I was diagnosed with type 1 about 2 weeks ago. I recently have started having low blood sugar levels before meals. I'm not sure if I should bring it up, then take insulin and eat or try to bring it up with my meal. If anyone has any advise I would appreciate it. Feel like I'm playing guessing games on a roller coaster!!
If you are constantly having low blood sugars before meals then you probably need to lower your basal insulin (like lantus) a little, but you would have to talk to your doctor about that first! to answer your question though, technically they say to treat your low blood sugar with ~15g of fast acting sugar and then check again in 15 mins, if it came up then take insulin & eat or treat again. now sometimes that might be ok to do, but other times it is really an inconvenience like when you are at a restaurant. in those situations I would normally just take a littles less insulin and eat my meal right away. I hope this helps!
I did talk to the Dr. He said I'm probably starting the Honeymoon Phase??? Been reading up on this now..... I can take a lower dose of the long acting insulin and don't have to take any fast acting with my meals, for now anyway. Well see where that takes me.
definitely try to treat with 15g fast-acting carbs, then retest 15 minutes later to make sure you're above 70 or 80 (whatever your target is), then dose for your meal. if you try and bring it up with the meal you might run lower after the meal and start a nasty trend. i speak from experience :/
I've always treated my low with my meal. If I'm eating more than 15 carbs, when I was on shots, I would eat my meal and then take insulin after I've eaten. Since being on the pump I just use a combo bolus which I can have give me my insulin shortly over a period of an hour or so. It all depends on what works for you, everybody is going to be different. Try out different ways of doing things, you'll figure it out!
Sounds liek you're getting your basal figured out with your doc. Keep your eye on your blood sugars and report back to him if this basal-but-no-bolus plan gives you high numbers because, FYI, I'm honeymooning and have to do pretty much the opposite. I get to take very little basal insulin, but I absolutely have to take boluses like a typical type 1 or I'd go sky high. Eveyone is different though. Just pay attention.
For the record, on treating lows right before a meal, one of my CDEs said that you can either go ahead and have your usual fast-acting carbs at the very beginning of your meal (like a box of juice), or if you're not actually below 70 you can count 15 carbs of your meal as your treatment and not give yourself insulin for that potion. I did this often if I was in the low 70s, while on shots. (Now I'm on the pump, and it takes that lower number into account when recommending how much insulin to take.)
But if I were ever really low, like below 55, I think I'd treat and wait to eat until I was above 70, to make sure that fat and fiber don't slow down the absorbtion.
What do you mean bu "low BG"? I don't consider anything about 80 a low and neither does my endo. Yours might be different.
[quote user="Khürt Williams"]
What do you mean bu "low BG"? I don't consider anything about 80 a low and neither does my endo. Yours might be different.
[/quote]I don't think most people consider 80 "low" persay, but it seems like the only time Sarah hits 80 is right before she hits 70, then 60... So at 80 we usually have her eat a snack to avoid the somewhat inevitable crash.
Sarah ALWAYS goes low if she doesn't have her snack between meals. If she's 120 in the morning and has her usual breakfast, and a snack around 10am, we can count on her being between 110-120 at lunch (12:20pm) - but if she forgets to have a snack (like today, grrrrrrrrr), she ends up in the school office with a blood sugar of 66 an hour before lunch.
We're working on teaching cause and effect, because this has happened a number of times...
@michelle My old endo used to tell me that I wasn't low until I was under 60. (Uh, I think the heart racing, sweating, etc. at 80 say otherwise, there doc.)
@chrisilyg First off, welcome to the world of Type 1 diabetes! I'm sure it was a club that you didn't even know existed, and probably didn't want to join, but hey, no one really gets a choice. :( Get comfy :) The best way to treat a low before meals is to not have it happen in the first place (yeah, yeah, I know...). If you start seeing things happening on a consistent basis, that is a pattern. And something must be changed. Like @Vered said, you probably need to lower your basal insulin.
I find that going low while trying to eat a meal, totally ruins the meal. Your heart is pounding, your brain is screaming, "EAT! EAT! EAT!" and you never actually taste the food, so my preference would be to treat the low. Wait 15 minutes, check my blood sugar, and then if it has risen, go ahead and eat the meal. Keep in mind that having a low blood sugar actually INCREASES the chances of having another low blood sugar within the next few hours, so I would probably bolus less that was needed, in order to stop this.
What do your doctors suggest you treat a low with? (21 years ago it was unlimited orange juice and grahamn crackers--which is way too many carbs and would then spike me up really high.)
[quote user="Lia Hollander"]
@michelle My old endo used to tell me that I wasn't low until I was under 60. (Uh, I think the heart racing, sweating, etc. at 80 say otherwise, there doc.)
What do your doctors suggest you treat a low with? (21 years ago it was unlimited orange juice and grahamn crackers--which is way too many carbs and would then spike me up really high.)
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Lia, Sarah never feels low at 80. She usually feels it around the mid 70's, but often not until she's in the high 60's. She even hit 47 last weekend and didn't begin to feel it (the shaking) until about 15 minutes later.
As far as what we use to treat, almost always those small cans of apple juice. They're nice and portable. She doesn't like the glucose tabs or any other kind of candy, so we're limited in our choices. Sometimes I'll let her eat some crackers, but those get crumbly, so unless we're at home - it's apple juice.
Weird note? Before she started on the pump, a small apple juice would bring her up 100 points. Now, about 30 - no idea why...
@Michelle
I forgot to mention that I use alternate site testing (my arm rather than my fingers) so my numbers will be 10-15 off of what my actual number is. That being said, sometimes I feel the low at 80, sometimes 90, sometimes I wake up at night at 60. It all depends. I usually get this feeling that something is coming before the shaking actually happens (as long as I am paying attention or awake).
The best thing to treat a low blood sugar with is dextrose. It starts digesting in the mouth (juice doesn't digest until it gets to the stomach) so it works much faster which often prevents the really horrible heart pounding and EAT, EAT, EAT feelings. I have Smarties Candies (3 rolls=15 CHO) or 8 oz of Gatorade (15 CHO) or Powerade. The Smarties are a little * tart * and it can be hard to stuff 3 rolls in your mouth sometimes (but I manage). Crackers aren't a good choice to treat a low with because they don't raise the blood sugar fast enough. (However, some crackers with some protein after the low are often nice.)
To stop my habit of eating everything in the house, I set a timer for 15 minutes. (All of this is ready to go.) I have my glasses already pre-measured at the 8 oz. mark. I drink my 8 oz. of Gatorade and then turn on the timer. Sometimes it's no big deal, but sometimes I have to actually take deep breaths to keep myself from eating everything in the kitchen. Then I check my blood sugar and if it hasn't risen enough, I start again. It doesn't have to always be this regimented but it stops the crazy highs that happen when you eat everything in front of you (which is what your body is demanding you do).
As for the apple juice, perhaps she has more basal in her body now that she did before???? 30 points is a more reasonable number anyway. :)
I couldn't agree with you more Lia!! Whenever my blood sugar is low, I feel like my brain is just screaming "eat EVERYTHING you can get your hands on right now!!!" And then of course I regret it a little while later when my blood sugar goes in the total opposite direction and is super high (not to mention all the calories of the stuff I ate!)
It's just so hard to be patient while my blood sugar is actually low and give it time to come back up. I just feel like I'm going to keep feeling shaky and sweaty unless I eat or drink more than needed. I've definitely learned my lesson about this quite a few times, so I'm trying to wait and re-test before I continue to eat peanut butter crackers or eat glucose tablets like a maniac!! Haha!!
[quote user="Lia Hollander"]
@Michelle
The best thing to treat a low blood sugar with is dextrose. It starts digesting in the mouth (juice doesn't digest until it gets to the stomach) so it works much faster which often prevents the really horrible heart pounding and EAT, EAT, EAT feelings. I have Smarties Candies (3 rolls=15 CHO) or 8 oz of Gatorade (15 CHO) or Powerade. The Smarties are a little * tart * and it can be hard to stuff 3 rolls in your mouth sometimes (but I manage). Crackers aren't a good choice to treat a low with because they don't raise the blood sugar fast enough. (However, some crackers with some protein after the low are often nice.)
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Unfortunately, Sarah is incredibly picky about what she'll eat/drink. She hates candy (except chocolate) so she won't eat smarties or glucose tabs, or skittles, starburst - anything like that. I tried giving her gatorade when she was sick once, and she is now very opposed to it. We've been using the apple juice since she was diagnosed, and it seems to work pretty well. You might be right that it brings her up slower, but usually by the time I check her 15 minutes after apple juice, she's back within her range. We also keep those small tubes of frosting strategically located in case she was so low she was unable to drink the juice, but we haven't had to use one yet.
Karla suggested we could add a packet of sugar to the apple juice. I could probably also get some sugar cubes to carry around. Anyway, it's been working. Funnily enough, she doesn't really seem that hungry when she's low.
@Sarah The body is a powerful thing and when it wants food it WANTS FOOD! I often drink my gatorade, set the timer and then sit there telling myself that I am not in fact going to die right now.
@michelle Apple juice certainly works! It is perfectly fine to use on it's own for an insulin reaction (I used it for years.) It just takes longer, which may make the reaction worse. There are different levels of reactions from mild shaking to full blown heart pounding, sweating, oh my god I will die if I don't eat RIGHT NOW ones. I just want to try and prevent the latter.
Gatorade comes in many flavors and colors, so you might want to try another one at some point. And she may eventually get sick of Apple Juice...
As for the actual reaction, I don't really find that it makes me hungry per se. It's not like a "mmm, my tummy is empty and my stomach is grumbling". At it's worst (for me) it's my brain screaming that it wants food and wants it NOW. Literally: EAT NOW OR DIE! Heart is pounding, I'm sweating, my body is doing everything it can to get the glucose to my brain and cells. Stuffing my mouth full of crackers, well, sadly, it feels wonderful. Of course, I taste nothing and continue eating long after I need to (even though my heart is still pounding). And then, comes the feeling really icky part. All those extra carbs catch up with you and you feel horrible. (This is what I am trying to prevent by using my timer.)