hypoglycemia question...

[sweetiepeas]

This might be a silly question but I'll ask anyway. If you have a patient that is hypoglycemic, we start with juice with sugar in it, or glucose tablets. I was told once that you'll want to follow up treatment with some protein, to help keep them from spiking (hyperglycemic). How does that work in the body? I tried looking it up, but no luck.

[mariebailey, MSN, RN]

Are you asking how protein works in the body to regulate blood sugar levels? I think it slows the conversion of sugar to blood sugar.

[CDEWannaBe]

Standard treatment for a low blood sugar is to give 15grams of fast acting carbs (sugar or glucose tablets are best because they're easy to measure accurately) for any low blood sugar between 50-80. Then test in 15 minutes and see if the number is starting to come back up. If not, give another 15g of carb.

If blood sugar is lower than 50, then start off with at least 30 grams of carb and check blood sugar again in 15 minutes. If not, give another 15g of carb.

The only way to prevent spiking is to not overtreat the low with too many carbohydrates. Orange juice with sugar in it is probably WAY too many carbs and is going to cause a spike within an hour.

A snack of protein, or more commonly a carb plus protein, is usually given after treating the low to help prevent active insulin in the body causing another hypoglycemia.

If the patient is having lows at the same time of day for more than 3 days in a row, the physician should be lowering the insulin or ordering a snack at that time of day to prevent it.

[sweetiepeas]

I miss spoke, we start with orange juice, if it is lower we will add a packet of sugar. We can give glucotabs, but sometimes the juice is more accessible.

The protein was to avoid the secondary spike in blood sugar.

[classicdame, MSN, EdD]

Think about fire.

Carbs burn like matches - hot and fast

Protein burns like logs - slower over a longer period of time.

So carbs get energy up, but protein keeps it there

[jennrn10064]

Protein does not cause a change in the sugar directly. It can affect the glycemic index. CHOs are used for energy and the more simple the sugar the quicker it is utilized. Table sugar is very quick because it is a simple sugar sucrose. When the blood glucose is low I like to look at other factors too. What medications the person took and when, when was the last calorie consumed, and had the person exercised in last 24 hours?

[mammac5]

15 g of carbs and recheck the CBG in 15 min. Four ounces of juice usually does the trick. The problem comes when the patient keeps asking for and drinking juice until he/she FEEL better...if you let them do this, they will be hyperglycemia later.

Protein doesn't have much effect on blood glucose, hence low-carb/high-protein eating plans. Fat can slow down absorption of sugar, which could defeat he purpose of treating hypoglycemia. So none of that juice and peanut butter crackers type of treatment. Just the juice and recheck.

Of course, if the patient is unconscious and cannot swallow, you'll have to treat with D50.