70 mg/dL, consume an additional 15 grams of carbohydrates. 6. Follow up with a light snack (or with a meal if it is mealtime). Mild to moderate hypoglycemia can usually be reversed rapidly, within 5-10 minutes. Using the “Rule of 15,” blood glucose concentrations increase quickly and you can avoid over-treating by overeating, which could lead to elevated glucose concentrations and an undesired blood glucose roller coaster. The table below lists 15-gram amounts of effective fast acting carbohydrates including glucose tablets, milk, fruit juice, regular soda, sugar, raisins, hard candies, and glucose gels. Avoid foods that are high in fat, such as pizza, candy bars, or doughnuts, because fatty foods slow the absorption of carbohydrates, making the blood sugar rise take longer. However, if the only sugary food you have nearby is a candy bar or a doughnut, it is much better than nothing at all. If you experience
a ‘low’ right before mealtime, go ahead and eat your meal without applying the “Rule of 15” as long as the meal you are eating has sufficient carbohydrate to get your blood glucose back up. Contact your healthcare provider if you frequently experience low blood glucose as your medication may need adjusting.
How Do You Treat Severe Hypoglycemia? Untreated mild to moderate hypoglycemia can lead to severe hypoglycemia and unconsciousness, a situation that cannot be selftreated. It is important to remember that the person experiencing severe hypoglycemia cannot swallow. Force-feeding food or liquid to an unconscious person can lead to choking. Treatment of severe hypoglycemia requires a glucagon emergency kit, which is available only by prescription. Glucagon is a natural hormone that works quickly to increase blood glucose concentrations. The glucagon mixing and administration instructions may
Fast-Acting Sources of Carbohydrates Source Glucose tablets Glucose gel Fruit snacks Raisins Non-diet soft drink Fruit juice (apple/orange) Milk (non/low fat)
Quantity 3-4 pieces (4 grams per piece) 1 tube of 15 grams carbohydrates 1 package 1 ounce 4 ounces (1/2 cup) 4 ounces (1/2 cup) 8 ounces (1 cup)
be confusing during an emergency. To prevent confusion in a stressful situation, it is vital to educate people around you (close friends, family, teachers, caregivers) how to prepare and administer glucagon before an actual emergency arises. Annual reeducation is recommended. Remember to check expiration dates regularly since you do not want to be caught in an emergency with an expired kit. Although some people go years without needing to use their glucagon emergency kits, it is very important for all patients on insulin therapy to have these kits available and to keep them easily accessible. Store them in several places such as in the bedroom, a purse, briefcase or backpack, and let the people around you know where the kits are located.
Bottom Line: Prevent and Prepare To take control of hypoglycemia and avoid severe episodes, prevention and being prepared are essential. Be aware of early warning symptoms of hypoglycemia and recognize when you are more likely to go low. Keep fast-acting sources of carbohydrates such as glucose tablets or hard candies in the car or with you when traveling. Mini 4-ounce juice boxes are the perfect size and contain 15 grams of carbohydrates— keep some by the bed as a quick source of glucose at bedtime or in (Feeling Low, continued on page 9)
Taking Control of Your Diabetes 7