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    Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

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  • Living with diabetes blog

  • Sept. 7, 2012

    Be ready to treat hypoglycemia

    By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

23 comments posted

Controlling Your Diabetes

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In the United States — maybe elsewhere, too — there is a popular saying: "Do as I say, not as I do" — meaning, "Don't imitate my behavior, obey my instructions."

Tonight, I went for a walk with my husband, who uses insulin. Every day, I educate people on how to treat low blood glucose (hypoglycemia). You know the recommendation: Always carry carbohydrates to treat hypoglycemia. Well we did that, but we left them in the car, which doesn't do much good if you're a mile down the trail and you experience hypoglycemia.

Indeed, we'd walked a mile when I noticed that my husband was breathing a little heavy and looking pale and sweaty. I had to run back to the car, grab the fruit snacks and run back to him. The fruit snacks did the trick and he is just fine, but I sure felt sheepish.

Here's a quick review of the American Diabetes Association's "rule of 15" for treating hypoglycemia.

If your blood glucose is less than 70 mg/dL (3.9 mmol/L):

  • Treat with 15 grams of carbohydrate.
  • Check blood glucose in 15 minutes.
  • Repeat treatment every 15 minutes until blood glucose is in your goal range.
  • If you've treated for hypoglycemia three times, seek medical attention.

Some easy-to-carry items that contain 15 grams of carbohydrate are:

  • Glucose tablets (three 5-gram tablets or four 4-gram tablets)
  • Five pieces of hard candy
  • A tube of glucose gel or frosting gel

And, most of all, do as I say, not as I did! Carry a carbohydrate with you at all times to treat potential hypoglycemia. We certainly experienced a scary situation and learned that lesson the hard way.

Have a great week!

Peggy

23 comments posted

blog index

  • April 17, 2013 11:25 a.m.

    Deborah: Yes, physical activity does help to reduce blood sugar levels. Exercise helps the body use glucose without needing insulin. If you are on insulin or a sulfonylurea you should test your blood glucose before, during, and after exercise. You also should carry hypoglycemia treatment with you.

    - Nancy and Peggy

  • April 3, 2013 8:53 p.m.

    I'm having symptoms of hypoglycemia lately. Does physical activity reduce blood sugar levels? At what point should I consider testing my glucose levels?

    - Deborah

  • April 2, 2013 11:29 a.m.

    High fat meals slow the absorption of glucose and causes high blood glucose hours after the meal has been consumed. If you take the rapid insulin prior to a high fat meal, such as pizza, you may experience a low blood glucose because the food response is delayed.

    - Nancy and Peggy

  • March 26, 2013 12:58 a.m.

    I have been diabetic, type 2, for 25 years. I have never been to an endocrinologist, just Family Practicioners. I have recently been having trouble keeping my glucose levels up. I have not changed my diet. I have adjusted my Novolog and Lantus, but the levels are just wacky! Tonight, after a carb heavy dinner at friends, (beef & bean burritos, chili, cheese and onions, iced tea, and apples) glucose level was 71. I was shaky. Ate peanut butter and bread. 2 hrs later, 129 and falling! Has my pancreas, miraculously, decide to work again or am I just gong nuts?

    - Dawn

  • March 11, 2013 3:33 p.m.

    Joy: Sorry that you feel that my example is upsetting. Alas, I am only human! :) My husband helps me in so many ways and as his wife a reminder to grab the fruit snack or other hypoglycemia treatment is fair payback. That's what marriage is all about.

    - Nancy and Peggy

  • March 10, 2013 5:39 p.m.

    Peggy, You are setting an upsetting example. Your husband should be embarassed that he did not have a fruit snack with him, not you. Perhaps you both have come to believe it is your responsibility to care for his blood sugar. He is a big boy. You both might consider letting him act the part.

    - Joy

  • January 27, 2013 9:47 a.m.

    The 15/15 rule is so important to remember and yet easy to forget. I am a Certified Diabetes Educator and through the years patients have taught me about how they treat hypoglycemia. Some patients like to treat with 15gm carbohydrates snacks that are easy to chew and carry such as raisins,jelly beans or other jelly like candy. The ADA also recommends having a meal or snack within 30 minutes after recovery.

    - Jane

  • October 24, 2012 12:36 a.m.

    I recently have been seeing a different doctor for my low blood sugar. My meds were changed to Acarbose and combined with Verapamil which is a high blood pressure med that helps keep my low blood sugar from bottoming out. At bedtime, I take Losartan, another blood pressure med, which keeps my blood sugar from bottoming during the night when I don't have access to food or knowledge of low blood sugar. I finally feel happy I have somewhat of control of diabetes.

    - Robbie

  • October 9, 2012 2:22 p.m.

    Intranasal glucagon, I hadn't heard of this until I read this blog comment. Sounds like a good idea. From my web search I don't see that it is available on the market and is still in research.

    - Nancy and Peggy

  • September 24, 2012 8:43 p.m.

    Is intranasal glucagon available for a hypoglycemic emergency? I haven't seen anything about it recently.

    - joyce

  • September 23, 2012 12:17 a.m.

    Hi! My 16 y/o daughter was having several symptoms from a-z. I took her to her Pediatrician who did fasting blood work and urine. He called me today requesting we come to his office first thing Monday morning, that she was hypoglycemic. I have a copy of all her labs and there is something that has left me confused. Her fasting blood glucose level was only 48 BUT her urine keytones were >80. How is that possible?

    - DeAnne

  • September 18, 2012 2:33 p.m.

    Pre-diabetes, if the blood glucose continues in the pre-diabetes level and you feel you have done what you can with exercise and weight loss, see your provider. Often the liver is putting out extra sugar early morning and there is a medication often used in pre-diabetes that is an option for you.

    - Nancy and Peggy

  • September 18, 2012 2:26 p.m.

    Insulin pump therapy may reduce the incidents of severe hypoglycemia over a multiple daily injection program. The insulin pump is a tool and is only as effective as the person using it.

    - Nancy and Peggy

  • September 18, 2012 2:24 p.m.

    People with hypoglycemia unawareness don’t experience the classic symptoms of low blood glucose. Instead, without warning they can lapse into severe hypoglycemia, becoming confused, disoriented or falling down unconsciousness. With longevity of diabetes and extreme variability of glucoses; the individual loses the epinephrine response to low blood glucose along with warning symptoms

    - Nancy and Peggy

  • September 18, 2012 2:15 p.m.

    Hypoglycemia is low blood glucose.

    - Nancy and Peggy

  • September 17, 2012 6:31 p.m.

    My Dad was diagnosed with diabetes but is able to control it with his diet. The problem is he has lost too much weight. How can a diabetic gain weight safely without compromising his diabetes?

    - Linda

  • September 12, 2012 10:52 p.m.

    Hypoglycemia unawareness is a major concern too. Guess we should make the bracelet common, especially for people who cannot identify hypo by themselves.

    - DoctorSpring

  • September 12, 2012 3:01 p.m.

    Hypoglycemia is low blood sugar. Think anything under 70 is considred low. Think you are more apt to have it if you are on insulin. I have been a Type 1 35 years. Type 2's can have it.

    - Linda

  • September 12, 2012 12:05 p.m.

    What is the difference between hypoglemia and type 2 diabetes?

    - Carole

  • September 12, 2012 11:41 a.m.

    I never leave home without glusoe tablets or a small box of juice. I no longer know when I am low unless I am reading and can't see. I test at least 7 times a day.

    - Linda

  • September 12, 2012 6:22 a.m.

    I am 51 years old and have been a type1 diabetic for the past 38 years. In 1988 I experienced a hypoglycemic coma which lasted several hours. Ever since I regained consciousnes my memory has not been the same. Even up to this day I have extreme problems with my memory. Now I am 75-85% of the time quite unaware of when my blood sugar level is too low. Last year it was confirmed that a degeneration of the brain was taking place due to my sometimes inability to experience any symptoms of hypoglycemia. I am of the opinion that a subcutaneous insulin delivery system would be the only answer....... Any advice or opinions on this subject would be greatly appreciated.Thankyou.

    - Trevor

  • September 11, 2012 1:43 p.m.

    what is hypoglycemia

    - fran

  • September 11, 2012 10:52 a.m.

    I keep testing Pre-diabetic glucose levels. How does one deal with this? I have lost weight, eat low fat, low CHO, whole grain meals, lots of fruit * veggies, exercise, and still test the same. No history of diabetes in the family.....

    - Connie

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