The weather is changing again, so my insulin needs are branching out into new and exhausting extremes. I have had two VERY low (26 and 37) glucose readings in the morning in the past three days. (Working on basals also...)
So, if your readings are low in the morning, do you bolus for breakfast? I was 37 at 7:30 am. Had a small glass of apple juice to begin the BG rise and an egg and cheese burrito (14 carbs.) Normally, even when low, I bolus for food using the bolus wizard, but thought 37, 14 carbs, and did not. I was 228 at 11:00.
I usually do not get huge liver dumps after a low, but suspect I am beginning to.
So, it you were 37 and ate 14 carbs, would you bolus for it? Think I would have avoided part of 228 if I had.
I would bolus for it. I'd probably wait until the apple juice hit and then test again and bolus off of that. In the AM I cheat by doing chinups and pushups, which also will push my BG up. Based on what you described, I'd say it's a food dump rather than a liver dump.
If I'm say in the 50s I will just go ahead and eat without bolusing. Then I'll test after I eat and bolus when I'm up high enough. (And hopefully not forget!). If I were that low, I might treat first and wait to rise, then bolus and eat. I ideally like to just eat and then bolus when I come up enough as I don't like eating sugar if not absolutely necessary.
If my BG is below 50 when I wake up and I have reason to think that I've been low for longer than 20 minutes or so, I will treat the low BG and wait a half hour and test again. With my body, if the low is longer than 20 minutes or a half hour, then the liver and counter-regulatory hormones are already in action and I will bounce to 180+.
The amount of BG bounce you get from your low treatment will be indicative for how long you were low. If you're less than 150 then it probably wasn't a sustained low. If you bounce to 180+ with the least bit of carb for the low then you probably were low for a while. That's how my body works, anyways.
If my BG is over 160, I don't eat. Period. I know it sucks and I don't like being hungry but I don't want to spend hours reeling in a stubborn and high BG.
In your case, if the low was not an extended one and the low treatment brought you to 120-140 or so, I would pre-bolus (15 minutes) and take the usual dose of insulin to cover the 14 carbs.
Liver glycogen can be released in response to pancreas glucagon and/or adrenaline when glucose drops too low. I've read about other counter-regualtory hormones resisting insulin action when too much is present but am not clear about how the details.
If I'm low at a meal, I treat the low and do not bolus for that food, but I do bolus for the food in my meal. I may bolus after the meal, though, if I'm really low.
I understand that food makes my BG rise, but 14 carbs with a BG reading of 37 + 4 ounces of apple juice (18 carbs) is a food dump? Wow! And my BG did not begin to rise until 10 and then it went up 15 per 5 minute readings by CGM. The actual meter reading was 228, but the CGM was 170. It went up like a rocket ship.
I had the dreaded "button error" on Thursday, so I switched to a backup pump, then the replacement on Friday. But I think I was low a lot over night--kind of a scary low, which would account for the liver dump, I suppose....
I believe it does. It doesn't take that much to crank us up. I'd guess it might've gone higher as the eggs, sausage, etc. got processed as the day went on.
I wouldn't bolus at 37 but then I usually hold off eating until my blood sugar is close to range. If I were hungry I would go with the eggs and cheese and correct later if I ended up high. At 37 all bets are off and that glass of juice might have only taken you to 50 if you were still dropping and a bolus for 14 carbs might have led to a disaster.
Had a 57 this morning, but was normal and functional as a person....
Like my grandbaby says: "We're having BREAD for breakfast!" Slice of bread with spread. Bolused for it with the wizard. A little low over the morning, but did OK--no 228!
In the last 4 days I have lowered my overnight basal from .475 to .375. That is a lot for me and was still 57.
I just hate weather changes. They make my life horrid!!!
I would not bolus for that at 37( I would never bolus for anything when that low), if I did I would go crashing down even if I ate something. I would treat it and then eat some protein or my meal with a bolus when I was back to normal. After a low like that I check every hour at least to find myself rising. Then I take 1-2 units to prevent a possible spike/glucagon reaction or just a rise from not bolusing for food. Lately I have had a lot of lows also, so I think maybe it is the seasonal change although it's still cold here, so I'm not really sure. The worst low was due to waiting too long to eat though not due to whatever else is going on. I find myself going low again after a spike if I exercise etc. When first diagnosed I could eat my breakfast meal of 9 grams with no insulin bolus at a bg of 60 and stay in normal range.. now I have to bolus from 50's up but be careful to start eating first so I dont' go too low before eating.
