Lows, alcohol and sick days: the food side

Three situations turn food into a safety question rather than a menu question: treating a low, drinking alcohol, and being too sick to eat. If you're a parent, partner or caretaker, the sections on lows and sick days are the two most worth saving on your phone.

Treating a low: the one piece of food knowledge everyone needs

Below 3.9 mmol/L, Diabetes Canada says to take 15 g of fast-acting carbohydrate, preferably glucose or sucrose as tablets or a solution, which work better than juice or gels.

Once you're back up, have the meal that was due. If it's more than an hour away, take a snack with 15 g of carbohydrate plus some protein.

In practice, many people need more than 15 g; one Canadian study found an average of 32 g. Start at 15, recheck, and set your own amount with your diabetes team.

What does not work

• Chocolate, biscuits, cake. The fat slows the sugar down.
• Milk, for the same reason.
• Diet or zero drinks. There is no sugar in them at all.
• Glucose gel is slow; tablets beat it.

The diet drink mix-up is the one that catches hosts: both cans sit in the same fridge and look almost identical. Check the label before handing one over.

Alcohol is a food question, not just a party question

Your liver has two jobs here: clearing alcohol, and releasing glucose when you're running low. It will not do the second while it's busy with the first.

So the low doesn't tend to come while you're drinking. It comes hours later, often in your sleep. And glucagon works poorly after drinking, because it works by asking the liver to do exactly the thing alcohol is blocking.

Sugary mixers add a twist: they push blood sugar up first, then the alcohol pulls it down later. Up, then hard down.

A word for friends and caretakers: being drunk and being low can look identical from the outside. At a party, the person slurring may not be drunk. Check before assuming.

Eating when you're too sick to eat

Carbs in liquid form. If solid food won't stay down, carbohydrate can come as regular soft drink, juice, sports drink, ice pops or sweetened tea, sipped steadily rather than gulped.

Salt and water too. Broth, bouillon or an oral rehydration solution. Dehydration concentrates ketones and makes everything worse, faster.

Check ketones, whatever the glucose reads.

Have a written sick-day plan from your team before you need it. Judgement suffers when you're ill, and the person reading the plan may well be a parent or partner.