Good morning everyone! I am kind of surprised I haven't seen this topic on here, unless I am completely clueless and should know. I am trying to figure out this bolus thing and lows. I assumed that if I was low, ate something to bring it up, that the bolus calculator would figure out how much I needed to raise my level to target range and offset the rest of the carbs...Am I wrong? I was 40 at 330 am this morning, so I ate. Used my level for the calculator when it said I was 50 (I guess thats the lowest it will let me do it) and went back to bed. this morning, I woke up and I was 54. This has happened many times. Any suggestions or advice to fix what I am doing wrong? Have a great Friday and a wonderful weekend!
Are you sure you have the reverse calculator on? That would be the first thing I would check, but then another one might be that your correction factor isn’t right - especially if it’s happened a lot. Beyond that I’m not sure.
I didn’t know there was a reverse calculator? Isn’t that the same thing that is normally on?
I’ve never used the reverse calculator, I just do a quick estimation. Usually I just pay (give myself) 80% of the insulin I would normally for the food. If I’ve recently eaten and I think the food digestion is lagging behind the insulin delivery I might just do a sugar pill since it’s so fast.
I like idea of trying the reverse calculator but I think this might be more complex than just a correction factor, at least for me.
funny, i 've been wondering the same thing lately… I have never heard of the “reverse calculator” and wonder if it’s a feature of the newer PDMs - my insurance only pays for the old ones.
one thing that i’ve been doing, unofficially - just playing myself - is that whenever I am low, the first thing I do after having a few Dex 4 tablets is to do a Temporary Basal in the off position for a half an hour. that means that no insulin will be delivered while my blood sugar gets back up.
I’ve also been temporary basal / off while working out/ swimming at the gym, and that seems to help me from going low right after a workout. I’d ask your Diabetes Educator/nutritionist to explain that further but it seems to be helping me.
FIrst, I’d suggest you call your endocrinologist or CDE for advice. But, that said, you shouldn’t be giving yourself any insulin when you’re that low. You’ve got to get your levels up FAST, and regular food with insulin won’t do that. You need to have 15 grams of a fast-acting carbohydrate, such as orange juice, and then retest after 15 minutes. If it’s not over 70 yet, then you have to have another 15 grams of fast-acting carbs. Once your blood sugar is above 70, then you have a mixed source snack, like an apple with peanut butter and give yourself insulin. Read more about it from the National Institute of Diabetes and Digestive and Kidney Diseases: http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/ - Scroll down to How Is Hypoglycemia Treated. And, please, don’t EVER get back into bed when your blood sugar’s only 40 or 50! And, again, I’d call your doctor, because if this is happening over and over again, your basal rate is probably too high at that time.
It isn’t necessarily on. You have to go into the settings menu to do make sure. If it isn’t on, then your PDM is going to recommend the normal amount of insulin and not subtract anything for the fact that you are low. It works really well for my son. We can usually use it to figure out how many carbs he needs to get back into range without using any insulin.
The reverse correction feature is on both 1st and 2nd generation PDMs.
The navigation for the reverse calculator (on the newer PDM) is:
>Settings
>>System setup
>>>Bolus/basal/calcs
>>>>Ratios/factors/targets
>>>>>Reverse correction:
I have had problems with going low as well. When I eat a snack because I am low, I don’t bolus. I enter what I am going to eat and then override the bolus amount to zero. When I am low, I usually continue to fall after I eat a snack. Also, “fast-acting” carbs don’t work all that fast on me. I usually don’t see results for about 30 minutes. I started a discussion called Fast Acting Carbs aren’t fast and the responses might help you. Paul ‘Boysie’ Barette’s suggestion to “swiggle” them around in my mouth has worked for me.
Kelby - I am soooooo glad you started this post, and I’ve learned that I definitely am not the only person with this problem. For the past 3 nights at about the same time I have had a low of 39-42. I have a Dexcom CGM however I am hearing impaired and I don’t hear the ‘alerts’. If I take 15 grams of carbs and wait 15 minutes, my BG just goes lower. Last night I darn near ate everything I could get my hands on including 2 small glasses of orange juice and my BG still kept dropping. I was so scared.
Brad - Thank you for sharing the suggestion given to you about ‘swiggling’ around your mouth. I’m hoping I won’t have another low tonight, but if I do - I will try the Gatorade and swiggling 
Serena, I DO give myself insulin when low if I’m correcting a low with glucose tabs, for instance, right before I also eat dinner. Or if I am treating a low with a big glass of juice and a cookie and I KNOW it’s more sugar than I need to treat the low (but maybe I wanted it or maybe I ate it all in a panic). Insulin works much more slowly to lower the blood sugar than a fast-acting correction will work to raise the blood sugar. That being said, it’s not something that anyone should be doing unless they are treating their low, know that they aren’t continuing to drop, and monitor it after they take the bolus. Overtreating of lows is one of the reasons we often succumb to the spiking roller coaster and taking insulin intelligently can sometimes help.
I probably correct for lows the “wrong” way: eat all the food in the pantry until I stop shaking and feeling woozy, check my blood sugar again, and then correct when my blood sugar sky-rockets. Not something I recommend, really. But when I do take insulin for the food I eat to correct my lows, it’s only a fraction of what I would normally take, or I’d be right back where I started, with another low bg.