How to treat a low right before a meal


#1

I’ve been trying to figure out how to act when my daughter (4) is about to eat but is also dropping low. Example this morning: I have turned on the suspend before low on her pump. So she was suspended and 5.1 with 1 arrow down. What I did was I unsuspended it, and bolused 15 grams of carbs and gave her probably 17 grams of carbs to eat – a few pretzels, some grapes and blueberries. What happened was she dropped to 3.9 and I ended up giving her about 8g of fast acting carbs which I didn’t bolus her for. Then she shot up to 10.8 with 3 arrows up and now she’s levelled off to 9.5. I would really like to know how I could have done it so that she didn’t do the big spike upwards or the hypo of 3.9 on her CGM. I think it would have been lower if I had done a finger prick.


#2

One suggestion that I do (especially for breakfast) is delay dosing until about 30 minutes post meal. If it is to much or little time change it by 5 minutes until you hit the sweet spot. If she is on a CGM look for the first uptick on the CGM then dose.

Good luck I know it is frustrating.


#3

It would depend on how low she is.

If the low is really bad, you should start with a few quick carbs and then have her eat the meal and then delay the bolus for a little while, maybe 15-30 minutes.

If the low is not very bad, you can skip the quick carbs and just delay the bolus.

When you do too much - like reducing the bolus and delaying it and giving quick carbs - you can end up with a high BG later.

It just takes practice. Don’t feel bad, it gets easier the more you experience it.

I like dropping when it is meal time. That can reduce the spike after the meal, and also means I can eat a lot!


#4

This is what I would do, with a meter check to confirm BG first.


#5

Thanks so much. I’ll start trying those suggestions!