For hypos, do you think more carbs works faster than fewer carbs?

I just terribly over-corrected a low. It wasn’t a sever low either (50) I should have taken only 8 gms of carbs to bring me comfortably back into target range. But I panicked when after waiting 1/2hour, my BG was only 53. So I took 1/3C of apple juice ad now my BG is 176 and climbing. It’s been an hour already.

What was I thinking? (I wanted to eat lunch and didn’t want to bolus below 70)

(and those 2 little glucose tablets seemed to have done nothing at all and there is only 9gms of carbs in 1/3 C of apple juice. What gives???)

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Well, call it Murphy’s Law or who knows what, but take 15 wait 15 only works when I don’t want or need it to work. And, when I’m low, 40-50ish, I become, sad-to-say, a vacuum and eat ten times that and end up rebounding with insulin and playing that game.

Here are a few of my favorites:

D-Parodies: Treat More Moderately (Jewel parody)

D-Parodies: So High Today (Carole King parody)

D-Parodies: Normals (Lorde parody)

D-Parodies: 365 (Dolly Parton parody)

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This is hysterical. Thank you so much for these; it completely made me feel more normal (in a D world).

and as I write this, my BGs are magically coming back down (154) so far. UGH!!!
( but who the heck would think that 16gms of carbs would have such an impact on my BG rising???) I mean, are you kidding? 50 to 176???

(Edit: now, just 15 minutes later, my BG has come down to 134. Go figure)

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:joy_cat: :joy_cat: :joy_cat:

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Love these, @Tapestry!! Thanks for the laughs. Dolly Parton one is my favorite.

@daisymae, 16g could easily raise me from 50 to 176! That’s why I rarely take that many for a low, unless I’m desperate in which case, as @Tapestry says, I could eat everything in sight, or I take insulin with the carbs, too.

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one thing that I have felt most frustrated by is when I go low (or am trending low) before a planned meal.

My reaction is to insure that I will be in bolus range for my meal, so I want to do a correction even if I don’t need one yet. this can get me into all sorts of BG trouble.

Anyone else have this happen?

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Ceteris paribus[1] doubling the amount of carbs doubles both the rate at which those carbs are adsorbed and the height which our blood sugars attain at the end of the adsorption.

Hence the roller coaster; if you are at 90 and your BG is heading down at 5/minute you will hit 50 in 8 minutes. What do you (or, indeed, I) do? We eat enough stuff to bring our BG up by 40 in 8 minutes. Ha ha, sick joke; roller coaster, but once you’ve bought the ticket and strapped yourself into the seat you can’t get off.

[1] science-speak for, “If you don’t expdel with anything else.”

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I would give you a 100 hearts if I could, too funny, especially Treat More Moderately and Normals. Hilarious.

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Do you have any good references for doubling the carbs doubles the rate of absorption?

This seems to be the case from my personal experience, but I can’t find any good references because the only things I see are the ADA telling people to treat with 15 grams and wait 15 minutes.

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For monosaccharides Fick's laws of diffusion - Wikipedia because no digestion is required. There is a 1933 paper which considers an analogous question; how long does it take an individual to absorb a fixed amount of glucose (injected into the stomach). I haven’t read it through but it summarizes a previous result thus, “Pierce, Osgood, and Polansky (3) obtained results which led them to conclude that the percentage of glucose adsorbed appeared to be dependent upon the amount of glucose remaining unabsorbed in the alimentary tract. Cori et al. (4) explain the findings of these investigators on the basis upon the basis that sufficient glucose was not not fed to allow adsorption rate to continue at the initial level.”

The eventual conclusion, emphasis added by me:

The absorption rate of glucose per unit of time from the intestinal
tract of male and female rats of various ages bears a more
constant relation to body surface than body weight. The amount
of glucose absorbed per unit of body surface per hour of time has
been used as the absorption coefficient.
The absorption coefficient is raised by increases in either the
amount or concentration of glucose administered.
Whatever the dose of glucose the rate of absorption as measured
by the method used here decreases with time after it is given.

So they are refuting Cori’s apparent implicit assertion that glucose adsorption saturates within the bounds of the experimental conditions. The experimental subjects were fasting (40 hours) so stomach contents will be minimal. The amount of glucose was around 1g as a 57% (570g/L I assume) solution, about 2mL, fasting stomach size is around 1mL so the glucose was pretty concentrated in the stomach.

The other half of the question is about digestion. I’m not considering rate of adsorption of glucose from things that require complex metabolism; just fast acting carbs that require the chemical degradation that happens in digestion. For sucrose this amount to hydrolysis to get the two monosaccharides out of the compound.

Even in the case of sucrose there are two things going on; acidic breakdown and enzymatic breakdown. If you follow the link in the above page to sucrase you will see that it is introduced in the small intestine; immediately after the stomach.

So adsorption is a function of two processes:

Firstly a simple chemical reaction in solution, the rate of which is expected to be proportional to concentration, the intuitive result. See the wikipedia article for why more complex (multi-step) reactions don’t obey this rule, and;

Secondly the sucrase enzymatic reaction. This presumably depends on the amount of sucrase and, given that the duodenum is not very acidic, is quite likely the only source of glucose+fructose. There are papers on this process, for example, however I suspect many of the dissertations I found were propounding some particular viewpoint or an agglomeration of many modern fads. I did find this 1966 paper which I tend to trust. That paper seems to imply that sucrase hydrolysis will also be primarily dependent on sucrose concentration, regardless of the chemical order of the reaction, because the first step is adsorption which is very likely to be covered by Fick’s law. However, on page 392:

There appeared to be a limiting velocity for both hydrolysis and absorption in all experiments.

Check out the graphs on page 393.

In general I would expect that most scientists would start from the hypothesis that adsorption/digestion/metabolism is proportional to concentration (not amount) and that variations from this are deserving of explanation.

The take-aways are:

  1. It’s concentration not amount. If you eat a glucose tablet then drink a pint of water it isn’t going to work as fast. If you have an empty stomach adsorption will be much, much faster than if you have just eaten a full meal.

  2. Glucose is yucky but it works; at least it is better than glucagon.

  3. Things containing glucose/fructose/etc are likely to be much better than things containing disaccharides or complex carbs; I find glucose tablets are fastest of all but fruit is pretty good. As I’ve commented before, broccoli works.

Also, not related to the above, fast helps avoid the roller coaster. So it’s tempting to eat a tub of ice cream and wait half an hour, I’ve certainly done that, but it is probably better to eat a glucose tablet, wait five minutes (for it to be adsorbed) then eat half a tub of ice cream (there has to be a reward.)

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Great write-up! Very interesting. Thanks @jbowler!

I have always just “felt” that way about more, but it is wonderful to see some of the research and explanation for this.

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@jbowler

check this out

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this is still awfully confusing to my P brain to process. But its certainly nice to know that something does work for those who understand how to balance it all.

I just overcorrected a high with too much insulin. I was impatient, and the BG that I saw on my meter shocked me (154 up from 90 within 1 hour after eating) So I corrected the high, then made the mistake of doing some household chores (boy did I work up a sweat!) and within 40 minutes my BG came crashing down to 80. My sensor read with an arrow going down, so I took a preliminary 4gm glucose tablet. Don’t know if that will do the job, but I am keeping my eye on it very carefully.

why oh why???

(of course this scenario has nothing to do with the thread’s topic, but I thought I would mention it anyway.)

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just so you know, I ended up doing 2 glucose corrections 1 hour apart from one another, and now that the insulin has finished its job, my BG landed nicely at 74. Phew, really dodged a bullet on that one. \

Sometimes, I just gotta trust in The Force. (and ignore my own brain from time to time. :rofl: )

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So I started dropping like a stone while I was eating lunch (was 101) and hit 47 before going back up. I panicked totally and shoved in 20 g of carbs over 20 minutes and leveled out at 135…then started climbing up again. So I figure I had at least 5 grams too many but worked it off with a couple of much delayed garden tasks. Whew!!! :flushed:

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Exercise/activity does wonders!

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I cant imagine who on earth made this ridiculous “system” up in the first place. It has NEVER worked for me. I need at LEAST a 1/2 hour to 45 minutes to see the rise, and sometimes I must even wait an hour to notice the full effects.

Once, when I was hospitalized for my viral pneumonia several years ago, I had been on very high TB and massive doses of insulin. But when they put me on an IV drip with all sorts of fluids, etc, my BG began dropping after several hours. When it became very low (30s) they made me turn off my TB and forced a child-sized container of apple juice down my throat. (as soon as they left the room, I raised my TB again). They returned in exactly 15 minutes to re-test my BG, which of course hadn’t risen one iota, and forced me to drink more apple juice. I tried my hardest to explain that they would have to be more patient bc enough time had not passed for that darn juice to have any effect on me yet. This went on for 3 more containers of juice. Finally I decided to bolus so I wouldn’t spike. They were absolutely clueless.
They should be embarrassed and ashamed of themselves. Stupid rule. Like a snake salesman.

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Nor do I. My 15 minutes is up, and I’ll likely wait another 30 or 45 before re checking with finger test. In the meantime I’ll just watch my CGM for indications of change. :partying_face:

BTW, 2.8 (50) is nowhere close to “critical low” :rofl:

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I usually start seeing the reading level off by 20 minutes…but once I recall it took almost an hour to start going back up. I am thinking my muscles must have been really depleted??

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I can usually see a stop to the drop at least in 15 minutes. I think it depends on how fast I am dropping if I respond again to taking anything. Most lows are gentle drops and I can eat 2-4 grams of carbs and be done and just wait it out. But if I have a pointed arrow down 4 grams isn’t likely to be enough to boost me to at least 80.

I usually get myself in trouble the most from my exercise bike. I bike for an hour by taking less insulin at a meal or just getting on when I am high because maybe I guessed wrong and I want to drop faster? But then I stay on too long and don’t catch the dropping in time and there I go dropping and where it stops who knows…

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