Low Before A Meal

What do you do if you're low right before a meal, I seem to get messed up when this happens?

Did a small correction after breakfast, too much, and before I started to eat lunch started feeling weird, CGM beeping double arrows down and 53..so I ate glucose tab and some jelly beans, bolused full bolus for meal and ate right away, I usually pre-bolus about 20 minutes prior to meal. So, now..I'm 220, that's a rise of 170 points in an hour. yuck! I, of course, want to correct right now but I won't, trying to wait it out an hour or so. So, what's your strategy when low and dropping before a meal?

Also, I was thinkin'...and maybe not healthy to do this, but...OH HOW NICE it would be to just be able to eat a meal and not even think about this. I know this will probably never be..but wouldn't it just be lovely?


Good question! I also wondered what others did.

For me, it depends on if I'm feeling the low. Sometimes,I can be way low and not feel it and other times I can be in the 60's and feel like I'm going to pass out. I think it depends on how fast I'm dropping for each.

If, I don't feel low, I will take advantage of those low numbers and eat my meal. But, if I'm feeling the low, I will take glucose tabs to bring it up first.

If I read 53 I eat 2 glucose tabs and wait to come back towards 80 before eating even if it means waiting an hour. If I'm a bit higher - let's say 65-70, I'll often eat a zero carb meal without a bolus and expect to have to do a modest correction a few hours later. Depending on the meal, I might end up at 130 at 3 hours but that's a lot better than trying to calculate the right dose.


In general I find that if I'm low before a meal, I don't need to treat in addition to eating or I'll be high. If I'm borderline, like 60 something I might just go ahead and bolus and eat right away. If I'm lower I will be more cautious and I'll eat and then check my blood sugar and wait till I've come up before I bolus.

So is there more variability 'feeling low' or more variability in the BG meters? Maybe a little bit of both.

My plan may have some risk to it but if it's not like gonzo low (lots of symptoms, etc.), I'll eat a correction snack and bolus for the # I'd aim at. Like if it's 60, that'd be like 2 jellybeans, 2 smarties and bolus as if my BG were 70 and perhaps eat the carbier food first off of whatever ison the menu.

At 53 I would correct with a small amount of fast acting glucose (8g) and watch my CGM, as soon as I can confirm that my BG is going up I will bolus for my meal and eat. 1 Dex4 will raise my BG 20 points if I do not have any IOB.

this happened to me just the other day, I tested at 114, did my normal workout, went to eat lunch, tested and was at 54 (checked twice was 54 and 56), felt fine but ate a small pack of fruit snacks (16 carbs) waited about an hr tested was at 96 so I bolused and ate my lunch as usual and was under 120 couple hrs after lunch. Since I am kinda still new with this (almost at my 1 yr diabetes anniversary, woohoo??) I am still a bit anxious about lows, ok let's be honest they freak me out!! ;) I like to correct them first before I bolus and eat as normal mostly due to my own anxiety about going too low.

I don't have a CGM but think I need/want one!

What were you @ 2 - 2.5 hours post meal? I find the 1 hour test to be so unreliable a predictor of where you will end up when the insulin is out of my body that it is worthless, UNLESS I am still feeling LOW!

I actually do the same thing. I've often been really low (like in the 40's and 50's) prior to a meal. So I figure out the carbs, bolus, and start eating immediately. I never treat lows when I know that I'm about to eat a meal; because you will definitely wind up high (as I've learned from experience).

If I’m low just beford a meal, I just go ahead and eat and then bolus when I’m done.

I write down the numbers. I know that 1 gram puts me up 6.5, I figure what number of grams will put me up to 100. I figure what grams are in my meal, subtract the grams putting me up to 100, and give insulin for the remainder.

If I am low and eat a meal, I find it takes forever for my bs to start to increase. IN fact, my bs will continue to drop and eventually goes up. I only bolus before I eat, If my bs is high. If it is low, I will do a combo bolus, usually 0:100% over 30 minutes to an hour. Sometimes I wait 1/2 an hour, recheck my bs, then decide how I am going to bolus.

My bs frequently goes up to over 200 after a meal, but will drop to normal by the 3rd hour. Not sure how to fix this, since by hour 4, bs is right where it should be.

The way to keep it from going up to over 200 is by pre-bolusing, 15-20 minutes before eating, otherwise the food has a head start on the insulin.

I tried correcting a low with a salad one time; only because I had the salad in hand when I realized I was low. I would not recomend this.I had to stop eating the salad because I was dropping way to fast. Then I grabbed a hand full of skittles and started eating and then the feeding frenzie was on. All thought process was out the window. Went to over three hundred this time.

Lows make me do some really strange things sometimes.

Thanks everyone for your kind replies. yes, will treat first, get blood sugars up then bolus and eat.

I'm a frickin idiot sometimes; I had a bad low this AM while I was getting new tires at the tire place. There I am, at the counter, in a room full of men - mechanics, I'm very tiny, petite...one of those lows where the 'disconnect' feeling starts, room is spinning, entire body shaking and sweating...had to go sit down, thought I was goin' down fast...one mechanic came over and asked if I was OK, guess I probably looked very odd. Downed 3 glucose tabs and just had to sit there for probably 1/2 hour or so. I have to stop over correcting! Note to self (ah, hello), when one (ME) increases basal by a unit and changes to humalog (seems wicked strong and fast so far), STOP over correcting. Again, makes me realize how truly insulin sensitive I am and how powerful analog insulin truly is.

yes, i'm finding this too. it depends how low and how long ago i took bolus and how much is still left, well, heck, it depends how so much sometimes, if i'm really active, have been active. i really don't like being low before a meal, hard to bolus for food and get ready to eat when my blood sugars are low.

What do you do if you don't eat all the carbs you've bolused for?

Do you have a clear handle on your ISF, Sarah? Also have you contemplated having different ISF's for different times a day? (Mine is 27 during the day and 55 at night). If you are continually over correcting highs and going low, than you might have to reevaluate your ISF. If you are on shots, it makes it harder to correct precisely as you can on the pump, so you might try rounding down to the nearest unit rather than rounding up.

Increase basal by a whole unit? Yikes !!! When I need to adjust my basal rates, I only increase by 0.025. Most of the time, that is all I need. I usually don't change more than one basal rate at a time, unless I am trending high over several days.