Low blood sugar: one size does not fit all

Treating a low blood sugar is much more complicated than diabetes docs and educators make it out to be. The usual advice? Simply eat 15 grams of carbs and wait 15 minutes to see if your blood sugar goes back up to normal. What's wrong with this thought process? This scenario can lead to high blood sugars or send you right back down again depending on the circumstances.

A low blood sugar in the middle of a soccer game requires much different treatment than a low blood sugar in the middle of the night or during your workday. Some lows would do just fine with only 5 grams of carbs while other lows could easily require 30 grams or more, along with some fat or protein, to truly come up and remain at a safe level.

My personal fave low blood glucose tricks 💡

I like to use fruit snacks, jelly beans, and, for the more severe lows, a GFB bar. I like using the bars when, for example, I’m chasing my kids around a playground and I know I’ll go low again if I only eat pure carb. I like using the fruit snacks or jelly beans because I can eat just 3 or 4 for a minor low, bringing a blood sugar of 60 mg/dL up to 90 mg/dL. If I were to eat an entire apple (what many HCPs might recommend), I would be up at 160 mg/dL. I can also treat many lows or one severe low with just one little pack of fruit snacks. And they don’t melt or mold if they sit in my car!

For those middle-of-the-night lows 😵

These can be tricky! It's the middle of the night, you wake up in a cold sweat and fuzzy in the brain, and it takes a few minutes to figure out exactly what's going on. Sometimes you don't even “come to,” you just head straight to the kitchen. This is middle-of-the-night beast mode for a person with diabetes. Your body is full-blown trying to survive, and you need sugar.

I sometimes use an overripe banana from the fruit bowl, because I hate bananas. I’ll usually only eat half of it, or all of it for a severe low, chug some water, and quickly fall back asleep. Remember: those bananas are carb-heavy! So I know, even with a severe, night-time low, eating an entire banana probably isn't in my best interest.

Another major pro-tip, especially for night-time lows: glucose gel and/or glucose tablets on your nightstand. There's no trudging to the kitchen and overeating everything in sight. Instead, simply roll over in bed and crush some gel packets, or glucose tabs! It may not the be the tastiest, but both get the job done, and FAST. ⚡️

I asked my diabetes Twitter community how they treat their lows, and here’s what they shared about what works best for them:

 

“If I’m trending low [on my CGM] and it’s bedtime, a small bowl of Cheerios guarantees a U-turn. If I’m in the 60 to 90 mg/dL range during the day, a pack of peanut butter crackers is enough but not so much that I would bounce high. If I’m driving and less than 70 mg/dL, about half of a 10 oz bottle of Coke is a quick-acting treatment for me.” Moe Giguere

“We use Smarties. A whole role is 6 grams but you can eat just a few if only a small bump is needed. We also use Fairlife Milk if my child’s blood sugar is in the 90s but trending lower [on the CGM].” Lauren the “Insulin Narwhal”

“Mini-juice boxes are just enough because the regular sizes always lead to a high. Plus the dollar store sells the mini boxes in sets of 4 for only $1.” D with T1D

“Our stash of Annie’s Fruit Snacks and juice boxes is as plentiful as our test strips stash! 14 to 17 grams of carbs in a serving.” Type One Dad

“I mix dextrose powder with a packet of Kool-Aid. It is 10 grams per tablespoon so I just add 1.5 tablespoons to a small bottle of water. It’s super cheap and an accurate hack for raising your blood sugar fast. And you can switch up the flavors, too, with different Kool-Aid packets.” Howard Kramen

“Starbursts work great for me and they’re delicious. Little hard to eat for middle of the night and early morning lows, though. I often find that treating with liquids only sustains me for a little while, and then I drop back down, so having a little carb helps avoid crashing again.” Aly Crofford

“I treat my lows by turning my pump off or setting it to a lower temporary basal rate. If I’m really low, I will use a glucose tab. I try not to over-treat.” Susan

“If it’s not too low, a Hoodsie ice cream works great. The best childhood ice cream treat ever! It’s the right amount of carbs and fat to treat a not too serious low. You don’t even need a spoon!” Kristin Percy

“We do glucose tablets and a small bite of peanut butter. If she’s going to be active, we may do a ½ Graham cracker with the glucose tab. Or sometimes we use a DumDum lollipop (which is 6.5 grams of carbs) if we feel she needs more than just a glucose tab.” Amy Knueppel

“If possible, I have a seat ‘cause moving around during a low just makes it worse for me. I would usually take a banana or a cookie, and have some milk. Worked well for me, especially because my lows happen more often in the night.” Joel Wijey

“Gatorade chews! Same amount of carbs per chew as a glucose tab but not chalky. These are our go-to for sports because they are super-fast, but easier to consume when you’re hot and sweaty.” Lauren Melton

“Chocolate milk. Because it has a lot of healthy, muscle-building protein. And it tastes good.” Christi Funkhouser

“Skittles! They’re about 3 grams of carbs per Skittle, so we can adjust how many carbs he eats based on how low he is.” Erin

“I have found that Snapple iced tea works well and also soft jelly type candies. Not an entire bottle of iced tea, though. I just sip some and watch my Dexcom. I think it’s very particular to each person how many carbs they need and how based on how low they are.” Risa Pulver

“We use the mini cans of Coke, it’s our ‘hypo cola’ for my daughter, and I find it helps very quickly, which helps prevent over-treating. There are 12 grams of carbs in one can.” Gayle Devlin

“Has to be liquid for me! Sweets, etc. don’t work quickly enough and I end up going lower before coming up. I use cola, and I sip and watch my CGM. I find the 150 ml (5 oz) recommended by my healthcare team is too many carbs -- I just spike!” Laura Cookie

“I’m old school. I was diagnosed back in 1969 and the practice then was to administer 16 grams of sugar (or orange juice, part of a Coke), wait 15 minutes and check again. I’ve always done better with glucose tablets or sugar as opposed to a sugar source like O.J. These days I use sugar packets because it’s cheaper.” Elizabeth Kamporo

 

Did we miss any hacks?

Let us know! What's your go-to secret for treating lows? I'm always up for learning new, inventive ways safely get my BG levels back on track, quickly and effectively. Give us a shout here, here, or here with your low blood sugar treatment hack!

 

For even more info on treating low BGs, check out the official One Drop Guide to Handling Low Blood Sugar!