# Night time hypo food



## Monica (Jan 17, 2011)

I've been wanting to ask this question for a while now, but keep forgetting. Last night's incident reminded me again.

What do you eat after you've treated your hypo in the night?

I've made a rod for myself, when Carol was still on Novomix30. Because she had to have snacks during the day, she opted for biscuits (she's not one for fruit). So that was 4 biscuits a day. So I didn't want her to have biscuits at night as well. I persuaded her to have a slice of toast instead. Now she doesn't have to daily biscuits anymore, I wouldn't mind her having them at night (or a flapjack), but she only wants toast!!!!!!

So, any ideas to persuade her to have somthing that doesn't need toasting???


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## Robster65 (Jan 17, 2011)

I used to have a digestive biscuit after treating a hypo. I find now that once treated with jelly babies and/or coke, that I can last through til morning but at her age it's probably a bit different.

A digestive is about 10g normally.

Rob


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## Monica (Jan 17, 2011)

Nobody told us to treat a night time hypo differently to the day time ones. So, 1 slice of toast 15g carb. This usually works, but this morning she woke up 10.4. Normally, after a night hypo she wakes up at around 7. Maybe it was different, because it was earlier in the night than normal.


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## everydayupsanddowns (Jan 17, 2011)

I've never been one for follow-up carbs aftrer a hypo unless I know it's caused by extra activity/exercise. I always found follow-up carbs bounced me high more often than not, though as Rob says it's probably different for young people.

Would a digestives/plain biscuit be worth trying? (10ish g carbs rather than 15-18g for a slice of toast)


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## Robster65 (Jan 17, 2011)

It's very much trial and error. I have a lot less than I used to because I didn't used to test so regularly and didn't see how high I was going in the mornings. 

I try to restrict what I eat/drink now for that reason. If it's a bad one (less than 2ish), I have a bit more, but if I'm in the 3s, I'll just have a couple of jelly babies maybe and go back to sleep after 10 minutes.

I can't remember how it was when I was a teenager. I think the few I had were quite severe on the old insulin regime.

Rob


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## bev (Jan 17, 2011)

Hi Monica,
The current thinking is that there is no need for a long acting carb after a hypo. Treating with 15 carbs (i.e.can of coke or similar) is enough for a hypo - as long as levels are back within range after 15 minutes. Overtreating a hypo is common - but if I were you I would just give Carol a coke (or glucotabs) in the night as this is enough. I would not be making toast any time during the night anyway. If this is common, perhaps you need to think about changing the basal or splitting the injection.Bev


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## Monica (Jan 17, 2011)

No, Bev, it doesn't happen often. This one must have been brought on by "exercise". Carol goes out to meet friends and I don't know how much walking they do. We've had trouble before that she always comes home very high (19 sunday before last), as she just doesn't realise she's hypo (I've told her to test halfway through the afternoon, but as I'm not there....). So Yesterday I told her to reduce her lunch insulin by 2u. This seems to have worked, as she was 9 when she came home. Then after dinner, she went out again for another hour. She did have something to eat before bed, but it seems it wasn't enough. I'm a bit too scared to not give her a snack after glucose, but I guess I could try to half the carb afterwards e.g. one biscuit to start with to see if that's ok. As to testing again after 15 minutes!!! Well, you already know what Carol would say to that! I can't way for FFL! I hope she will listen then.


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## bev (Jan 17, 2011)

Monica said:


> No, Bev, it doesn't happen often. This one must have been brought on by "exercise". Carol goes out to meet friends and I don't know how much walking they do. We've had trouble before that she always comes home very high (19 sunday before last), as she just doesn't realise she's hypo (I've told her to test halfway through the afternoon, but as I'm not there....). So Yesterday I told her to reduce her lunch insulin by 2u. This seems to have worked, as she was 9 when she came home. Then after dinner, she went out again for another hour. She did have something to eat before bed, but it seems it wasn't enough. I'm a bit too scared to not give her a snack after glucose, but I guess I could try to half the carb afterwards e.g. one biscuit to start with to see if that's ok. As to testing again after 15 minutes!!! Well, you already know what Carol would say to that! I can't way for FFL! I hope she will listen then.



Hi Monica,
That is why FFL will be good for Carol - they have heard it all before from teenagers and they will have all the answers for Carol. You really need Joe Solo to have a chat with Carol - he deals with stubborn teenagers all the time and he knows how to handle them. Do try not giving the long acting carb as it might help to stop the later high's after a hypo and once you have tried it I am sure you will both feel that its allright to do this and levels do come up to within range without having to overfeed the hypo.Bev


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## rachelha (Jan 17, 2011)

I have a packet of rich tea biscuits by my bed.  The problem is just having one or two.  I over treated last night and ended up at 18.  I thought I would need more than usual as Nathan was on his second night time feed, but I was wrong.


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## martindt1606 (Jan 17, 2011)

bev said:


> Hi Monica,
> The current thinking is that there is no need for a long acting carb after a hypo. Treating with 15 carbs (i.e.can of coke or similar) is enough for a hypo - as long as levels are back within range after 15 minutes. Overtreating a hypo is common - but if I were you I would just give Carol a coke (or glucotabs) in the night as this is enough. I would not be making toast any time during the night anyway. If this is common, perhaps you need to think about changing the basal or splitting the injection.Bev



Bev - are you saying that if after treating a hypo based on the 15 carbs / 15 minutes rule and your blood sugar is back over 4 (?) there is no need to do anything else?  The last 2 hypos I've had, the first 15 carbs has had minimal impact (2.2 to 2.4 and 3.6 to 3.9).  In both cases the second round has taken me up over 4 - to 4.4 and 4.9.  Not sure I would have the confidence not to back up with a longer lasting carb to ensure I didn't fall again.  Note in both cases the next meal was over 2 hours away.


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## sofaraway (Jan 17, 2011)

During the night I would personally always follow up with longer acting carbs. In the day it depends on the situation if I decide to have a snack. I just wouldn't feel safe to go back to sleep.


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## Carynb (Jan 17, 2011)

When my son was on MDI we always followed up a hypo with long acting carb like 2 digestives after the 15g of quick acting carb but found that he went high quite often afterwards. On the pump we only treat with 15g quick acting carb and no follow up carb- in fact if he is hungry after a hypo we bolus for it as long as his level has come up. It's quite hard at first getting used to bolusing staright after a hypo!


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## bev (Jan 17, 2011)

martindt1606 said:


> Bev - are you saying that if after treating a hypo based on the 15 carbs / 15 minutes rule and your blood sugar is back over 4 (?) there is no need to do anything else?  The last 2 hypos I've had, the first 15 carbs has had minimal impact (2.2 to 2.4 and 3.6 to 3.9).  In both cases the second round has taken me up over 4 - to 4.4 and 4.9.  Not sure I would have the confidence not to back up with a longer lasting carb to ensure I didn't fall again.  Note in both cases the next meal was over 2 hours away.



Hi Martin,
What I am saying is that once you are back within range (this is what you are comfortable with) then you dont need the extra long acting carbs. If your levels are still only on 4.4 then this is fairly low - so I would give perhaps another 15 fast acting carbs and test in 15 minutes. If Alex was only 4.4 at 3am then I would give him one can of coke - but wouldnt give any long acting carbs after it as levels would most likely come up to 6 or 7 and wouldnt want them to go any higher.Bev


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## Lauren (Jan 17, 2011)

half a glass of fruit juice has about 15g fast-acting glucose and is easy to drink when you're tired in the night


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## Estellaa (Jan 17, 2011)

my hypo treatment no matter what the time is consists of glass of orange juice and two biscuits (whatever biscuits are in the house), i don't have follow up carbs never actually heard of that before soo..
if im out an about its a sugary drink of sorts, 4 odd gluco tabs and perhaps go and buy a chocolate bar.
If she won't budge on the toast thing? then just leave it, shes a teenager what do you expect ^^


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## Liz! (Jan 18, 2011)

It's funny, at night I feel like completely different things than in the day, and I don't feel like sweet, so it might be that she feels like it rather than biscuits. I crave tea and toast. There's also the 'do what you're used to' feeling because anything different is too hard to think about. Toast is very coforting because it's warm as well. You do lose heat when hypo - one degree on average.


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## everydayupsanddowns (Jan 18, 2011)

Estellaa, from what you said you are following up. The glass of fruit juice will be 15-30g rapid carbs(depending on size), and the two biscuits around another 25g and a bit longer-acting. More often than not that would out me into the teens whether it was day or night. As long as we test afterwards to see where we end up and try to make sure we don't either skyrocket or dip back down below 4 I guess. 

A lot will have to do with what caused the hypo in the first place, of course.


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## bev (Jan 18, 2011)

Lauren said:


> half a glass of fruit juice has about 15g fast-acting glucose and is easy to drink when you're tired in the night



Hi Lauren,

Fruit juice is allright - but it doesnt work as quick as something like coke or lucozade. Fruit juice contains 'fructrose' which has a different and slower profile than 'glucose' which is in something like a can of coke. I used to give Alex apple juice until I realised that his hypo's were taking too long to treat and so changed over to coke and the difference was obvious.Bev


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## bev (Jan 18, 2011)

Estellaa said:


> my hypo treatment no matter what the time is consists of glass of orange juice and two biscuits (whatever biscuits are in the house), i don't have follow up carbs never actually heard of that before soo..
> if im out an about its a sugary drink of sorts, 4 odd gluco tabs and perhaps go and buy a chocolate bar.
> If she won't budge on the toast thing? then just leave it, shes a teenager what do you expect ^^



Hi Estellaa,
If you are having two biscuits aswell as the orange juice then you are having the long acting carbs. Have you tried just having the orange juice on its own, as this should be enough to get your levels back within range. (orange juice isnt a great choice as it is slower than coke or similar). Chocolate isnt a good choice for a hypo as the fat in the chocolate slows down the absorption of glucose. If you are having all this for a hypo then I would think you must be going high after it.Bev


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## chrismbee (Jan 18, 2011)

Coincidenatlly, after reading this thread yesterday, I woke up at 1am with BG of 2.4.
Determined not to binge on whatever is in the cupboard (as has been my previous habit) I thought I'd try the 15g quick route. Faced with a lack of sugary drinks (we never have any in the house!) I dissolved two teaspoons of sugar (16g - I weighed it) in a small glass of diet pop.
15 mins later I was 2.9  Then the hypo-fuelled eating urge took over my brain and two, choccy digestives were rapidly consumed.
After waking up to the alarm with a bladder fit to burst, I re-tested and found myself at 14.9.  Clearly more work to do here!!

PS. Gave up looking for the thermometer - hypo-induced confusion and irritability don't make good searching buddies.  Thermometer now installed in an easily-retrievable location, out of reach of kids.  For the record (see separate thread on body temp) I was absolutely roasting again.  It's just me - I'm odd


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## everydayupsanddowns (Jan 18, 2011)

Chrismbee

Hard to know whether your liver had anything to do with the bounce back to 14.9... The ole hormone response to a hypo can involve your liver dumping glucagon (to release glucose) into the bloodstream. 

When I use sugar to treat a hypo (esp in the 2's) A tablespoon is more like it. I'm sure I read somewhere that since sucrose is only half glucose and half something more complex, it's not especially quick either. Tch! we can't win!!


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## chrismbee (Jan 18, 2011)

I agree, Mike - it is difficult enough for us "long-termers" to weigh up all the factors (state of health, amount of food, type of food, activity, hypo-bounces etc. etc.).  It must be really daunting for all newcomers to our club, hence the value of the support group.
As with any process, you can only take in bite-size chunks at a time, and try to understand the effect of each stimulus, before attempting to tackle combined reactions.
I had been diagnosed for 20 years before it really sank in that (the presence of) insulin is important in the absorption of glucose - I had previously thought that exertion alone could do it.  Whilst I don't believe I'm stupid (I have a degree in Physics), I was clearly ignorant of all the facts.  I concur with a comment made in another thread that established diabetics can be forgotten about by the medical profession, when discussing new research/findings.


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## Monica (Jan 18, 2011)

Thanks for all your replies.

Since I am in control of treating her hypos, she doesn't overfeed after the glucose. She gets the 15g carbs and that's that. If she's still hungry, then I usually say, that means you haven't recovered from hypo, do another test!! This very rarely happens though. 

People here are commenting about being tired. Well, she always looks very chirpy to me when she's hypo!! And by the time she's tested and eaten the glucose, I'm usually wide awake too.


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## Liz! (Jan 18, 2011)

Potato is absorbed - well assimilated into usable sugar more quickly than sucrose! Its chemical structure is very simple. That's why potatoes are not a very good thing to eat as carbohydrate. They don't last. 

Does anyone else find glocose tablets difficult to eat though when hypo? they are so dry and they make me gag. I'd rather have chocolate and do it slowly!


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## AlisonM (Jan 18, 2011)

Hmm, when I was being told about the Byetta last week, I was told to ask for some glucotabs or something similar as well (not that I'm in danger of hypos yet, I forgot, but I suppose I should look for something. I have ahrd time swallowing pills anyway and it doesn't sound like the tabs will be much better. What else is there? I can't tolerate lucozade, the stuff makes me sick.


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## Monica (Jan 18, 2011)

AlisonM said:


> Hmm, when I was being told about the Byetta last week, I was told to ask for some glucotabs or something similar as well (not that I'm in danger of hypos yet, I forgot, but I suppose I should look for something. I have ahrd time swallowing pills anyway and it doesn't sound like the tabs will be much better. What else is there? I can't tolerate lucozade, the stuff makes me sick.



Alison, the Glucotabs are nice. They dissolve in your mouth quite quickly, and in my opinion don't taste chalky at all. They come in orange and raspberry flavours. They are a bit more expensive than Dextroenergy tablets, but they also taste nicer. Also, the Glucotabs are 4g carbs and the Dextroenergy are 3g carbs each. No whole tablet swallowing involved at all. Coke is good too. You can buy the mini cans, which are 15g carbs. Perfect, if you like coke.


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## AlisonM (Jan 18, 2011)

Thanks Monica. All this is taking a bit of getting used to and I'm trying to plan ahead. I'll get in a stock of mini cans for my mini fridge.


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## Monica (Jan 18, 2011)

AlisonM said:


> Thanks Monica. All this is taking a bit of getting used to and I'm trying to plan ahead. I'll get in a stock of mini cans for my mini fridge.



They sell them in 12 packs in the supermarket. Or singles if you prefer. But they are a bit bulky to have in your handbag at all times. Maybe you should just give the glucotabs a go too. That reminds me, Carol needs some more Glucotabs!!! Best be off shopping now.


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## tracey w (Jan 18, 2011)

Estellaa said:


> my hypo treatment no matter what the time is consists of glass of orange juice and two biscuits (whatever biscuits are in the house), i don't have follow up carbs never actually heard of that before soo..
> if im out an about its a sugary drink of sorts, 4 odd gluco tabs and perhaps go and buy a chocolate bar.
> If she won't budge on the toast thing? then just leave it, shes a teenager what do you expect ^^



Estella, the biscuits and chocolate bar are your "follow up" or slow release carbs. After the juice or gluco tabs which are your "fast acting" hypo treatments. Has your dsn not explained this to you?


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## bev (Jan 18, 2011)

chrismbee said:


> Coincidenatlly, after reading this thread yesterday, I woke up at 1am with BG of 2.4.
> Determined not to binge on whatever is in the cupboard (as has been my previous habit) I thought I'd try the 15g quick route. Faced with a lack of sugary drinks (we never have any in the house!) I dissolved two teaspoons of sugar (16g - I weighed it) in a small glass of diet pop.
> 15 mins later I was 2.9  Then the hypo-fuelled eating urge took over my brain and two, choccy digestives were rapidly consumed.
> After waking up to the alarm with a bladder fit to burst, I re-tested and found myself at 14.9.  Clearly more work to do here!!
> ...



Hi Chrismbee,
Its great that you had the forethought to experiment.
If this had been Alex I would have given another 15 carbs after the first treatment, as if you have the biscuits it slows down the absorption from the first treatment and can delay the levels from coming back into range. Just keep remembering the 15/15 rule as many times as you need to get back within range. Fast acting all the time. I think you went up to 14.9 because you didnt need the biscuits.Bev


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## everydayupsanddowns (Jan 18, 2011)

Alison/Monica

I've never liked any of the gluco dextro plaster of paris tabs (sorry Monica!) if you can't cope with Lucozade apparently Coke is fine - I guess any full sugar drink would be not too bad. 

My other regular go-to is fruit pastilles (3 or 4) or a handful of skittles. 

Yum!


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## Monica (Jan 19, 2011)

everydayupsanddowns said:


> My other regular go-to is fruit pastilles (3 or 4) or a handful of skittles.
> 
> Yum!



Yum indeed! That's why, as a mum, I've tried to stay away from giving Carol sweets as a hypo remedy. I wanted Carol to realise that a hypo treatment is just that, a treatment, not a treat

At first, her sister (aged 7 then) didn't like it when Carol got dextroenergy, as she wanted some too. I occasionally gave Fiona one piece, but said, this is not a treat, it's Carol's treatment and you don't need it. Fiona's not bothered now.

I do have the mini cokes in, but Carol rarely asks for them, she uses them mainly if poorly or hasn't come up sufficiently the first time.


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## Pigeon (Jan 19, 2011)

Does anyone worry about their teeth with night time hypo treating? I used to brush my teeth again after eating, but then I read that you're not meant to brush them after sugary drinks as you end up brushing off the enamel. So now I just have a few mouthfuls of water, but often wake up in the morning with a sugary feeling on my teeth.

In answer to the original question, if I don't feel too low then I just swig lucozade. If I feel really shaky and confused, or get a reading in the 2s (don't always take a reading) then I'll have a digestive biscuit as well. I tend to have the biscuit at the same time as the lucozade, reasoning that if I then lay back down in bed it won't matter if the lucozade is absorbed slower... levels will come back up in the end.


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## rachelha (Jan 19, 2011)

Pigeon said:


> Does anyone worry about their teeth with night time hypo treating? I used to brush my teeth again after eating, but then I read that you're not meant to brush them after sugary drinks as you end up brushing off the enamel. So now I just have a few mouthfuls of water, but often wake up in the morning with a sugary feeling on my teeth.
> 
> In answer to the original question, if I don't feel too low then I just swig lucozade. If I feel really shaky and confused, or get a reading in the 2s (don't always take a reading) then I'll have a digestive biscuit as well. I tend to have the biscuit at the same time as the lucozade, reasoning that if I then lay back down in bed it won't matter if the lucozade is absorbed slower... levels will come back up in the end.



Yes I worry about my teeth, I am sure I am not doing them any good at all. I try and have some water too, but often forget.  I have thought of chewing gum, but am a bit worried falling asleep whilst still chewing it.


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## shiv (Jan 19, 2011)

Monica said:


> Yum indeed! That's why, as a mum, I've tried to stay away from giving Carol sweets as a hypo remedy. I wanted Carol to realise that a hypo treatment is just that, a treatment, not a treat
> 
> At first, her sister (aged 7 then) didn't like it when Carol got dextroenergy, as she wanted some too. I occasionally gave Fiona one piece, but said, this is not a treat, it's Carol's treatment and you don't need it. Fiona's not bothered now.
> 
> I do have the mini cokes in, but Carol rarely asks for them, she uses them mainly if poorly or hasn't come up sufficiently the first time.



I still get a funny feeling eating sweets like Fruit Pastilles or Skittles - they are SUCH a treat to me, I could never have them as a child. As a child they advised me to have chocolate as hypo treatment...hence why I can't look a Mars Bar or Twix in the face.


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## chrismbee (Jan 20, 2011)

I was originally steered to Mars bars to combat hypos and have stuck to choccy bars ever since - until, that is, seeing numerous references to jelly babies.
Have now bought my very own packet to try out, so next hypo will be "treated" with 2 JB's; we'll see how that works.


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## Northerner (Jan 20, 2011)

Pigeon said:


> Does anyone worry about their teeth with night time hypo treating? I used to brush my teeth again after eating, but then I read that you're not meant to brush them after sugary drinks as you end up brushing off the enamel. So now I just have a few mouthfuls of water, but often wake up in the morning with a sugary feeling on my teeth...



I'm fortunate in that I rarely have to treat a night hypo these days, but when I do I have a couple of jelly babies. I might also have a small cereal bar too if it was particularly low - I would rather overtreat and feel safer going back to sleep.

I went for a dental check up yesterday and we were discussing my diabetes. I had a great number of problems in the couple of years leading up to my diagnosis, including the removal of a tooth that had previously been root-filled but had a flare-up of the original infection after more that 14 years - no doubt all due to my (unwittingly) increased BG levels. Since diagnosis I have passed each check up with flying colours. My dentist thinks that because I am much more disciplined about the sugar I eat - hypos or combined with a meal - this has had a significant effect, plus my stable levels will also have helped. We actually discussed the night hypo thing and he said it would be insignificant in view of the other dietary modifications I have made sincce diagnosis, so I wouldn't worry too much about it - unless it's happening frequently, in which case you have bigger issues to worry about! 

Having said all that, apparently mashed potato converts to glucose quicker than sugar, so anyone prepared to try that instead of sweets? 


p.s. Mars bars/chocolate are not considered good hypo treatment these days because the fat in them means a slower effect on the levels than something which is more purely sugar.


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## everydayupsanddowns (Jan 20, 2011)

I must be one of the only diabetics who doesn't have a problem with mashed potato... Well certainly not our 'rough and ready' variety... Had some at my sisters once that had gone through a 'ricer' and that was a nightmare, but ours at home is usually a bit more... er... rustic.

By the way Chrismbee, standard bag JBs are 5-6g CHO each so you may need more that two (depending on your standard hypo treatment amount). And yup they are much quicker than chocolate.


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## chrismbee (Jan 20, 2011)

Not sure I fancy peeling tatties, boiling and mashing - at 1:00am, whilst under the wonderful feelings of a <2 hypo!
Kinda reckon most things would absorb quicker than that process


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## Monica (Jan 23, 2011)

Well, Carol was hypo again last night. I chickened out about only giving her one biscuit instead of 2 ( absolutely not ready to give nothing after glucose). This morning she was 8.something (I never know what's after the . as Carol always rounds down when telling me)


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