# of times need to treat highs/lows

Curious as to others’ experience w/ these…

How often on average would you say you have to eat extra carbs you weren’t planning on eating in order to prevent or correct a low? How many of these carbs on average?

How often on average would you say you have to inject insulin you hadn’t anticipated needing to inject in order to prevent or correct a high? How much such insulin on average?

I rarely have lows since being on the T-Slim with Dexcom. Maybe I correct a low one a month. Usually 10-15 grams of sugar will take care of it. For highs I maybe give a correction bolus 3-4 times a week. Not a big bolus since I catch it quickly. However, if I am at 200+ bg I usually need to add extra insulin from what my correction factor calculates. I might add an extra one to two units for this.

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Do you have to buffer with carbs more frequently than once/month in order to fend off lows, even if you don’t actually go low?

No, Control IQ works really well for that. I’m careful, of course, and I’ve been doing this for a long time. But I love the fine-tuning of Control IQ

Wow that’s great! Thank you for your input.

I just react, when needed, and don’t keep track.
I also use T-Slim pump, and generally it keeps me in range better. I have alarms set for bg levels I may want to take action on to adjust insulin or eat, otherwise pump does pretty good without my interaction.


I hate high BGs and that means I have more lows than I should, so probably most days I eat extra carbs to treat lows or prevent them. I am on a pump (Medtronic) but I run it in manual mode because Auto Mode keeps my BG higher than I like. But usually it takes only 1-2 glucose tablets to treat the low. I do end up with some more severe lows at times, often for no reason I can figure out, and might need more carbs and/or something more lasting than glucose tablets (like cheese & crackers or PB & crackers).

As I said, I hate highs so I usually don’t have to do many corrections. When I do it’s small amounts, usually less than 1/2 unit.


I have been on T:Slim w/C-IQ for 4 months. After doing some minor tweaking of the settings, I am very pleased. If I have what worries C-IQ about going low, say less than 80mg/dl, I mostly don’t treat. I have found that C-IQ will suspend basal and the numbers will go up a bit.

I have not had any severe hypos since I began with the T:Slim. My problem was the wizards behind the screen at Tandem are too conservative for me.

Something odd I noticed after tweaking the settings. When I was on MDI my TDD was around 32u with 25u being Lantus. Since using the pump my TDD is 25 to 27 units.

I hate highs, so I can be pretty aggressive about treating them. I use a pump and will give small boluses whenever needed as my preferred range is 80-105. I don’t mind if I am a little off in dosing as it allows wiggle room. Given that, I keep fresh cut up pineapple around that I love to eat, so if it looks like I am going to run a little low I eat 1 or 2 pieces which is 1-4 carbs. If I haven’t eaten pineapple for a couple days I will purposely bolus for it so I can have some.

I don’t keep track. My alerts are set early so I can make adjustments to trending to going low. Actual lows are very rare. But I would say I am eating 1-4 carbs every day or two to prevent the going “too low”? And lately mistiming has really bugged me, so maybe I am giving a small correction and/or riding my exercise bike extra because of it every 1-3 days. I have been doing a lot of guessing lately at food carbs and seem to be reacting to high protein foods hitting 2-4 plus hours later, . And using Afrezza more, so a lot more guessing and adjusting feels like it’s been going on. I am suspicious that the Afrezza use has been what is causing the protein to hit later as I used to have more insulin in my body for longer?

But trending to go low, maybe every day, as I eat some pineapple almost every day. Highs, every 1-5 days (if I go above 125) I give small boluses to correct the trend pretty quickly. Maybe too quickly, but I hate highs.


Couple times per day.

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"I have been on T:Slim w/C-IQ for 4 months. After doing some minor tweaking of the settings, I am very pleased. If I have what worries C-IQ about going low, say less than 80mg/dl, I mostly don’t treat. I have found that C-IQ will suspend basal and the numbers will go up a bit.
I am just realizing this. I am now less apt to overtreat lows. I try to keep skittles around. 5 or less does the trick

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I make no guarantees just something I’ve noticed. It may be a good Alpha cell ( glucagon) response in myself.

These aren’t true lows just what C-IQ thinks, below 80 and trending down. If you are in hypoglycemia, do treat.

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Multiple times on most days. My basal is less than 3 IU/day (15-20% of total insulin, +/- 110 gr carbs), so temporary basal rates aren’t effective.

Today I corrected for lows at night, on walk after breakfasr, while moving my mother-in-law. I also corrected for highs because I ended up lowering my temp basal rate too much for low during walk and ended up doing less cardio while moving of furniture than I had expected. It is usual for me to correct for lows and highs because my activity level is not well controlled. I am very frustrated with this. Preparing for parties, taking care of kids, exercising in hotter weather, going to large stores, all bring down my blood sugar. Bad pods, bubbles, underbolusing, forgetting to start a bolius I have entered and confirmed, medications, illness, unexpected inactivity, all bring it up. My Dexcom settings are 70 -140. I use glucose pills, juice, or hard candy to bring it up and exercise for highs as much as possible. I try temp basals but haven’t mastered them.


Mostly for me it depends on if I remembered to pre-bolus. (Or heck, bolus at all!) If I’m good, then I seldom have to do much. I have a high alert set at 140, and I do hit that most days after dinner regardless of pre-bolusing or not, and I re-evaluate IOB at that time. I may choose to correct at that time, but I don’t think that’s quite in the realm of the original question. I seldom hit 180 if I’m correcting at 140. And Control-IQ is great at reducing insulin if necessary here, too.

Now, things go haywire if I don’t bolus before eating. There are plenty of times, especially in the morning when my pre-coffee brain is addled, where I forget to bolus at all until that 140 alert goes off and I’m already climbing. Then I panic bolus aggressively, and doubly so, since Control-IQ was already increasing my insulin. I can usually avoid the high, but there’s going to be a wicked crash later that I have to correct with carbs. And I have zero self-control when I’m low, and always eat too much… So here comes 140 again, and I have to correct! LOL

I get really good TIR, even on the correction-heavy days, but I’m no flat-liner! I’ve still got terrible personal habits that leave me on a rollercoaster. It’s just a kiddie coaster with smaller hills, now.


That’s really impressive. I have extremely good bolus and record-keeping discipline - not bragging at all, just saying this to say the following, which is that still probably most days there’s at least one meal (I only eat two) when I’m going at least to 180. I eat pretty well - vegan, mostly whole foods. But I don’t totally avoid snack foods and added sugar either (though most days I eat less than the recommended max). So I don’t think this is a diet issue. I do do MDI w/ finger sticks, maybe that’s the difference. I tried Dex6 for six months and I learned some stuff about general trends that was helpful, but it turned out to be so unreliable so much of the time that I was having to finger stick even more than I do now, getting false low alerts overnight, and got so frustrated I had to quit. So I hear good things about Control IQ, but am very leary about trying it since it relies on Dex (which is prob. the best CGM available). I don’t know why some people find CGMs reliable and others don’t, but unfortunately I seemed to be squarely in the latter category. Anyway thanks for your input, I really appreciate it!

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Yes activity can make big differences. I once hiked up a hill for about 10 minutes to get a 200 blood sugar down, and ended up 20 minutes later at 65. haha! yeah. I did inject short acting insulin not too long prior for meal bolus, that was what did it. Just one example. It’s a daily grind to manage. Anyway thank you for your input and kudos for managing so well!!


@BKN480 Did you try to calibrate it several times? I aggressively calibrate my Dexcom so it stays within about 5 points of accuracy when I am between 90-110. But I do calibrate it several times, as much as needed.

I consider myself a committed sugar surfer, and anyone who is sugar surfing will have to answer that they are “treating” lows and highs continually throughout the day.

Sugar surfing means you are always looking to tweak your food and insulin by small amounts to adjust to whatever unpredictability life throws your way. I always carry, but almost never use, glucose since I save that for emergencies. Instead I use fruit or whatever other carb I want to eat.

So I consider these “treatments” normal and positive as a way of keeping my BG steady in a normal range. They are not a negative, as some responders seem to imply.


Good thing to track. I’ll do it for like 2 weeks and get back to you. I would just say there are in general, low sugar days, and high sugar days. Because I have one of those In-pens, when I’m running high and I need a correction dose, it will let me know when I put in the number. This week it was twice for the high, but that consisted of taking an extra unit before bed.

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