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Let's talk hypo treatments

  • 1.  Let's talk hypo treatments

    Posted 15 days ago

    Hi all,

    We are loving the conversations that are happening within the community. There has been some great tips and advice, especially for our newer members joining us.

    For our next conversation starter and advice thread that may help someone else: What is your go-to snack or drink option for a hypo treatment?

    We look forward to hearing from you.



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    Natasha, Ange and Erin

    Membership and Community Team
    community@diabetesaustralia.com.au
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  • 2.  RE: Let's talk hypo treatments

    Posted 14 days ago

    Firstly having a CGM makes it much easier to avoid hypos* but when it happens I use the GlucoHit raspberry glucose tablets, only because they are the only ones I can get at only one chemist in the area (regional NSW). I ordered some of the Citrus Glucology tablets online but as with these things, postage adds to the cost. Otherwise, the only glucose tablets available in chemists and supermarkets are the iNova Glucodin chewable tablets (not to be confused with Glucogen injection) - I like jelly beans but I don't find them convenient to store or carry with me.

    I have always found it useful to keep a pack of iNova Glucodin glucose powder on hand because in some situations it is easier to dissolve a few teaspoons of powder in a little bit of water and swallow it rather than trying to crunch and chew up tablets e.g. the glucose powder is handy to have around after a visit to the dentist, for those who wear dentures and for sick days when you need a concentrated hit of glucose and don't much feel like eating.

    I have found it useful to have barley sugars to suck on when I'm heading low is a good method of raising BSLs before going hypo, but not good to use for treating hypos because they take too long to dissolve. The glucose tablets are good to keep in the car (they store better than jellybeans) and easy to carry with you when you are out and about. 

    The lack of availability of flavoured glucose tablets at chemists has always frustrated me. As I mentioned above, only one chemist in the area stocks flavoured tablets so ordering them online and paying postage is the other alternative. Perhaps Diabetes Australia might be able to advocate with chemists to stock the diabetic specific glucose treatments.  

    *Comparing CGM readings (interstitial fluid) to finger pricks (capillary blood) the CGM will warn of a hypo at a higher reading than I would see on a finger prick i.e. my CGM is set to alarm below 3.9 mmol/L, if I do a finger prick to compare that reading it is invariably around 4.5 mmol/L - you personal experience may differ but it is a worthwhile exercise to compare the two - and always keep a blood glucose monitor (and in date test strips) handy because the CGM might fail at the worst possible moment.

    These are very funny videos about managing blood sugar (BSLs are referred to in mg/dL, not mmol/L), well worth a look:

    If Blood Sugar Could Talk [Type 1 Diabetes] part 1

    If Blood Sugar Could Talk [Type 1 Diabetes] part 2

      



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    David B.
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  • 3.  RE: Let's talk hypo treatments

    Posted 14 days ago

    Hi David,

    Thank you for adding to the conversation.

    One thing that might help you with ordering online, remember all Diabetes Australia members get FREE shipping on our Diabetes Shop online. Use the code VIPSHOPPER at checkout.

    Here is a link to the page with hypo treatments.

    Thanks again for sharing.

    Have a great weekend, Ange.



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    Natasha, Ange and Erin

    Membership and Community Team
    community@diabetesaustralia.com.au
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  • 4.  RE: Let's talk hypo treatments

    Posted 13 days ago

    I have Lucozade, it's a great stand by 😃



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    Wilma
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  • 5.  RE: Let's talk hypo treatments

    Posted 13 days ago

    David B, I enjoyed your links and watched a few more from the same source - good chuckle - thankyou. 



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    Jock
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  • 6.  RE: Let's talk hypo treatments

    Posted 13 days ago

    For me, the fastest recovery is with orange juice, about 200mls. Simple and effective, also easy to purchase and not as expensive as some of the products sold for hypoglycaemia.

    I agree that fluids are more quickly absorbed than hard food items.

    However, each to one's own. No your body and what works best for you .



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    Julie
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  • 7.  RE: Let's talk hypo treatments

    Posted 13 days ago

    Woops, should read "Know"



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    Julie
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  • 8.  RE: Let's talk hypo treatments

    Posted 10 days ago

    Hi David

    I too am frustrated by very few pharmacies stocking glucose tablets. As I am a T1D with coeliac disease, most of the readily available jelly contain gluten (some of that are gluten free are also sugar free which defeats the reason for taking them to treat a hypo!). I have to order my glucose tablets (GlucoBlast or GlusoHit) on-line and in bulk).

    Recently I got caught out whilst beginning a day walk in Parramatta. I had not put glucose tablets in my pack. I stopped at a large well-known discount chain chemist and asked the pharmacist for such. She recognised I was close to a hypo but could only offer me the standard jelly beans, which I thankfully accepted. (My endo has told that hypo treatmernt must always override my strict gluten free diet). Some of the large pharmacies stock glucose tablets for their on-line store but not in their bricks and mortar stores. I assume the local demand for glucose tablets for people dropping by a store are too low to make if economic (or profit??). I would be interested in other coeliac T1Ds' experinces with hypo treatments. As to the tiny amount of gluten I had to injest it would not cause any recognisable reaction as I am asymptomatic.



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    Harwood
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  • 9.  RE: Let's talk hypo treatments

    Posted 10 days ago

    Hi Harwood,

    I have coeliac disease as well. I used to use the tablets you mentioned but they became hard to source. Now I have the natural confectionery fruit salad jubes, or mentos or soft drink. All gf and readily available and cheap! All available from ordinary supermarkets, corner stores etc…Mentos are nice and compact. I put into the reusable hypo tablet container when I'm out and about. I am very symptomatic with coeliac disease so always stay on the gf diet. Too difficult to manage the type 1 otherwise. 



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    Michele
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  • 10.  RE: Let's talk hypo treatments

    Posted 10 days ago

    Harwood

    I too am T1 and coeliac.

    I always carry some jelly beans I get from the Base Warehouse. They are Glute Free by ingredient.

    I find them good and effective whenever I get a hypo.



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    David
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  • 11.  RE: Let's talk hypo treatments

    Posted 9 days ago

    Thanks David for that tip!



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    Harwood
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  • 12.  RE: Let's talk hypo treatments

    Posted 10 days ago

    I am coeliac as well, and my go to is the Woolworths brand jubes. They are pretty easy to eat, cost effective and GF.

    I carry them everywhere, but the one or two times I have forgotten while out I just grab a bottle of soft drink / juice.



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    Adan
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  • 13.  RE: Let's talk hypo treatments

    Posted 9 days ago

    Thjanks ADan for that tip.



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    Harwood
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  • 14.  RE: Let's talk hypo treatments

    Posted 9 days ago

    Hi Harwood,

    Thank you for contributing to the conversation.

    As with my reply to David, our online Diabetes Shop may be a help to you. They have the GlucoBlast (50pk) tablets and also the gel (15g). All products on the Hypo Treatment page are currently on sale too. Here is a link and remember to use the code VIPSHOPPER at checkout for free postage, for all Diabetes Australia members no matter what your spend is.

    As there are a few who have commented about living with both T1D and coeliac disease in this thread (and there would probably be many others) would you find it helpful if I went to one of our health professionals to see if they have any other recommendations for hypo treatments, when living with type 1 and coeliac disease? Which might be fitting as it is coeliac awareness day on the 16th of this month, and I had already planned a post on this.

    Thanks again to you and everyone else who has reached out in this post to share their treatments, and experience. 

    Have a great day, Ange.



    ------------------------------
    Natasha, Ange and Erin

    Membership and Community Team
    community@diabetesaustralia.com.au
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  • 15.  RE: Let's talk hypo treatments

    Posted 9 days ago

    Hi. My first time on this forum. I'm really enjoying hearing from other T1 folk. Diagnosed at 64 and coeliac as well I'm battling the BG roller coaster. I would love more info for people with both conditions. Eating gf and low carb is not simple. Bread for example! Thanks for all the tips



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    Susan
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  • 16.  RE: Let's talk hypo treatments

    This message was posted by a user wishing to remain anonymous
    Posted 8 days ago
    This message was posted by a user wishing to remain anonymous

    Hi Susan

    Tony here. I am late onset T1 diagnosed last year and age 72. Hope the below is not too much detail.

    I am not on insulin but manage levels with diet, exercise and some yoda/meditation. My Hba1c was 11 but now down to 5.6.

    I am not coeliac but diet basically avoids wheat etc. Thus typical breakfast is 2 eggs, avocado and salmon, lunch is salad often with can of fish, dinner is meat, low GI vegetables (eg broccoli, cauliflower, mushrooms, capsicum). Occasional desert is almond flour cake with strawberries, raspberries i.e. low sugar fruit, all sweetened a little with monk fruit that doesn't raise my blood sugar levels, and some cream. I now eat much more diary inc. cheese, yoghurt and cholesterol levels are still good. I snack on walnuts, almonds, seeds. All this is quite low on carbs so have started to add in a slice of toast at breakfast, and an apple or ornage in the afternoon.

    Exercise is alternate days of swimming (30 mins) and gym (45 mins), and moderate walking or biking.




  • 17.  RE: Let's talk hypo treatments

    Posted 7 days ago

    Hi Tony,
    Thanks for your diet input. Just so you are aware in T1 diabetes the pancreas produces little or no insulin from an autoimmune degradation of pancreatic islet cells. If you are aged 72 at diagnosis and are not requiring insulin it is more likely you have type 2 diabetes. 



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    Phil M
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  • 18.  RE: Let's talk hypo treatments

    Posted 7 days ago

    Hi Tony

    I sort of agree with Phillip. But if you have been diagnosed as Type 1 do not seek to change the diagnosis. There are many benefits Type 1 receive. You are most likely LADA, a slow progression to Type 1. I was diagnosed with LADA with my first Endocrinologist appointment. I am afraid my slow progression to Type 1 Diabetes only lasted 3 months and that is why I was finely classified as Type 1    

    I was also diagnosed at an older age, 56 and now I am 72. I was incorrectly diagnosed as Type 2 because of my age and because there were no ketones even with a BGL of 27.3 mmol/L. I was then diagnosed as LADA by my endocrinologist. Although I tried exercise and diet, within 6 months of my first symptoms of diabetes, caused by a head cold followed by some tropical virus, I had to inject both bolus and basal insulin. I am now classified as a Type 1 Diabetic.

    I struggled to keep a stable BGL even although my HbA1c was usually well under 7. Within a year and a half, I was quickly developing peripheral neuropathy to the stage where my feet were feeling numb and when I got out of bed, it felt like I was standing on a thousand hot needles. The same endo identified the problem as quickly fluctuating BGLs from Hypo to Hyper. Although I have lost some sensation with the tips of my toe, I still have good feeling with the rest of my feet, some 12 years later.   

    More stable control of my BGLs was achieved by choosing the right foods for my work as a fisherman and farmer, when and how much insulin that I injected and keeping BGLs in a tighter range without having too many Hypos. This proved to be very difficult without a CGM and my saying was, if I was not having at least one Hypo a day, I was not working hard enough.  

    Because you have been diagnosed as a Type 1, you automatically qualify for a free CGM. The graphics show you how different foods will spike you Glucose levels and by how high and when you should be exercising to control this spike.  

    For me, it was not only achieving a three monthly HbA1c of below 7 but also stabilizing extreme fluctuating BGLs. Now I try to keep spikes below 10 mmol/L and I am always intervening if BGLs are above 10mmol/L for a period of time. This control has been made much easier by the Dexcom 6 CGM but I still have to calibrate it every morning to keep readings agreeing with my morning meters (Performa and FreeStyle) tests.   






  • 19.  RE: Let's talk hypo treatments

    Posted 4 days ago

    Thanks Philip and Paul

    I probably should have provided more information. I do have a CGM having been diagnosed as Type 1 LADA by an endocrinologist last year. I can get up to a level of 8-9 after breakfast (and some morning phenomenon still occurring but reducing) but I then hit the bike, gym or pool for exercise. Levels through 9am-noon are on average 7.7 but otherwise hover just over or under 6.

    So not getting huge spikes, In 90 days I have gone just over 10 once and never under 4. I see an optometrist almost annually and there has been no deterioration in my sight or nerve damage. I guess I am pleased my regime is working for now at least.

    Thanks again

    Tony



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    Anthony
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  • 20.  RE: Let's talk hypo treatments

    This message was posted by a user wishing to remain anonymous
    Posted 4 days ago
    This message was posted by a user wishing to remain anonymous

    Hi Philip

    No definitely type 1 as GADS levels shows and also that I was never overweight. Yes some insulin still being produced but so far I seem to be maximising its utility by diet and exercise in keeping sugar levels in range. I may well be in a so-called honeymooon period but time will tell. I know of someone who has been on honeymoon for 10 years now.

    Tony




  • 21.  RE: Let's talk hypo treatments

    Posted 3 days ago

    That is great Tony and thanks for the input. BTW I had an aged friend that said he had kept his diabetes under control from his youth without medication. Not sure what type he had. Keeping my carbs and grains low has enabled me to greatly reduce my insulin amounts. 



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    Cheers
    Cris
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  • 22.  RE: Let's talk hypo treatments

    Posted 7 days ago

    Anon:  that's a great result and takes a lot of self-control.  Well done - keep it up !



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    Jock
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  • 23.  RE: Let's talk hypo treatments

    Posted 5 days ago

    Hi Tony, what a great summary of your efforts to manage diabetes. I learned a lot. Thank you. I'm going to check out monk fruit, it's not something I am familiar with. Have a great day! 



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    #insulinjunkie
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  • 24.  RE: Let's talk hypo treatments

    Posted 2 days ago

    Hi Tony

    You are doing well to control Type 1 LADA by what and when you eat and by physical activity without insulin. Keep it up!!!

    I already had a son who was diagnosed with T1, some 12 years prior to my diagnosis. My first diagnosis as Type 2, by my GP did not relate to my symptoms.

    Being very fit, then within 3 weeks, losing a lot of weight and lacking energy but eating very high carbs so I could finish that year's cane plant, did not add up to Type 2. A reading of 27.3mmol/L put me into hospital. At the same time, I was contracted by the local sugar mill to keep the production of sugar in the premium quality range. This is where I caught the head cold and when my progression to Type 1 Diabetes started.

    I was diagnosed by a young endocrinologist as LADA. Blood tests showed that both GAD and IA2 results were in the extreme range and came back as greater than the maximum for both tests. They were in the thousands!!!

    I flew twice a year from the Whitsunday airport to Brisbane for appointments. He is now at Monarch University researching Diabetes.  He was the one that prevented the progression of the peripheral neuropathy in my feet. From the time he diagnosed me as LADA until he left, he was my only endo.

    Do not give up testing your BGL with a meter, Tony as this test will give you the earliest indication that something could be changing. A test, first thing of a morning than another, one and a half to two hours after breakfast, give the best indication of how things are going. With a higher than normal reading with a BGL meter over a period of time mean you should be seeking medical advice.    

    When I have been inactive for a few days and I am doing computer work of a morning and with my standard breakfast of coffee and Weet-Bix, I may have to raise my NovoRapid from 4 to 10 units. My educated guess, is because I am not active and with Glycogen being fully replenished, the liver is releasing too much Glucose. I have to drink my coffee (14 -18g carbs) over a period of 40 minutes and check the graphics to adjust my NovoRapid before I have the Weet-Bix. A higher than normal meter BCL and/or a normal morning BGL that keeps rising after insulin and after breakfast, tells me that I have to be more active.

    So far you are managing T1 very well and as long as you keep on top of things, you will achieve the best outcome.

    Best of luck. Paul



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    Paul
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  • 25.  RE: Let's talk hypo treatments

    Posted 2 days ago
    Hi Paul 
    Thanks so much for sharing your family experiences and knowledge
    Yes l must check my levels with a finger prick more regularly
    i know the sensor is in error after swimming heading for 4 when I feel fine and the finger check is nearer 6.
    I avoid carbs with breakfast except for a little slice of sourdough. Even a small bowl of oats sends my levels up as I suspect would weetbix.
    For a couple of months my low carb, low GI, high protein and good fats made me tire quickly in the arms while swimming but now I am fine. I am thinking my body has adjusted to getting energy from the changed diet.
    Most people here would be familiar with Dr Brukner's Defeat Diabetes campaign for Type 2's
    I have found his book and recipes excellent guidance in my case. His red,amber and green listing of foods is alone a valuable guide,
    One final strategy I find useful is to at least have a walk after eating. Even 20 minutes seems to arrest levels.
    Thanks again 
    Tony








  • 26.  RE: Let's talk hypo treatments

    Posted 14 days ago

    For hypo treatment we use Fruit salad jubes from The natural confectionery co., normally one or two are enough.



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    Peter
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  • 27.  RE: Let's talk hypo treatments

    Posted 13 days ago
    Hi, I use Glucojel jelly beans from the chemist and chew about 6 for a hypo. They're ready available and only about $3 a packet. Also easily carried around 
    John 






  • 28.  RE: Let's talk hypo treatments

    Posted 14 days ago

    The best hypo treatment that I have found in Lucozade. It's a small bottle of carbonated soft drink that is sweetened with glucose. You can drink a dose really quickly and it is absorbed much faster than solid food. You can buy it at most major supermarkets. Once degassed, I decant it into treatment size bottles to carry with me. 



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    Anna
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  • 29.  RE: Let's talk hypo treatments

    Posted 13 days ago

    When my alarm goes off at 5mmol/l, I have an "up and go". Because of the threshold being high, at where you can drive, I can avoid the spikes. If I can't get to that quickly enough, glucose jelly beans when at home and glucodin tablets in the car (followed by a muslei bar of the sort that can survive storage in a hot car).



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    David
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  • 30.  RE: Let's talk hypo treatments

    Posted 13 days ago

    My go to is an apple juice popper. Standard 250ml contains 24.5g sugars. They can be stored at room temp and have a long expiry. Also, drinking from a straw is fast and easier when my blood sugar level is low.



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    Mark
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  • 31.  RE: Let's talk hypo treatments

    Posted 12 days ago

    Hi All,

    My libra 2 is set to sound at 5 mmol/l being crucial reading level for driving.   My go to treatment can vary from glucojel jelly beans, popper juice or even some custard.

    It all varies at where my notice happens however all treatments work for me.

    As previously mentioned, I do notice that there is a difference between my libra 2 reading and reverting to a finger prick.

    Hope this is of benefit to my fellow Type 1's.

    Enjoy your weekend.

    Jeff - Redcliffe



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    Jeffrey
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  • 32.  RE: Let's talk hypo treatments

    Posted 11 days ago

    I am using the Dexcom 6 CGM but have to self-calibrate it every morning. To self-calibrate you do not enter the sensor code when the new sensor is applied.  I calibrate the Dexcom 6 CGM, because when I am working physically hard as a fisherman and farmer, my meters (both Accu-Chek and FreeStyle) reading, can be reading up to 2 mmol/L lower than the Dexcom 6 of a morning when BGLs are stable and below 6.5 mmol/L.

    I have been caught out too many times with fast falling Hypos even with the low alarm set at 5.5 mmol/L. With the self-calibration of the Dexcom 6, the largest discrepancy that I have registered with normal readings, has been 0.5 mmol/L higher, which is within the normal acceptable allowable range of errors. Most of my comparisons between meters and Dexcom 6 are now about the same. I try to calibrate the Dexcom 6 to read about 0.2 mmol/L below the meter reading of a morning.

    Being physical active and keeping BGLs within a normal range, for me, is very difficult. Now that I am self-calibrating the Dexcom 6, I can rely on readings and alarms. When levels are in normal ranges and stable is the only time that meters and Dexcom 6 give similar readings. All other times, I only take notice of the graphics.

    If the Dexcom reading is falling slowly and even at 3.5mmol/L, I will have some food. If grapes are in season and I am working hard I will eat 20 to 40 grams carbs, e.g; 100 to 250g of sweet grapes. I have to be careful if I have stopped work. It is better for me, under this circumstance to wait and see if BGLs are rising from 3.5mmol/L before I eat.

    If the Dexcom 6 GLs are at 4.5 mmol/L and falling fast and I have bolus on board, I will have about 20 grams of honey then test with the Accu-Chek Performa meter. After 10 minutes, if the Performa reading has not risen, I will have another 20 grams of honey.

    The reason I use grapes and honey to treat low BGL events, is because both have high levels of Glucose and Fructose. If my stored Glycogen levels are low, the liver will quickly take up the Fructose.

    I have stopped using Coke and all sweets as regular hypo treatments. I used Dextrose for a period but had to was it down with water. Honey can be stored in a small flip top container and be stored in my small esky, along with food and diabetes requirements.

    I also use a Dexcom 6 reader and the Dexcom 6 app on my phone when I am working in the shed. I set different alarms and set the reader at 5.5 mmol/L and the phone app at 5.3 mmol/L. This usually gives me time to prevent a Hypo and indicate how fast I am falling. 

      Paul: The Fisherman, Cane Farmer & ex Sugar Chemist.



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    Paul
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  • 33.  RE: Let's talk hypo treatments

    Posted 8 days ago

    My hypo treatments include many that are mentioned.  I vary mine according to the required response time and try to use natural foods such as grapes and honey - but not always...... I agree that liquids act faster as someone mentioned.

    But I sometimes make a mistake and over-compensate, which leads to high BGL, which requires fast-acting insulin (or fast walking), which leads to another hypo later with the tail of the insulin response, with leads to adding weight, etc.......   Does that sound familiar ?



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    Jock
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  • 34.  RE: Let's talk hypo treatments

    Posted 8 days ago

    That is why I have not stop testing with meters, Jock. CGMs are reading GLs in interstitial fluid and under these circumstances this reading is at least 10 minutes behind a meter BGL reading. Don't worry Jock, it is hard to have an even keel response with Hypos but the CGM graphics shows what you should have done. I say better luck next time and I try not make the same mistake with the next Hypo.



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    Paul
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  • 35.  RE: Let's talk hypo treatments

    Posted 8 days ago
    Jock, I agree with Paul. It took me a while to transfer from fingerpricks to CGM readings. It's just like any other readings, you have to accept it as accurate and then use the  reading in your diabetic management at that moment.
    John 





  • 36.  RE: Let's talk hypo treatments

    Posted 5 days ago

    All too familiar to me. I am notoriously bad at overtreating a hypo and not being patient enough for the treatment to take effect. 

    Since switching to Dexcom my control is greatly improved but I don't seem to get used to the delayed effect of exercise hence the hypos and now carrying more weight than I would like.

    My go to has always been Glucogel jellybeans or an Apple/Tropical juice popper for quicker response for Hypos. If I am at home I will often just dissolve a spoon of sugar in some water. I have had T1 now for 38 years with no major complications  and still using MDI.



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    Michelle
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  • 37.  RE: Let's talk hypo treatments

    Posted 5 days ago

    Hi Jock and others.

    You can include me the occasional roller coaster after hypo situation. If I am out doing a farm job without a remedy at hand and don't want to stop, whether going low or high and before I get to food, the resultant waves on the graph take a while to level out. It seems that after many years on the insulin regime it takes longer to level out the bumps. I recently started taking an insulated bag with honey, apples and insulin all the time unless I forget. That seems to be helping. The sooner I get on top of the out of range the quicker the waves level.

    I've found that all devices are quite inaccurate at times. And at some times when both devices agree, I have a low feeling at different levels to other times. That's confusing.

    I am wondering if adjusting digestion could help with hypo thing in some instances. Particularly when one is at the stage they want to eat something the size of Tasmania and overdo it. As far as I know, about 30% of the carbs are absorbed in the mouth and we are told that nothing more is released to the blood until it leaves the stomach. So, hard as it is, keeping the sugar source in the mouth as long as possible should help. I guess that is why sucking a barley sugar was the option we were given decades ago. When we get to the stomach little is released until it is fine liquified chime. I wonder if, when having had enough carb and little effect and knowing that more is going to produce a hyper effect, drinking enough water would cause the stomach to release some chime early, carrying carbs to where they can be assimilated? Not the best for digestion but may help the hypo thing. This is what Dr Google said:

    As you drink water, it enters your stomach and is quickly processed through to your small intestine. The large intestine (colon) also absorbs some water. Nearly all the water is absorbed into the bloodstream from the small intestine.

    The water surely carries the dissolved sugars???



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    Cheers
    Cris
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  • 38.  RE: Let's talk hypo treatments

    Posted 4 days ago

    Chris & Michelle et al:

    1/  through this forum, I discovered gastroparesesis (slow stomach emptying ) which might explain why "we" occasionally might continue feeding hypos with no effect and then, at some point, the stomach empties the accumulated carbs which causes a hyper swing.   According to wikipeadia, diabeties is a risk for  gastroparesesis (damage to the vagus nerve). I wonder.....

    2/  I agree that drinking any fluids increase the rate of bgl increase (even water).

    4/ the self-competition to stay in range is a strong motivator to over-react.

    3/  maybe gastroparesis could be another topic for a DA expert panel session ?

    All the best.....



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    Jock
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