Does anyone have a good method for when you are low at mealtime for when to give insulin and do you account for all the carbs eaten even if low at the time?? I never seem to time it right and if I delay bolus half the time forget to bolus later.
Unless I am really low, I bolus at the regular time, but not the full amount. If I am really low, I get the fast acting carbs and delay the bolus.
If it happens once, I will bolus the usual amount of insulin for the meal but treat the low with an appropriate amount of fast acting glucose. If there are some fast acting carbs in the meal, I’ll eat them all first.
If a low mealtime BG is part of a trend, say the last three days, then I’d look at the basal insulin and adjust.
I would also look at any increase in activity, especially exercise, and take that into account.
The biggest risk in treating mealtime lows is over-treating and rebounding high after the meal. If you fear that possibility, I’d make an effort to take a brisk 15-20 minute walk about an hour after the meal insulin dose.
If I’m around 60-70 range, I treat that as a low and treat it. I use juice that is in the 15-20 carb range. That usually brings me up somewhere between 90-100 pretty quickly. I would get my food ready in the meantime and my family’s. Then I will bolus before eating and eat. Its pretty hard for me to forget to eat if I’m really hungry.
Right now, I’m pregnant with my 4th child, 2nd T1 pregnancy and if I don’t do it this way, I will forget to bolus, get sky high and get a finger shaking from my high risk OBGYN. I have to see this doctor every week while pregnant. I found this method works for me. If you have proper basals, carb ratios, and sensitivity ratios set, then bolusing at the beginning of a meal should workout for you by the time you are ready to test after your meal. I do the same thing when not pregnant and it works out for me just fine.
The tricky thing about treating a low is, what do you consider a low? I don’t get shaky and sweaty until i’m somewhere in between the 70-60 range. Its different for everybody.
If you do forget often and you have a cell phone, set an alarm on your phone for about 10 mins later, and then just account for maybe your dinner carbs and not the carbs you ate or drank to increase your BG. I know that when I’m not pregnant, my body is way less sensitive to carb response to treating lows and more sensitive to lows. This meaning that it takes more carbs to treat a low and when I am low, I feel my “low” symptoms a lot more. When I’m not pregnant, I usually don’t bolus for the carbs I drank to increase my BG for a low, I just bolus for the meal and I’m good.
I wish you the best,