large bags of gummies will stay fresh for months. They work quick, don’t leave crumbs, don’t make noise when you chew (in public places where you want to be discreet). One gummy strawberry will raise my BS 20 mg/dl. I fill (very) small ziplock bags with about a dozen candies. I throw a bag in the my pocketbook, keep one in my office near my desk, and keep one next to my bed. I have set my cgm to alarm at 85 BS (though I should probably raise it to 90, as everyone has pointed our how slow the cgm is compared to real BS levels). During the night, I will eat 2 gummies and go back to sleep shortly, knowing my BS will come up to acceptable levels. Yes, it is annoying that sometimes the alarm keeps ringing, even though I treated, but I don’t know what we can do about that. If, for any reason, I need more sugar, I will wake again and eat another 1 or 2 gummies (very rarely does this happen). Since my low time seems to be about 3-4am, by the time I get up around 7am, the BS is usually within range again.
When my little baggie of gummies runs down, I just replace it with another bag, always being sure i have at least 4-6 gummies with me at all times.
Good luck with whatever you try.
Terri
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I think we all have very similar issues. We need to put on our patience pants maybe. There are 1 or 2 things that seem to increase my glucose faster so I use those things. We all are different though as far as what that will be. It’s strange for me that glucose tabs are about the worst at it. A huge delay. So don’t worry, you are not alone.
I second granola bars. I keep a box of Quaker Oats Bars in my nightstand and unless it is an unusually tenacious low (usually caused by a lot of activity during the day in my case), one bar will typically solve the problem for me. They’re wrapped in foil, so they’re good for months. I am an avid cyclist and I keep several in the bike phone bag, several in the car for long trips, some at work… etc.
The quickest way for me to raise my BG is juice. I drink the juice and follow that with an Atkins protein bar. I do occasionally go a little higher than I’d like but after a lot of lowsI would rather go a little higher than too low.
Welch’s concord grape juice. I keep the ten-ounce bottles in my nightstand, in my car, in my wife’s car, and anywhere else I think I may need it. My CGM goes off at 70, or if the trending is indicating a rapid drop. I don’t feel the hypo affects until I’m in the low 50’s or upper 40’s, but as soon as I get an alarm for a low glucose, I’ll get up and do two things. First, I eat a Hostess mini-pie (apple or cherry, doesn’t matter. They’re both 100 calories, but mostly carbs), and drink a half bottle (five ounces) of grape juice. It takes a while for the CGM to indicate a rise, as everyone has already said. But I know it’s happening, so I go back to sleep and ignore the next couple of warnings. If you want a really quick way to raise your blood sugar, keep a large jar of Jelly Belly jellybeans nearby, and eat a handful. Your blood sugar will rise PDQ.
My endo always stresses that I eat a snack before going to bed. She recommends apples and peanut butter (yuck). I prefer something like a chocolate chip cookie from Costco (the best!) and a half glass of milk.
When I was first diagnosed with diabetes and was in the hospital for initial treatment, I had my first hypoglycemic reaction in the middle of the night. The RN working the shift had worked with diabetics and brought me an eight-ounce container of milk and a six-pack of vanilla wafers to reverse the hypo. Her explanation was that the best intervention for hypo is protein, which I was getting from the milk, and the sugar and carbs I was getting from the wafers would quickly resolve the symptoms. While her logic was pretty good, she didn’t understand the importance of quickly increasing the blood glucose, and using her method, I felt like crap for quite a while!
A DNE told me yogurt is a good becomes snack too. Thought I would mention it in case you like it.
I find this treatment of lows actually very poor without anyone mentioning the importance of swish and spit using water. Perhaps everyone just knew that but didn’t want to share it.
Lets face it: DENTAL CAVITIES ARE EXPENSIVE AND PAINFUL so WHY NOT SWISH WITH WATER AFTER TREATMENT THEN SPIT OUT.
Thanks David, you bring up a point worth mentioning. With overnight lows I was always in the habit of getting up, drinking fruit juice then swishing with warm water & spitting out. This worked fine until last year -while doing so I literally passed out in my kitchen and fractured my foot in 2 places. Bear in mind this is before i had a CGM with alarms (of course this accident had me change to a CGM with alarms).
I still have to fight the urge to get up when i alarm. I now keep juice boxes & a glass of water for swishing by the bed. I also set it to alarm at 80 to be safe. Eating anything will necessitate getting up to brush teeth, which I’m trying to avoid.
However my post originated because the Dex is slow to recognize that I’ve treated & keeps alarming. If there is a liquid that works faster than fruit juice, that would be ideal.
I’m 50 years with T1D and sometimes marvel that I’m still alive given the many, many severe hypos suffered overnight (before a CGM and when I was while living alone).
Thanks to watching The Human Trial- I feel more hopeful that a cure for T1D is finally getting close - cheers to that !
Treating lows: fastest recovery for me is with glucose tablets, or a sugared soda, or cranberry juice. For me any sugared soda works roughly the same, whether it has real cane sugar or high fructose corn syrup.
Other juices (orange, apple, grape) will raise BG, but the effect takes more time in my body.
Sweet food items such as fruits, cookies, ice cream will raise BG but have a much slower onset/effect than glucose tabs or regular soda.
When I am training and I need simple sugars I find that Snickers bars, peanut M&Ms, or Honey Stinger waffles work well. they provide a boost but not a spike in BG.