Treating Lows as Quickly as Possible is Key
By Sheri R. Colberg, PhD
Every once in a while, research studies come out and prove what you knew to be true all along. For example, a systematic review and meta-analysis (looking at the results from multiple studies simultaneously) in Emergency Medicine Journal in 2017 compared how quickly glucose tablets worked compared to other dietary sugars for treating hypoglycemia (a low blood glucose) in adults who had symptoms.
I personally had conducted a simple “study” on myself years before, back when one of my sons was doing a 6th grade science fair. Agreeing to sacrifice my body for the sake of my son’s project, I took in equivalent amounts of different sugars without any insulin to see which ones hit my bloodstream the fastest. Interestingly, when I first got diabetes back in the “dark ages,” we were taught that any type of sugar, skim milk, or juice was equally fine to treat lows. After testing straight glucose versus milk sugar and fruit sugar (in grapefruit juice), I definitely knew that was not true—but I digress.
Back to the published study. In that, the dietary forms of sugar tested were even broader, and they included the same amounts of sucrose (table sugar), fructose (fruit sugar), orange juice (containing fructose), jelly beans, Mentos, cornstarch hydrolysate, Skittles, and milk.
What they found came as no surprise to me: glucose is the winner! It worked faster in the first 15 minutes to raise blood glucose and relieve symptoms of a low than any other type of sugar. And who wouldn’t want to treat a low as quickly as possible? It is a medical emergency after all!
Why does glucose work faster?
It’s because glucose is the actual sugar in the blood that you’re trying to raise.
There are three simple sugars in our diet: glucose, fructose, and galactose. Sucrose (table sugar) is a compound sugar that is half glucose, half fructose. Unless you eat a candy made out of straight glucose—also called “dextrose”—like you can find in Smarties or SweeTARTS, it’s going to be slower-acting because fructose is the slowest to get absorbed and converted into blood glucose and makes up half of the sugar.
Most juice is all fructose and not an ideal treatment because it’s a lot slower, and it’s very easy to consume too much of it while you’re anxious for your symptoms to go away. Likewise, milk can also act more slowly (especially if it has any fat in it) because lactose (milk sugar) is another compound sugar, this time half glucose and half galactose.
Blood glucose lows occur for all sorts of reasons—including missing a meal, exercising, giving too much insulin, and more—how you best treat them depends on a number of factors, and not all treatments are going to work the same in every situation. The rate at which your blood glucose gets low can also vary, as can how low it goes and how long it continues to drop.
If you have some glucose handy, though, the fastest way to initially bring up your blood glucose is likely by consuming some straight glucose, which you can get in glucose tablets and gels, Gu (maltodextrin), Gatorade and other sports drinks (glucose polymers), and even Smarties candy (dextrose, another name for glucose).
That’s also where Glucose Revival comes in. It’s a great new company that makes innovative glucose gel products, most specifically the Thrive Medical Alert Oral Glucose Gel Necklace that contains 15 grams of fast-acting glucose, used by EMT's and people with diabetes who are active and on the go.
This necklace is a simple solution to an all too common problem: having a low with nothing handy to treat it. Simply yank off the necklace, uncap it, and squeeze the gel out and apply the glucose gel to the gums, tongue and/or swallow.
The Thrive Medical Alert Oral Glucose Gel Necklace can be used to treat minor, moderate and severe low blood sugars, and it comes in a Jr necklace with 10 grams of glucose for active kids. The design is simple: each necklace is a hollow tube with glucose gel on the inside, held together with a magnetic clasp that can easily be taken off quickly in case of an emergency. Each necklace has a pendant containing a blue circle, the international symbol for diabetes, which makes it a medical alert device at the same time. What’s more, it’s easily refillable after each use.
To sum up, to treat hypoglycemia, you should focus on doing three things:
- raising your blood glucose out of the low range as quickly as possible
- not overtreating
- avoid taking in more calories than necessary.
For these reasons, it helps to take it at least a small amount of glucose to initially relieve your immediate symptoms—like you can find in your Thrive necklace—and then deciding based on when you last ate, what you ate, how much insulin you’ve had, activity levels, etc. if you need to anything more to fully resolve the low, prevent it from recurring, and not overshoot your blood glucose target. At least at that point, your brain should be working better after the glucose gel kicks in!
Avoid gaining excess fat from having to treat too many lows or from overtreating them (requiring more insulin later to bring down highs). Treat them with as few calories as possible for all these reasons! Be prepared and always carry some glucose with you, along with other snacks.
About the Author
Sheri R. Colberg, PhD, FACSM, is professor emerita of exercise science from Old Dominion University and author of The Athlete’s Guide to Diabetes and 11 other books on diabetes and healthy lifestyles. A graduate of Stanford University and Cal Berkeley, Sheri is a world-renowned expert in exercise, diabetes, and healthy lifestyles. You can learn more by visiting her websites at shericolberg.com and diabetesmotion.com.