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  1. Safety

    1. Insulin and secretagogues carry a risk of hypoglycemia.
      • Ensure an appropriate amount and distribution of carbohydrate. Encourage moving towards more equal meal sizes. Some individuals may benefit from healthy snacks, which may improve glycemic control and reduce hunger and subsequent over-consumption at the next meal. Inclusion of snacks should be individualized and balanced against the potential for weight gain.
      • Activity may lower blood glucose levels. If this is an issue for your client, medications might be adjusted, or extra carbohydrate may be consumed.
      • Alcohol intake can inhibit the release of glucose from the liver, which may lead to lowered blood glucose levels. For people on insulin or secretagogues, recommend
        • Avoiding excessive alcohol intake
        • Ensuring that alcohol is not consumed on an empty stomach
        • Checking blood glucose before bed, after having consumed alcohol.
    2. SGLT-2 inhibitors increase the risk of dehydration, so ensure an adequate fluid intake.
    3. Though not used very often in Canada, acarbose (Glucobay) inhibits the digestion of disaccharides, so inform patients on acarbose that treatment for hypoglycemia needs to be glucose.

  2. Healthy Eating

  1. Carbohydrate Management Strategies