What, then, can we use to raise blood sugars rapidly with a predictable outcome? The answer, of course, is glucose.
Glucose, the sugar of blood sugar, does not have to be digested or converted by the liver into anything else. Unlike other sweets, it’s absorbed into the blood directly through the mucous membranes of the mouth, stomach, and gut. Furthermore, as we discussed in Chapter 14, “Using Exercise to Enhance Insulin Sensitivity,” we can compute precisely how much a fixed amount of glucose will raise blood sugar.
If you have type 2 diabetes and weigh about 140 pounds, 1 gram of pure glucose will raise your blood sugar about 5 mg/dl—provided that your blood sugar is below the point at which your pancreas starts to make insulin to bring it down. If you weigh 140 pounds and have type 1 diabetes, 1 gram of glucose will raise your blood sugar about 5 mg/dl no matter what your blood sugar may be, because you cannot produce any insulin to offset the glucose. If you weigh twice that, or 280 pounds, 1 gram will raise your blood sugar only half as much. A 70-pound diabetic child, on the other hand, will experience double the blood sugar increase, or 10 mg/dl per gram of glucose consumed.
Thus, the effect of ingested glucose on blood sugar is inversely related to your weight. Table 20-1 gives you the approximate effect of 1 gram glucose upon low blood sugar for various body weights.
If you have handled glucose tablets, be sure to wash your hands before rechecking your blood sugar. If a source of water is not available, lick the finger you intend to prick to remove any residual glucose. You can dry the finger by wiping it on your clothing or a handkerchief.
Do not keep glucose tablets near your blood sugar meter or test strips!
Many countries have available as candies or confections products that contain virtually all of their nutritive ingredients as glucose. These glucose tablets are usually sold in pharmacies. Some countries even have glucose tablets marketed specifically for the treatment of hypoglycemia in diabetics.
Of the glucose tablets listed, I personally prefer Dextrotabs because they’re very easy to chew, raise blood sugar quite rapidly, taste good, are conveniently packaged, and are inexpensive. They are also small enough that they usually need not be broken in halves or quarters to make small blood sugar adjustments (except for children). Each jar of 100 Dextrotabs* comes with a small plastic envelope that holds 20 tablets flat. This envelope fits easily into your pocket or purse and can be refilled as often as needed. For smaller children I prefer Smarties* or Winkies because of their tiny size. Most glucose tablets begin to raise blood sugar in about 3 minutes and finish after about 45 minutes, if you don’t have gastroparesis (if you do, see Chapter 22).