Yes - glucose tabs are great for rapidly raising low blood sugar and they are unique in how they do it compared to alternatives. This story that you shared has several areas for further discussion:
- Special care to clean fingers after taking glucose tabs (ie - residual glucose on the fingers provides false high readings) vs. alternatives that come individually wrapped.
- Differences in test strips when dealing with high altitude (ie - 1% to 2% diff for each 1k feet elevation; source: Kenneth S. Fink, Dale B. Christensen, Allan Ellsworth. Diabetes Technology & Therapeutics. December 2002, 4(5): 627-635. doi:10.1089/152091502320798259.)
- Chocolate (or other high fat carb sources), how they effect blood sugar and when it may be more appropriate to use vs glucose tabs.
In the first instance I discovered the residual glucose only after bolusing insulin to correct a night time high blood sugar 25 minutes after treating a severe low. How many people don't catch this mistake and end up with severe lows or seizures self-induced just because they handled the glucose tab and didn't think to wash their fingers before the next time they checked?
Thanks David!
For emergency situations, we always have Insta-Gucose on hand. This is what the paramedics carry in their emergency vehicles. It comes in a plastic tube which snaps off. Liquid glucose is absorbed very rapidly and can be rubbed on a diabetic's gums if his blood sugar drops really low.
Joan
i agree- one issue that wasn't discussed here was absorption- liquid is better than solid, so OJ is better than GLC tabs, if available- also better for gastroparetics who go too low- and absorption is another argument for why chocolate is worse, because the fat will blunt the GLC spike, tho as another poster pointed out, in some circumstances this may actually be more desirable
Another factor re: how low I should go is what medication, if any, I am taking to control my diabetes. A basic rule of thumb: The greater my usual dose of sulfonylurea or insulin, the more conservative I should be re: my lower end of target BG range.
Corollary: If I am on a sulfonylurea and/or insulin and my BG is frequently @ the lower end of my target range, it is time to consider decreasing my medication, either temporarily or permanently, based on my circumstances.
I don't like eating anything artificially preserved, colored or flavored. So why does glucose tabs have all the artificial junk in them? Why not take a pure form that's a better source and better for you? Trouble is, it's not available... I was told that the only source for dextrose in bulk, appears to be available at brewing supply stores for making beer. Seems to me, someone ought to make a natural flavored variety for those who would really like to maintain their BG levels in the healthiest form possible!
Dear Barry,
That's a good point, which my friend Karen dealt with when she wanted to give herself a glucose tolerance test without going to a doctor. She bought dextrose (exactly the same as glucose) somewhere. You might want to ask her. And if she bought it in bulk, she probably could send you some.
Best regards,
David
Whether or not a particular number is low depends on your meter and your physiology. If you feel low, then you are low (but if you don't feel low, you could still be low).
What was missing in this scenario was Mark's therapy and any knowledge of whether he was on the way down (then 75 could quickly become 55) or holding steady.
If he is type 2 and was simply a little low for him but holding steady, then I'd agree with him that you might as well eat a little of something you enjoy but don't eat very often, like some delicious fruit or a small piece of bread. In that case, the speed wouldn't matter much.
But if he was on insulin (or a sulf) and thought he might be falling fast, then the glucose tabs would definitely be the best solution.
One problem for a type 2 is that by the time you're feeling symptoms, your counter-regulatory hormones have kicked in so whatever carbs you eat will probably make you go higher than you expected. I've had a LC meal send me high when I eat right after a low.
I read somewhere that milk was as good as any tablet. Is that true?
Thanks for asking, but that is sadly another example of the terrible information you can find on the Internet from dumb sources. Milk is a terrible choice! It is, of course, liquid and totally unsuitable when you are out and about. It's probably a terrible choice for anyone but children in terms of our health. But even more to the point it is a terrible choice because it has such a low glycemic index, which means that it has little impact on our blood glucose levels. While glucose has a GI of about 103, the GI of full-fat milk is 39. The GI of skim milk is even lower, 37. See http://www.mendosa.com/gilists.htm
Best regards,
David
I've used glucose tabs on occasion but have found that it can sometimes push me into a hyper condition. I picked some Glucose Rapidspray from a local Rite-Aid. It is a sub-lingual spray. The difference from the tabs is that is delivers a micro-dose in comparison. Despite that the glucose is absorbed very quickly and there is a noticeable difference after 10 minutes or so. My first test was a rise of 10 points in a 10 minutes. I don't think it will completely normalize a hypo condition but, considering it is a small pocket unit, it is very practical as a stop-gap measure until one can get something to eat. I used it once while driving and perked right up after a bit. More info at http://www.glucoserapidspray.com/
It was interesting to read your opinion on the glucose tabs. I, however, have not experienced that to be the case for my daughter. She is Type 1 diabetic, on a pump, and very athletic. She is 10 years old, 55 inches tall and only 60 pounds. When she is "low" she very rarely responds to juice or glucose tabs and its very frustrating as they are the easiest to store in her "kit" that she always has with her. She seems to do better with Gatorade and for those times (which happen at least half the time) when her glucose level still doesn't raise up (sometimes even will drop lower!) she will have a yogurt or chocolate milk. The protein in these items seem to "work" for her. Anyone else have this experience? Thanks!
see my reply to comment one above. I too believe it is the protein that smoothes things out and better yet holds them there. I agree that insulin dependent diabetics may have different issues than I do but even if I need a quick boost I find it better to follow it with some protein - I favor tuna fish, my Mom favored peanut butter on thin sliced diet bread.
From a medical stance, I cannot dispute the assertion that glucose tabs are best. HOWEVER, one early morning many years ago, I woke up and my level was in the low 60's. Very groggy, I gulped a glucose tablet which immediately got stuck in my throat. I was seriously choking because the tablet was the size of two or three quarters or Necco wafers. Fortunately, I had some water at my bedside and poured some down, which sufficiently dissolved the tablet to allow me to catch my breath. After that, I switched to M&M's at my bedside. I'd grab a handful and go back to sleep. I don't have lows anymore with much better control of my BG, so this is an old issue for me and the M&M's are long gone away. But, whoever designed those glucose tablets apparently didn't figure that people half awake might gulp one or two down and choke to death. Then again, that would certainly end one's diabetes! Hmmm. Great cure...!
Hello David & everyone,
Just had to throw my 2cents in here-- I'm T1 for 30 years, on insulin pump for 11 years, very brittle AND I have hypo unawareness. Also gastroparesis, but I'm trying to reverse/"better" that and the hypo unawareness if I can!! My A1Cs average 7%. I have multiple lows weekly, that is just how my body has always been! I can be 100, and then 30 within in an hour or less, even when I'm just sitting around & 2 hours after eating a meal!! ...That said, eating 3-4 glucose tabs almost every single day costs TOO much money!! I used to buy 2-3 big bottles at a time, and they're hard to chew up quick. Forget buying those skinny expensive tubes of glucotabs too, those only last 2 lows for me!
So for the past 10 years+ my solution is to carry rolls of "Smarties" in my purse, pocket, fanny pack, lunch bag etc. Each roll is 5g carbs, so 3 rolls is 15g. They are easy to open, just twist the cellophane. They are small, easier to chew quick. They don't go stale! You can buy a big bag of them at the $1 store!!! They don't melt!! Eat 3 rolls and no over-carbing a low!
Too many diabetics eat horrible choices when they have a low!! NO chocolate! It's high fat, takes too long for the carbs to kick in, it's fattening & it melts!!
My 2nd choice for lows would be 2T light pancake syrup, IF at home (or in a restaurant LOL). My 3rd choice would be 2 graham crackers- yes I know that's 24g of carbs, but just 1 graham doesn't cut it for me...
If I don't get enough carbs quick up front sometimes tho, I can bottom out again, back to back...I have had lows, get 15g carbs, retest, then 15g more, then retest in 15 mins, and another low within an hour or less!! Not fun! But that's just me.
I have had 7 low blood sugar comas, my record low blood sugar is 18!! (no comas since 1993, knocking on wood & my head! LOL) ... I can be very concious, communicate sensibly talking & make myself something to eat (sandwich, yogurt, fruit & drink) at 30, so I don't take any chances!
I live alone too, so between cheap cost, quick access & easy carry-ability, I chose those Smarties over any other hard candy too--ever had a low & tried to open a piece of hard candy & the plastic clear wrapper is melted onto the candy?!??! Yikes!!! You end up crunching the candy & spitting out the wrapper in pieces!! LOL
1/2 can of soda--GAG! too sweet! makes me nauseous just to think of it!! too easy to drink the whole can, so too much sugary carbs!! I don't want to gain weight from sodas either!! Talk about a bad rebound headache too! dang!!...
Reen1960 you are the FIRST person I have read about so far that has teh same problems I have. I so appreciate your awesome tips, look me up. thedudeyouremailing@gmail.com I just got slammed really hard with this hypoglycemia and is crushing my ego. Im so depressed and scared to go anywhere. I ve been to so many dr's and ER's . Spent several thousand in just teh last 2 weeks rushing to find answers. Im slowly getting a good picture of whast going on now. I really thought I was dieing and still cant accept its just hypoglycemia. But the reality id all have to do is eat sugar! Yes it does take me out of the death zone. But even though Im upto 140 I still like crap. As soon as I do excersizes, walk or do any kind of labor I get low again. And my low starts at 80. I know I have minutes to get sugar or Im seeing baby Jesus if I dont. Id like anybody to email me and educate me on this serious condition cause I just started getting this and need answers. I dont have any more money to give Dr's plus they dont seem to care anyway. I do appreciate this. Its my life and I must keep goin for my kids sake.
I also favor the use of glucose tablets to correct low blood sugar. I carry a package of them in my purse at all times as I am a Type 1 diabetic using insulin, and sometimes go a bit too low. I don't agree with the rule of 15, however. I think you need to know your own sensitivity to glucose and plan accordingly. I know from experience that one glucose tablet (4 g of glucose) will raise my blood sugar by 30 counts. It is quite predictable, especially if taken on an empty stomach. When my blood glucose is at 60, I begin to feel symptoms of low blood sugar. I measure my blood sugar, and would take one glucose tablet to correct, expecting a rise to 90 over the next 15-30 minutes. If I were to simply follow the rule of 15 and take 4 tablets, my blood sugar would go up by about 120 counts, bringing me to 180! Not good. Again, you should do the experiment on yourself, and know how glucose tablets affect YOU!
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75 isn't hypo, in fact it's pretty close to normal. My BGLs stay in the 80's & 90's and do dip into the 70's though not as often as I would like. Unless you are consistantly running high 75 should not be an issue.
Hugs,
Gracie
I think it depends on one's meter and establishing a record of one's reaction. Personally I can tell when I go below 79. If I were 75 and in the course of activity, I'd want to get it a bit higher before I encounter a trail situation.
I was a pilot and trained that anytime over 12,000 feet to have oxygen. Even driving from Denver to Grand Juction I get lightheaded knowing that I'm over 10,000 feet. (oxygen when between 10,000-12,000 for more than 1/2 hour). The sensation is much like being low. Therefore I'd want to make sure that my blood sugar is a little higher so that low oxygen and low blood sugar don't become an issue at one time.
That would be a bad combo! For me I feel great at 75, and have not had a hypo episode in over 18 months, but each of us is different, and the amount of physical stress you are under is also a factor.
Hugs,
G
It is all relative.
For me to see anything at or below 80 (other than at morning fasting) is when I'm testing because I already have 'crashing' symptoms. If it is above 40-50 I treat with tuna fish because even though it comes up slower it holds better AND I don't risk over eating like with candy. The tear open packs are easy to carry in a purse or backpack.
Below 40 I do the glucose or candy and follow with tuna fish.
Though you contend that 75 isn't hypo, for some patients it is hypo and we feel it. Great for you staying in the 80s and 90s.