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How to Treat Lows Without Sabotaging Your Diet (or Your Blood Sugar) – Diabetes Daily

Diabetes is basically a never-ending test of willpower, and there are few tests more frustrating than properly correcting a hypo. Your challenge: consume just the right amount of sugar, enough to pull your blood glucose into a safe range, but not too much to send it high. This exercise will be performed under immense stress and in an impaired mental state, and may require advanced math skills and superhuman self-restraint.

We’ve all been there—hypoglycemia hits you like a ton of bricks and leaves you weak-kneed and trembling, and your body is screaming at you for the one thing it needs: sugar! It can feel like every bone in your body is pushing you towards the snacks, and before you know it you’re shoving food into your mouth, blowing way past the modest amount of carbs you actually needed.

Binge eating during a hypo admittedly feels great for a few minutes, but it almost always ends in regret. That blood sugar is about to skyrocket back up to the stratosphere, and might require an insulin correction to bring it back down again, triggering the dreaded rollercoaster. Not to mention what your emergency indulgence might have done to your diet—people with diabetes are not generally known to reach for the healthiest treats when fixing a hypo.

The standard advice, the so-called “15-15 Rule,” is a fine starting point, but advanced diabetes management can benefit from a more subtle approach.

Here are some strategies that might help you treat blood sugar lows without sabotaging your blood sugar or your diet:

Go Boring

The yummier your hypo solution is, the more likely you are to overeat. As fun as it is to use a mild hypo as an opportunity to indulge, this is exactly the wrong time to dig into that box of cookies you’ve got squirreled away. Save those treats for a time that your blood sugar is acting predictably and you can bolus responsibly.

It’s much better practice to view the food or drink you consume to correct a hypo as medicine. Because that’s exactly what it is, a medically vital intervention to be dosed precisely. Hypoglycemia is a serious business.

So, go boring with your hypo rescue solution, the more boring, the better. One reason that experts recommend glucose tabs is that they don’t really taste all that good. That’s a feature, not a bug: medicine isn’t supposed to taste good.

Listen to Your Body – But Not Too Much

The classic symptoms of hypoglycemia—shakiness, hunger, and so on—constitute a critical warning system that you should heed seriously and quickly. (The unlucky minority of patients with diabetes that can no longer feel these symptoms are at a greatly enhanced risk of severe hypoglycemia.)

But as soon as you’ve ingested the proper amount of carbohydrates, it’s time to start ignoring those body cues. You may still feel awful, but you need to let the sugars in the food you’ve eaten get into the bloodstream. The standard advice from medical authorities is to wait 15 minutes before checking your blood sugar, and only then think about applying another dose of carbohydrates.

An early study of this topic showed that people with diabetes that treated their hypos by eating “until they felt better” had A1c’s 0.5% higher than those that scrupulously avoided overeating. That’s a huge difference.

Know your Carb Count

Individual candies and glucose tabs are great because the portions are controlled and identical. A single Skittle is always about 1gram of sucrose, every time. Cereal or orange juice? Not so easy to be precise, unless you have the rare presence of mind to break out the measuring cups or kitchen scale during hypoglycemia.

Understand Your Glucose Trends

The standard recommendation of 15 grams of carbs to treat a low may be more or less than you need, depending on how quickly your blood sugar is moving.

If you have a load of fast-acting insulin on board, or if you’re in the middle of an exercise, you might already know that you need more than just 15 grams. A continuous glucose monitor and its trend arrows can make this decision even easier to make.

Alternatively, if your blood glucose level is fairly steady and there’s no reason to suspect that it will drop precipitously, just a few grams of sugar may be all you need to bump it back up into a safe area.

Avoid Fats

When you opt for more complex snacks than simple sugar candies—say chocolates, cookies, or potato chips—you’re usually letting a lot of fat come along for the ride. Those fats might taste good, but they’ll probably just slow down the absorption of the carbohydrates. The longer it takes for your blood sugar to rise, the longer it leaves you in uncomfortable, ravenous limbo, making it more and more likely that you’ll overeat.

And it should go without saying that those added fats are not doing much good for your diet. There’s not a dietary authority on earth that wants you to reach for that sweet, starchy junk food.

Avoid Fructose

The juice box has been a mainstay of hypoglycemia treatment for decades, especially for kids, but it’s not actually the best option for speedy corrections. Why not? Fruit and fruit juices have more fructose than glucose, and fructose, which first has to undergo fructolysis in the liver, is metabolized more slowly. Several studies have found that fructose’s treatment effectiveness is “significantly lower” than that of sucrose or glucose.

It’s also an unfortunate fact that the healthier a fruit product is, the less appropriate it probably is for hypoglycemia treatment. For one thing, less-processed fruits, juices, and snacks are more likely to contain fiber. That’s certainly healthy in other circumstances—fiber slows the absorption of sugar—but in a hypo emergency it’s exactly what you don’t want.

Fructose is found primarily in fruits; manufacturers also use it as an additive in many mass-produced food products, often in the form of high-fructose corn syrup.

Binge Healthy Food

Sometimes it seems impossible to restrain from eating. In those moments, you can opt to “binge” on food that you know won’t sabotage your diet or your glycemic management. Take the appropriate dose of sugar or carbohydrates first, and then stuff your face with a lower-carb food that you won’t feel guilty about overeating: try crunchy veggies, almonds, or a source of lean protein like smoked turkey. Sometimes I reach for cheese, which is probably not ideal, but at least I know that it won’t spike my blood sugar.


Hypoglycemia too often compels people with diabetes to overeat, which is almost always bad for blood sugar management, diet, and overall health. You should look at your hypo correction snack as a type of medicine, to be dosed quickly and precisely.

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