# How much sugar needed to recover from hypo



## Lynna

Hi
At the moment my daughter has 100 mls of apple juice if her bg is below 4. However apple juice is not always convenient and I was thinking about giving sweets such as jelly babies or pastilles instead. But how many would she need? Ie how much sugar should it take to bring bg levels back up. (she is 10 and slightly built)

Thanks
Lynn


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## Northerner

Hi Lynn, I usually have three jelly babies to treat a hypo. This is about 15g of carbs  I think fruit pastilles are slightly lower, so four of those . Whatever you use, try to work out 15g fast carbs, then wait 15 minutes - if still low then repeat. On very rare occasions I might need 20-25g carbs for a bad hypo.


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## Hanmillmum

Hi Lynn 

My daughter needs 2 jelly babies, sometimes only one if only just below 4. Anything above this sends her into the teens. Rule of thumb is 15g carbs and check in 15 mins so 3 jb's would be a fair starting point to see how that brings the BG's up ?


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## trophywench

Fruit pastilles come in at 3 = 10g but dunno what their precise content is. Haven't got any handy.

Personally, I'd rather use straight glucose meself, when possible - and I plump for Lucozade.  Orange flavour cos it's nicer.  However it is heavy to cart about and bulky.

I agree 15g/15 mins.  Although on my pump the default setting is 12g and 10 mins!  If after 15mins it hasn't got high enough do it again.  And add a slower acting carb snack if you aren't gonna eat otherwise in the next 45 mins.  A biscuit or whatever.  Again, 10 or 15g.


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## Lynna

Thanks all for your replies. 15g of fast acting carbs is what I was after.


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## Pattidevans

Any kind of sweeties have to be first chewed and second digested so their action tends to be slower than pure glucose.  Lucozade (as Trophywench uses) or Glucose tablets - such as Lucozade tablets - don't need digesting but begin to be absorbed directly through the cheeks and sublingually, therefore are that much quicker to work.  I can recover from a hypo quite quickly using pure glucose, and nice as Jelly Beans are it takes that much longer, during which time I tend to gobble more of the things.


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## bev

trophywench said:


> And add a slower acting carb snack if you aren't gonna eat otherwise in the next 45 mins.  A biscuit or whatever.  Again, 10 or 15g.




Hi Trophywench,

The latest advice given to paediatric patients on MDI is not to follow up with any long acting carbs - it isnt needed and mostly sends levels too high. Alex was one of those children who couldnt have the recommended 10g snack inbetween meals as it sent him high.

Lynna fast acting carbs such as a mini can of coke (15g) is perfect for a hypo and then follow the 15/15 rule until levels come up. If you give a long acting before levels are fully in range it means any coke or lucozade wont be as effective.Bev


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## megga

Small bottle of coke are around 10 grams, i find this gets me out of a hypo quite fast, and as sudgested, no follow up carbs (New advice given to me from my diabetic nurse)


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## trophywench

Thanks Bev, 

I don't have the slow either unless it's exercise induced hypo and will therefore continue if I don't, but I thought best to err on the side of caution for a child as I didn't know what the advice was for kiddies.  

Mind you, your little one is on a pump like me - is it different for MDI kiddies?


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## bev

trophywench said:


> Thanks Bev,
> 
> I don't have the slow either unless it's exercise induced hypo and will therefore continue if I don't, but I thought best to err on the side of caution for a child as I didn't know what the advice was for kiddies.
> 
> Mind you, your little one is on a pump like me - is it different for MDI kiddies?



Hi Trophywench,

The same applies to children on MDI.Of course if you do happen to have a team who isnt quite up to date with the latest advice then they will probably still be advising to give long -acting after.Bev


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## Pumper_Sue

bev said:


> Hi Trophywench,
> 
> The same applies to children on MDI.Of course if you do happen to have a team who isnt quite up to date with the latest advice then they will probably still be advising to give long -acting after.Bev



This made me laugh. I was diagnosed in the 1960's and have never ever used follow up slow carbs after a hypo.


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## Ruth Goode

I give C a 100ml orange juice for under 4s but I prefer to give her a small can of coke for under 3s as its do bring her out of hypo quicker than orange juice.


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## Amanda102

3 jelly babies is my daughter's preference and seems to do the trick. Our nurse told us she should have starchy carbs after, but we stopped this as it sent her high, unless she has been doing exercise. Our nurse also told us to give Hannah 30g free carbs before bed to keep her going through the night. We stopped that too!


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## Ruth Goode

I treat C with 100ml orange juice if she is at between 3-4 less than 3 I treat her with mini full coca cola because its work faster than orange juice. Now she's bit older I will try some jelly babies.


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## Tina63

My lad, but of course much older, has 3 dextrose tablets.  They are lovely, I sneak one occasionally   They come in all sorts of flavours (orange, lemon, tropical, blackcurrant and probably more - orange is lovely) and are chalky but kind of cold tasting and crumbly.  They melt quickly in your mouth.  Try them yourself!  Or Glucotabs are the same kind of thing, they are good because they come in a plastic tube thing so good to keep safe and dry and therefore easy to throw in a bag and carry around.  With the dextrose tablets they are just in a paper/foil wrapper like other sweets so once open it's hard to keep the rest of them clean and dry.  They are quite expensive though at about 65p a pack, but then again, how much are Jelly Babies or Fruit Pastilles?  Probably not a lot cheaper actually.  

With Jelly babies, my lad would have just gobbled the whole pack.  If you can resist eating them then fine, but if not, something looking more tablet-like might be more sensible.  You could probably find a really tiny container somewhere and just put a few in.  My lad used to have the coke, but he did find when shaky it could be hard to drink the coke withough spilling it, if indeed he could manage to open the can in the first place with the shakes!!

We incidentally, were told only 2 years ago that we SHOULD follow up with the 15g slow acting carbs!  It really still amazes me how advice differs so much from area to area.  Mad.


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## Stuart Knox

As a first aid trainer, the latest guidelines we follow are 20g glucose - either 4 jelly babies, 20 skittles, 200ml lemonade (just over half of a can), 150ml lucozade, 200ml orange juice, dissolve 4 teaspoons of sugar or glucose tabs (these vary but 20g of tabs).


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## Radders

I wonder where the 15g recommendation originates. Since everyone has their own carb sensitivity factor, it follows that 15g won't be the right amount for everyone, and surely it also depends on other factors such as how low one is, whether there is active insulin on board and what has caused the hypo.
On the DAFNE course we were given lots of pointers to working out our ratios etc but the same 15g was recommended for everyone.


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## Copepod

Stuart Knox said:


> As a first aid trainer, the latest guidelines we follow are 20g glucose - either 4 jelly babies, 20 skittles, 200ml lemonade (just over half of a can), 150ml lucozade, 200ml orange juice, dissolve 4 teaspoons of sugar or glucose tabs (these vary but 20g of tabs).


Welcome to the forum, Stuart Knox. Please introduce yourself in the Newbies section, if you'd like.


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## Robin

Radders said:


> I wonder where the 15g recommendation originates. Since everyone has their own carb sensitivity factor, it follows that 15g won't be the right amount for everyone, and surely it also depends on other factors such as how low one is, whether there is active insulin on board and what has caused the hypo.
> On the DAFNE course we were given lots of pointers to working out our ratios etc but the same 15g was recommended for everyone.


It also doesn't sit squarely with the other mantra that's often quoted, which is that 10g of carb raises your BG by 3mmols. Again, that's something that's an individual thing, it works for me, but means that if I treat a hypo of, say 3.5 when Ive got no short acting on board, with 15 g of carb. I'm going to end up at 8 which is much higher than necessary.
However, I can see from the point of view of first aid training, when you don't know anything about the person you're faced with treating, erring on the generous side to make sure they get over the hypo is going to be the first priority.


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## Pumper_Sue

Stuart Knox said:


> As a first aid trainer, the latest guidelines we follow are 20g glucose - either 4 jelly babies, 20 skittles, 200ml lemonade (just over half of a can), 150ml lucozade, 200ml orange juice, dissolve 4 teaspoons of sugar or glucose tabs (these vary but 20g of tabs).


This would very much depend on the age of the child. As a 4 year old I had 1 sugar cube (5 carbs) and at around the 10 year old stage it was 2 sugar lumps.
Personally I do not need any more than 10 carbs to treat a hypo, unless I am out on a long walk with the dog and going away from home then for obvious reasons I have more.


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## Pumper_Sue

Stuart Knox said:


> As a first aid trainer, the latest guidelines we follow are 20g glucose - either 4 jelly babies, 20 skittles, 200ml lemonade (just over half of a can), 150ml lucozade, 200ml orange juice, dissolve 4 teaspoons of sugar or glucose tabs (these vary but 20g of tabs).


For someone having a hypo that needed help from a first aider the worst thing you could give them would be skittle the chocking hazard doesn't bare thinking about.


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## Radders

Having tried skittles when I ran out of Dextrosol in a carpark once, I think they are possibly the second worst hypo fix I have ever tried, as most of them ended up stuck to my teeth! 
The worst was individually wrapped chocolate biscuits which I had by the bed and after quite a bad hypo episode in the night I awoke to find I was lying in a pool of chocolate and crumbs!


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## Shivles

Interesting that you all say slow acting isn't needed as we was just told a month ago to do this, think I'll stop doing it as it does tend to send her high


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## SB2015

I have found out that between 3.5 and 4.0 I need one jelly baby, 3.0-3.5 I need two and less that 3 I take three jelly babies. It is different for different people.  

I have also stopped any long acting after unless I have done exercise and need restocking stores.  The important thing is to wait 15 min before retesting.  That is the difficult bit, especially if I started very low.  Any hotter and I end up over treating.


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## Carol F

I was recommended 60 mls lucozade (original) or 3 dextro tablets..seems to do the trick...dextros are very small and convient to carry about x


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## SB2015

The gluco tabs, jelly babies etc are a lot easier to carry that a can of drinks and you can then adjust how many you eat.  With a can you can't leave half for the next hypo.


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## Radders

SB2015 said:


> The gluco tabs, jelly babies etc are a lot easier to carry that a can of drinks and you can then adjust how many you eat.  With a can you can't leave half for the next hypo.


Funnily enough, at home I drink half a carton of Ribena and put the other half in the fridge. Not practical when out and about, clearly!


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## SB2015

I have a carton of cranberry next to the bed.  There is a half carton left there at present, but I think I might need to get rid of it now.  It is a while since the last night hypo. (The fridge would have been the sensible place for it)


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