Wednesday, June 15, 2011

To Carb or Not To Carb

I am not a fan of the rule “must have fast acting sugar along with slow acting carbs” for a low reaction. In the past, before CGM days, I had called the paramedics a few times for bad lows when Vince went unconscious. They insisted he have slow acting carbs in addition to fast acting carbs. If we refused transport to the hospital, which we did because once his sugar was up he was fine of course, they require to see you consume the slow carbs before they leave. Also, I put this in quotes because everyone responds to diabetic care in a different way. I believe paramedics are trained in immediate diabetic care, not the long term care, which comes into play when over correcting. In Vince, most of the time this rule results in over correcting and a very high number hours later that he is chasing with a bolus to get back down. Normally, especially with his CGM tracking his numbers, if he is low, he will have a cup or two of soda or juice to bring up his low. This normally brings it up to a decent number and he is good to go. One of the only times he eats carbs with the sugar, such as a sandwich or crackers of some type, is if the low is near mealtime and he is going to be eating anyway, or if he is active, say at the beach and is sweating a lot.
Last night (early morning) his CGM starting beeping low. He tested and he was running about 50. I got him a cup and a half of sweetened iced tea, he gulped that down, and we went back to bed. I woke up for work and realized he was not in bed. He said he got up earlier and was still low so he had a “carb filled” snack/breakfast to boost him up. He knew this was more than he would need so he gave himself a small bolus for the food. When I left for work, he still had active insulin in his system and it had been a few hours since he ate. This made me nervous, coming off a low, so I reminded him I would call him in a few hours to be sure he was okay. When I checked in with him later in the morning, he was 165. Not bad for all the correcting and eating going on.
Just a reminder to us to pay close attention to details and always treat each situation as needed. A one-time fix such as, “always eat xxx food when your low” doesn’t work.


  1. Hey, it's the mantra of Your Diabetes May Vary - what works for one may not for another. I've not heard anyone say before, though, that they're able to maintain a BG level post-Low if they've only eaten the juice or fast-acting carbs. While it's not good to combine slow-acting with fast-acting, because it slows down the absorption, the rationale for following up with cheese/crackers/etc is to keep it at that level you've just used the glucose tabs, juice, or honey to get it up to. It's like a quick boost, and then making sure it stays put over time. But again, you're absolutely right: to each their own, and any blanket rule across the board is likely to fail because YDMV.

  2. Lol yep, a lot of the time a cup of soda or juice does him just fine. Other times, such as insulin still active in his system, he may need s bit more, but not all the time. A lot, it just ends up overcorrecting him. I think it boils down to how much active insulin is on board :)

  3. i have to agree those rules dont work for everyone. when we went into hospital following a low they gave Reuben (then, just over age 1) 2 peices of toast! im like, wtf? he never eats that at one meal sitting let alone to get a blood sugar to hold following a low. that is a true recipe for needing insulin to cover it in a short while. crazy. also the 'amount ' of juice or lemonade the hospital prescribe is insane.
    my guess is they didnt have much experience with long term care, or babies for that matter.

  4. Yep...I actually do not let Joe eat "slow acting" carbs when he is low...I wait for him to come up and then if he wants he can have a snack or what-have-you. And...everyones body reacts to different foods and insulin and activity differently. I think everyone should do what works for them... for sure.

    Love that you call to check on him. You are uber-awesome Sandy.

  5. Reyna, it is more like I am uber paranoid lol but I have to say, I have caught some bad episodes by checking in and racing home to rescue him so I allow (and so does Vince) myself to be uber-paranoid and contue to call lol

  6. Sorry, I'm a new reader so I don't know if you have already discussed this prior. Have you two discussed getting a diabetic assistance dog? They prevent lows before they happen by smelling the change in the pH balance on your breath. I've been researching dogs at both Can Do Canines and Scent Angels. Just a thot.
    Keep up the good work! (((hugs)))