From healthcentral.com
Low blood sugar or hypoglycaemia happens when you have type 1 diabetes. Learn how to handle it—or dodge it in the first place
The drop can happen at the worst times—on your commute, midway through a hike, or during a concert. When you live with type 1 diabetes (T1D), a sudden low in blood sugar levels throws you into scramble mode to consume the right dose of simple carbohydrates and quickly bring your numbers up to a safe range. To help you get your game plan down for those inevitable lows, we went to T1D experts for their best strategies—and snacks—for both bouncing back and heading them off.
Heed the 15-15 Rule
Sound familiar? You likely know this golden rule of combatting the lows of hypoglycemia from the American Diabetes Association: If you feel shaky, dizzy, sweaty, or your blood glucose meter reads under 70 milligrams per decilitre (mg/dL), consume 15 grams of fast‑acting carbohydrates, wait 15 minutes, then recheck your glucose. If it’s still under 70 mg/dL, it’s time to take another 15 grams and recheck.
“Fifteen grams of fast‑acting carbohydrate is usually enough to raise blood sugar without causing it to elevate too much,” says Theresa Gentile, R.D.N., a registered dietitian and nutritionist in New York City and a spokesperson for the Academy of Nutrition and Dietetics.
Sounds straightforward, but it can be tricky to judge what that just-right dose is for the job. “Often, the go-to fast-acting carbs are things like orange juice, non-diet soda, and candy,” says Manny Hernandez, the Miami-based CEO of The Diabetes Link, a national non-profit that provides resources, community support, and career opportunities for young adults with diabetes—who is a T1D warrior himself. “The real downside with these options in my experience is that you are not likely to measure the right amount, so you end up over-treating the low, which leads to a spike in blood glucose afterwards.”
Luckily, our experts have ways to help you hit the spot.
The Best Fastest-Acting Snacks
When your blood sugar is below 70 mg/dL, you should reach for something that doesn’t just include 15 grams of carbs—it is solely 15 grams of carbs (sorry, chocolate!). “Fast-acting carbohydrates do not contain fat or protein, which slows down digestion and the absorption of sugar in the bloodstream,” explains Gentile. “They promote an accurate blood sugar reading in 15 minutes and prevent panic-eating.” She recommends juice (about 6 ounces of orange juice or apple juice), honey (about a tablespoon), or glucose tablets: flavoured chewables that provide about 4 to 5 grams of pure glucose.
Hernandez also recommends carrying glucose tabs or glucose gummies, which can be critical when people feel like they might pass out, or if they’re unsure if they can swallow safely.
He’s not a fan of the chalky taste of glucose tabs, however, so he sticks to Glow Glucose Gummies for his own low blood glucose episodes. “They taste like a treat, which makes for something special in an otherwise yucky moment. You take four of them to get the 15 grams you need, then wait 15 minutes and check your monitor,” says Hernandez.
(For lows under 55 mg/dL, those call for 20 to 30 grams of fast-acting carbs; other instances of severe hypoglycaemia when carbs are not sufficiently raising glucose levels may require an injection of ready-to-use glucagon, a formula that causes the liver to quickly release glucose into the bloodstream.)
To ease the angst about experiencing unexpected lows, our experts advise stashing one measured fast‑carb option in several places so that you’re never empty-handed: your jacket, your bag, your car, your desk, your nightstand.
Snack Formula to Prevent Low Blood Sugar
“If you are starting to go low—and you know that your next meal isn’t for a while—the right snack can help stop that roller coaster,” says dietitian Grace Derocha, R.D., a certified diabetes care and education specialist in Detroit, who also serves as a spokesperson for the Academy of Nutrition and Dietetics. Derocha recommends planning for a snack every three to four hours and using her PFF rule: Mix your carbs with protein, fibre, and fun. “The goal is to stay in that normal 70 to 180 mg/dL range as much as possible to help avoid being hangry or moody or not feeling our best,” she says. To that end, these are some variables to consider when choosing a snack:
Protein: “Protein naturally helps to slow digestion and stabilize blood sugars,” says Derocha. Her top picks include nuts such as pistachios, seeds, and roasted chickpeas or roasted edamame. String cheese or a cored apple filled with almond or peanut butter is another favourite—and she tops it with cinnamon. “Some research is showing cinnamon can help stabilize blood sugar—and it feels fun,” she adds.
Fibre: “Fibre helps slow down the digestion and absorption of carbohydrates. It helps to prevent a rapid spike in blood sugar and avoids the roller coasters,” says Derocha. Most people only get about half the grams of fibre they should be getting each day, and she advises aiming for 25 to 40 grams a day, roughly the adequate intakes suggested by government guidelines for women and men respectively. “Snacks can be a great way to get in more,” says Derocha. She recommends whole fruits like apples or pears as well as nuts and seeds. “The best for diabetics are hemp seeds, chia seeds, and sunflower seeds,” she adds, as they combine high fibre, healthy fats, and protein content.
Fun: Derocha likes to remind her T1D clients that snacks are a tool for balance, but one that doesn’t have to go down like medicine. ”In order to be fully satisfied, it goes back to the fun and pleasure,” she says. Dark chocolate, natural dried fruit, or chia pudding (topped with berries, peanut butter chips, and chocolate chips) are all Derocha favourites. For a savoury treat, her pick is tuna with cucumber slices doubling as the sandwich bread: “It delivers a satisfying crunch.”
A Note on Bedtime Snacks
If you regularly see overnight drops in your blood glucose levels, Gentile recommends choosing a small night time snack that’s lower in carbs and higher in protein and healthy fat to get you through the night: a handful of nuts; plain Greek yogurt; an apple with an ounce of cheese; cottage cheese with berries; or a small serving of air‑popped popcorn. Derocha seconds the bedtime snacking tactic: “Protein and fat help sustain glucose levels while you sleep.”
And if your continuous glucose monitor alerts you to a low in the middle of the night, remember to reach for those fast-acting carbs—and try to get right back to shut-eye once your blood sugar numbers recover. “Low blood sugar episodes are always going to be yucky,” says Hernandez. But having a solid plan for safely treating those lows can mean you’ll lose less sleep over them.
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