Some of what I read from several sources there’s been an international shortage of dextrose, including for medical use such as IVs.
It’s probably a perfect storm of the pandemic, causing a slowdown of production combined with lower crop yields of maize (corn) and wheat. Those grains are the major sources of glucose.
No problem, just hit me up anytime if you want them.
Correct. They never gave an explanation during the shortage, but there was much media about a shortage of dextrose primarily in the States, and what paramedics should do instead. (Given that the manufacturer is in Quebec and always had bilingual labels before, I doubt that was the reason for the holdup – although it was for children’s pain and fever meds last winter.)
Last week I mistakenly clicked on the website for Diabetes Express, where I buy my Omnipods, and which has been out of stock since at least last fall. They had one flavour in stock and I snapped some up. Two days later there were two flavours. I just looked and six out of seven flavours are back in stock.
Fantastic! I order my pods from the same place and had noticed the same thing, I have not found the Dex4 tablets there since maybe September. And bingo, you are right! I just saw like 4 flavors (CA$10.99 each) so I nabbed 3.
I’m glad to be able to order again with my pods.
@cogdog I’ve also had issues with availability here in Virginia (US) over the past year with store brands. I usually purchase the 50 tab bottles for refilling the 10 tab containers I normally carry around with me. Used to be there was space on shelf for them, but last year the larger bottles disappeared from the likes of Wegmans, Target, Walmart, and even the smaller 10 tab tubes were sparse (except at the small Walgreens out close to our cabin in Berkeley Springs WV, they never ran out of multiple flavors of both bottles and tubes). My last order from Walmart for 9 bottles (free shipping limit based on total charge) came from 3 different stores across the US with two shipping 5 and 7 days late respectively). Given the shipping costs alone, they had to lose money on the deal.
The common refrain from store people (which I don’t think really know): supply chain issues. Really? Glucose tabs? I didn’t see the supplies of Smarties and and the various candy isle products with like ingredients disappear.
Fortunately, most of us can use various supplies of Smarties, juices, candies, but your question is still valid. Is Dex4 pulling their Canadian business?
I’d be surprised. Dex tabs are probably a small share of the company’s business, but there isn’t much competition, unlike in the States. One major multi-province pharmacy chain had their store brand – different manufacturer, and slightly larger than Dex4 tabs so that, irritatingly, they didn’t fit in the same tube – and they’ve also been out of stock since mid/late last year, with a gap still on the shelf.
Here are some links about a shortage of Dextrose, not just tablets.
https://www.usfa.fema.gov/blog/ig-072122.html#:~:text=The%20Food%20and%20Drug%20Administration,anything%20else%20disrupts%20the%20supply.
ue%20to%20manufacturing%20delays.
You will have to scroll down quite a bit to see shortages of dextrose IV solutions.
I am going to corner the market on U.S. dex tabs and then offer them to my Canadian friends in exchange for some maple syrup.
I had T1D for more than 20 years before buying sugar tablets pre-packaged for people with diabetes in an airport. When I’d first seenthem, I couldn’t afford cost or wasting calories. What I used initially were packets or cubes of sugar, but this changed quickly as I got a better handle on my warning signs, used slower carbs and ate snacks sooner. Now I keep former test strip cannisters of 5 tablets packed where I live, work, and travel, but strictly for emergencies.
But in Walmart. seeing 4 grams of corn syrup sugar compressed in a pill and selling for selling for $0.10@, I wondered why. It doesn’t seem like mixing in “Cellulose, Citric Acid, Magnesium Stearate, Natural & Artificial Flavor, Ascorbic Acid, FD&C coloring” pressing it into tablets, putting them in a plastic bottle and transporting them could increase the cost that much. All the ingredients are things used as fillers in supplements. I guess it’s the cost of convenience, getting a refined food packaged as a “medicine”.
This ad got my attention:
I looked up the price of sugar in the US and Canada. According to this the average US price is 1.60USD/kg and the average price in Canada is 1.14USD/kg. Why would any primarily sugar product be more much more expensive in Canada than the US?
I know that table sugar isn’t the same as dextrose. Dextrose (anhydrous) is crystallized alpha-glucose obtained by enzymatic hydrolysis of corn starch. Table sugar is sucrose, a double sugar with a 1:1 ratio of glucose and fructose. Hydrolysis of sucrose into detrose/glucose can be accomplished by treating sucrose with an acidic solution.
Dextrose is very slower to metabolize than sucrose, but easily split into glucose and fructose. The practical difference for treating a low is table sugar gives half the surge of an equal amount of dextrose in 15 minutes and the other half later from the intestine and liver. Personally, I felt that this was an advantage unless I was very low, and if so, either it was too late for sugar by mouth, or I could take more now and then adjust later. .
imo Since Canada produces corn , anhydrous dextrose, and sugar, the only explanation for the extraordinarily high price and poor availability for dextrose tablets - is that Canada doesn’t manufacture dextrose tablets, but imports them as a manufactured product.
That’s 4 pounds of a disaccharide, sucrose, not the monosaccharide glucose. It will work but is slightly slower because it must be digested into fructose and glucose and only glucose is going to raise blood glucose levels fast. Fructose will need to be further metabolized by the liver to become glucose.
I prefer glucose tablets because of speed and it is easy to take a measured amount. I don’t have to use them often, sometimes none in a month, sometimes several times in a week. The later is unusual.
On bike rides I use a mixture of glucose syrup (Karo lite with no HFCS). 1 1/2 oz equals 45 g. I dilute this for a total of 5 oz, each oz is 8 g. This is easy and really cheap, compared to commercially available gels.
You sound like a competitive rider. If that works for you, good. I’m neither.
I don’t want to ever again depend on sugar highs and empty calories for safety, and need to plan on burning them off through activity. I don’t want Karo or any other form of empty calories food in my life unless I have an actual problem. To me that’s wasted energy.
I can’t build, repair or replace worn tissue with sugar like I can with fat, protein, vitamins and minerals. For a planned heavier than normal baseline activity, I prep with a nutritious meal that will deliver what I need throughout the activity without surges or drops. I supplement it only with lost electrolytes. I can do this because I wear a CGM. Knowing how I react based on experience, I can match my activity to my “fuel on board”.
I believe that we evolved glycogen as a specialized stores to handle short bursts of activity. Artificially boosting BG ignores that. If I don’t use and rebuilt it, I’m not exercising my “machine”. Raising my BG beyond my balance level assists in storing more durable fat for a famine I won’t experience, and I gain weight.
Ha Ha! Thanks for the humorous compliment. I did 30 miles this morning with the main part of the group dropping me around 10 miles. They probably did 70 miles.
I ate my regular breakfast 2 hours before and had a nut bar just before starting. BG rose to 140 dropping to 99 to finish. No need today for anymore fuel.
There have been some rides where BG dropped fast, and a bit of glucose saved the day. There’s no way to know what will happen from on ride to the next. I’m just following the old scout motto, “Be Prepared.”
BTW- after biweekly strength workouts and the weekly group rides I have been drinking one Boost-bolusing for the carbs. I have been steadily losing weight over the last year and not wanting to lose more.
This is a reasonable perspective. I use glucose and gels to prep and fuel for my runs because they’re predictable: I know the onset time and duration, so I can plan for my activity with some precision. Most of the meals I would eat have way more carbs than I need for a run; without insulin even 18g is more than enough for 5-6mi, and larger meals for longer distances run into problems with digesting while in motion. I could likely fine tune this with practice but haven’t tried yet.
But I do appreciate the point about empty calories and potential weight gain. I was underweight when I was diagnosed (a somewhat gaunt ~129lbs at 5’5"); I definitely needed to put on a bit, particularly rebuilding muscle. I was also too skinny to inject easily. I’m now around 135lbs and I don’t want or need to gain any more. So I do worry about how I’m fueling for my exercise and how it affects my weight. (Maybe this is worth a separate thread.)
It’s not an empty calorie if your body is using it to fuel a run. It is an extremely useful and efficient calorie.
During a run, your body does not use glucose at the same rate that slower and more complex carbs are absorbed. That’s why marathoners are not typically eating rice cakes during a race. Sure, it is a fine thing before, but not really very useful during.
Every carb you eat, complex or simple, is broken down into one of 3 simple sugars (monosaccharides) - glucose, fructose, or galactose. Mostly glucose!
The only difference is the rate it is broken down. So you use the right thing for the right time.
The site currently states that they are suffering “inventory shortages”, i.e. they are selling like hot cakes.
Probably not just to T1s any longer; there’s only so much highly flavored glucose we can consume (though based on a brief Reddit search it has been the go-to good flavored food of low T1s for some time).
I suspect it’s being used as a dietary supplement.
I’ve carried glucose tablets even before using insulin. We type 2s can have hypos
My apologies; I did not mean to diss T2s. The OP is a T1 hence my comment.
I know you didn’t, I was just putting in a word for my clan.
Just to close the case, I got in the mail (in Canada) 3 brand new bottles of Dex4 tablets ordered from my Omnipod provider (DiabetesExpress).
It’s always interesting to read so many different approaches to managing the lows. I am coming up on my 53rd year id T1 (got my Joslin 50 medal thanks to inspiration elsewhere in the forums), and while I swing high and low more than I like, I’ve been able to keep the A!Cs near or just below 7 for the last 5 years.
@cogdog First, Congrats on getting your need fulfilled! Secon, Congrats on you Joslin 50 medal!
Third, I too have a success story to report on tabs. I ordered THIS morning 12 bottles (free shipping, 4 Raspberry, 4 Orange, 4 Grape) from Walmart online order. I’m impressed by the speed! Ordered this morning, first 4 delivered an hour ago…SAME DAY! Second set of 8 supposed to be delivered today as well (I’ll believe it when they arrive!). What I do NOT understand is why two different shipments, why not combine into one?! Yes, it could be different are stores, but I saw the van Walmart+ paint job, gas powered, driver…I’m sure they’re still making money on it, but seems a bit odd.
Anyway, nice to have two WINS to celebrate!!
(Also noted the “moose mug”! My wife and I just got two very similar for our WV cabin, I think the same “moose” but one of the cups is green and the other is red plaid on the cup background instead of the moose. Are we perhaps related??)
