If you experience any of the symptoms of hypoglycemia detailed earlier—especially hunger—measure blood sugar. If blood sugar is 10 mg/dl or more below target, chew enough glucose tablets to bring blood sugar back to your target. If you have no symptoms but discover a low blood sugar upon routine testing, again, take enough glucose tablets to bring blood sugar back to your target. Having no symptoms is not a valid reason for not taking tablets. A low blood sugar without symptoms carries more risk than one with symptoms.
If you weigh about 140 pounds and your blood sugar is 60 mg/dl but your target is 90 mg/dl, then you might eat 4 Dextrotabs. This would raise your blood sugar, according to Table 20-2, by 32 mg/dl, bringing you to 92 mg/dl. If you are using Dextro-Energen, you’d take 1. tablets.With B-D tablets, you’d take 1. Simple.
If your low blood sugar resulted from taking too much insulin or OHA, it may continue to drop after taking glucose if the insulin or OHA hasn’t finished working. You should therefore recheck your blood sugar about 45 minutes after taking the tablets, to rule out this possibility and to see if you’re back where you belong. If blood sugar is still low, take additional tablets. If you have delayed stomach-emptying, you may have to wait as much as 2 or more hours for full effect.*
What if you’re out of your home or workplace and don’t have your blood sugar meter? (A major crime, as noted earlier.) If you think you’re hypoglycemic, play it safe and take enough tablets to raise your blood sugar about 60 mg/dl (7 Dextrotabs, for example, or 2 B-D tablets)
You may worry that this will bring you too high. If you take insulin, this poses no problem. Simply check your blood sugar when you get back to your meter. If it ’s above your target, take enough lispro (or aspart or glulisine) to bring you back to target, but be sure to wait 5 hours after your last dose of rapid-acting insulin. If you don’t take insulin, your blood sugar should eventually come back on its own, because your pancreas is still making some insulin. It may take several hours, or even a day, depending upon how rapidly you can produce insulin. In any event, you may have saved yourself an embarrassing or even disastrous situation.
WHAT IF BLOOD SUGAR IS LOW JUST BEFORE A MEAL?
Take your glucose tablets anyway. If you don’t, you may become very hungry, overeat, and be too high many hours later. The medication you take for a meal is intended to keep your blood sugar level. So if it was too low before a meal, it will be too low after if you don’t take your glucose but eat properly.