Dear Dani, Grace and Jude,
Note: This page is advice for Grace, Jude and John. For any other reader, it’s information only. No therapeutic relationship is formed – read this.
Let’s start with a bit of a revision on why sugar is the loser when it comes to hypos.
Did you remember that fructose gets stuck in the liver and only half of the grams of the sugar treat they hypo?
That’s why I needed three Coca-Cola’s just before bed on Christmas day 2018, then shot back up really high.
This is the exact same issue this young lady had before using Dynamic Glucose Management.
What about lots of fructose flooding the liver turning on the overeating switch that we learned from Peter Attia’s podcast:
Here’s how it all works again.
I know I have raided the fridge on more than one occasion after using Coca-Cola to treat hypos.
This shows why glucose is the clear winner for preventing and treating hypos.
Did you remember that the maximum absorption of glucose is one gram per minute?
What about it taes 20 minutes for the hypo treatment to show on the CGM device?
Swapping Coca-cola for Dextrose tablets is part of the reason why my Christmas day 2019 hypo prevention worked so well.
After switching to Dynamic Glucose Management this young lad no longer needed double hypo treatments.
Ready to take preventing lows to the next level?
What is new about MATCH?
The new element is adjusting the glucose amount based on glucose value and trend arrow.
All hypos are not the same and therefore do not need the same treatment.
If you are dropping fast, more glucose is required.
If you are just falling, less glucose will do the job.
How this works for me.
I weigh 100kg so my glucose amount is 18g, six dextrose tablets.
If my glucose level was 5.5mmol/L (100mg/dL) and just falling, I would need 50%, so 9g which is three glucose tablet.
However, if my glucose 5.5mmol/L (100mg/dL) and falling rapidly, I would need 18g which is six glucose tablets.
Grace, you currently weigh 20kg, so your amount is 6g or two dextrose tablets.
If your glucose level was 3.5mmol/L (65mg/dL) and just falling, you would need 75%, so 4.5g which is one and a half glucose tablets.
However, if your glucose level was 3.5mmol/L (65mg/dL) and falling rapidly, you would need 125%, so 7.5g which is two and a half glucose tablets.
This graphic pulls MATCH together.
Remember to wait 20 minutes before you take a second treatment. It takes that long for the glucose to get absorbed and register on the CGM device. Jude, don’t be impatient!
Will this table work 100% of the time?
Dani, by now you know the answer is clearly no.
This table is a guide based on what works for the majority of people. However, we know type 1 diabetes is highly individual and each hypo has a unique set of preceding circumstances. For example:
- The amount of circulating bolus insulin
- The amount of activity and exercise in the previous three hours
- How hot and humid it is
- How many hypos had in the previous 24 hours
- The list goes on
Therefore, you will have to learn on the job and employ my guiding principle:
There are so many charts and pictures to remember, is there not a one pager that pulls it together?
I was thinking the same thing.
Next step: Infographic
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