Hello! I’m pretty new at this and hoping I can learn from your expertise! I am recently diagnosed type 1 - I have been on basal insulin for a couple months and just added with meals last week. I think the basal amount is ok for now because my fasting numbers are decent, but I’m still working out mealtime doses. I’ve not yet had any significant lows, but it’s gotten lower than I’d like a couple times (60’s) and it really freaks me out
What I’m wondering is, at what number is it a good idea to have a little food to prevent it going lower? Anything below 100 I start to get nervous, which is probably irrational, but I’m not sure when I should start to worry. At that point, what’s a healthy snack to bring it up a little and keep it steady when it’s not yet super low, but I don’t want it much lower either? I try to eat healthy, so I want to save the straight glucose for when it’s really necessary, and make healthy choices the rest of the time! Any guidance would be great!!
It’s not as simple as just looking at a single blood glucose number. That number exists in an important context. When did you last eat? What was the size and delivery time of your last meal insulin injection? How much time did you allow to elapse between your meal insulin dose and your first bite? Have you been very active?
100 mg/dL is not low. It’s a slightly elevated blood glucose. Non-diabetics spend most of their time between 70-99 mg/dL.
If you want to deal rationally with insulin therapy, you need to understand the basics of insulin therapy. You need to understand that each insulin formulation publishes insulin traits such as onset time, peak time, and duration time. You need to figure out your insulin sensitivity factors and insulin to carbohydrate ratio.
When you dose insulin and eat, what you’re trying to stage is the effects and timing of the insulin dose to exactly match the effects and timing of the food. This is what we all shoot for but unfortunately are not able to pull off every meal. I highly recommend that you pick up a fundamental book on dosing insulin, like Think Like a Pancreas by Scheider.
If you want to reduce your learning time, I would keep a log that tracks insulin dose size, timing, food and timing, blood glucose checks and numbers and any other things you think are pertinent.
It really depends on how much longer your fast acting insulin will be working. If you took a shot of Humalog 1 hour ago and your BG is under 100 then I would have a snack. If you are eating low carb then some nuts and/or cheese can stop a low but if you eat a regular diet then maybe an apple and some peanut butter would work, as long as you eat something with some fat in it to slow the absorption down it should work fine.
Also do not be afraid of using glucose. It is the fastest acting remedy when your BG is dropping too fast and chances are you will not need very much to correct a mild low. 1 glucose tablet should raise you by about 20 mg/dl so most lows are easily treated but if you have a lot of insulin still on board then you’ll probably need something to back up the glucose so that it doesn’t run out before your insulin does. Glucose only stays in your body for about an hour btw.
Juggling food and insulin can be a real coin toss at times.
I use DEX4 sugar pills to treat lows or potential lows when i am not 100% sure.
1 DEX4 = 4 carbs and works fairly quickly to bring my BG number up. I may take 2 or 3 if I am really low.
I find that using the DEX product is quicker and more reliable than food. Also if you can count carbs in your meal within 4 carbs you are doing way better than me. And I have been carb counting for 10 or 12 years. Essentialy the 4 or 8 carbs from a DEX4 wont hurt you and may save you.
I NEVER leave home without DEX.
As you gain experience the anxiety about lows will subside. BUT lows are to be avoided at ALL COSTS.
HOPE that helps.