Q: What are the best foods to have on hand when a child has a low? Are candy and juice really the only options?

A: Monitoring blood sugar levels as recommended by your child’s healthcare provider, along with following consistent daily routines; carefully counting carbs in foods to accurately calculate insulin doses; and making needed adjustments during illness or exercise can all help reduce the frequency of low blood sugars. However, even with these kinds of efforts in place, it’s normal for people with type 1 diabetes to still experience a low from time to time. Treating low blood sugar generally consists of giving 15 grams of “fast-acting” or rapidly absorbed sugars by mouth, repeated as needed every 15 minutes, until the low is corrected.

There are a number of food options available to treat lows. Fruit juice and certain types of candy are commonly used, because they do a good job at quickly raising blood sugar levels. Drinking 1/2 cup (4 ounces) of fruit juice is one of the easiest ways to provide sugars that are rapidly absorbed from the stomach. As for candy, hard candies, gum drops and jelly beans are rapidly absorbed, because these types of candies are essentially 100 percent sugar. Chocolate candy is typically not recommended for treating lows, because chocolate contains fat, which can slow the absorption rate of sugars.

Beyond juice and candy, glucose tablets or glucose gel are specifically made to provide pure glucose, and they work very quickly to raise sugar levels. Your diabetes care team can give you information about how to obtain these. However, some children don’t like the taste of these products. Another option, which may taste better, is to use about a tablespoon of cake icing or frosting (check the label for the amount needed to equal 15 grams of carbs). A small tube of cake frosting is something that is very easy to pack in a school bag or diabetes care pouch.

If your child is ill and has an upset stomach, a 15-gram equivalent serving of fat-free saltine crackers can be effective in providing carbohydrates. Another favorite of mine to use during illness is a regular (sugar-containing) Popsicle®. The cold Popsicle can soothe the stomach and has about 10 grams of carbs. Likewise, a 1/2-cup serving of regular (non-diet) soda, such as ginger ale, is another option if juice is not available. A tablespoon serving of pure table sugar or honey or a 1/2-cup serving of skim milk may also be given.

No matter which rapidly absorbed sugar source you turn to, if your child is experiencing frequent low blood sugars, it’s important to make contact with your diabetes care team to discuss possible changes to his or her diabetes management plan. Your doctor or diabetes educator may have additional suggestions for foods for treating lows and can give you specific instructions based on your child’s needs.

 –David Nickels, M.D., is the director of pediatric endocrinology at East Tennessee Children’s Hospital in Knoxville.



How Other Parents Deal
“As a parent of a child with type 1 diabetes, it’s funny to me how my views of juice and candy have changed since my son’s diagnosis. We used to be ‘that family’ who tried to give out healthy treats on Halloween. Now I hoard candy at Halloween, because those snack packs of fruity and tart candies are ideal for stashing in my purse, my son’s kit, his classrooms at school, in the car, etc. Same with juice boxes! Having my son quickly come back from a low trumps junk food worries any day of the week.”
–Rebecca L., Melrose, Mass., mom of 12-year-old Oliver


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Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.

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