How long does your dex usually take to turnaround for a low?
It seems about 20 minutes? I get impatient around 15 minutes and start giving more carbs ending up overtreating the low
Also I'm curious how long it takes for you so see the full effects of the carbs and how much higher it takes your blood sugar, assuming your basals are set right? like 30 minutes?
just going over our first weeks numbers and feeling a little overwhelmed!!
Hi Natalie,
I think what you are asking is very different for everyone. Your response rate does not really have as much to do with the Dex as it does with your patterns. The Dex just reflects what your body is doing. I would discuss this with your endo or diabetes educator. Good luck!
I see similar reaction times on my body - about 20 minuteds to start to see the curve turn around on the Dexcom. It also depends on how much "extra" insulin
you have on board...i.e. if there was a lot of extra insulin that caused the low versus just a little, that will require more carb to compensate.
In general, when correcting a low, I try to eat just enough carbs to bring me back into the normal range, not just blindly eat 15 grams.
First I know how much one gram raises my BG from a stable state. This can be approximated by dividing your ISF by your I:C ratio. Example : my I:C is 7 grams/unit of insulin, my ISF is 26 mg/dl per unit. 26/7 = 3.7 (or approx 4 )mg/dl per gram of carb. You can test this value to see if it works for you.
If I am at 65 and want to be at 90. then 90-65 = 25, 25/4 = 6 grams of carb. I'll try
eating 1.5 dextrose tablets.
If I am below 60, I dont fool around and I eat a full 15 as I don't want to take chances, even though I know 15 grams will probably raise me 60 mg/dl.
As always , your diabetes may vary.
I see the same thing as far as the Dexcom sensor/receiver recovery from a low. It takes a good 25-30 minutes for the receiver to move off the 52-60 range. I do a fingerstick if the Dex reads low If I am in fact low I eat or drink about 15 grams of carbs. I wait another 15 minutes of so and do another fingerstick. If my blood sugar has come up sufficiently and the Dex still reads low, I just calibrate it. If after the 15 minutes my blood sugar still has not come up, I have a few more carbs. But I don't rely on the Dex because if I did I would be overtreating all the time.
Hi, Natalie -
There are 3 unrelated components to the time it takes for a recovery (or start of a recovery) to be reflected in your Dex unit.
1) the amount of time it takes for your body to digest and distribute what you have ingested
2) the amount of time it takes for that change to be reflected in the interstitial fluid as measured by the sensor
3) the amount of time for the data point to be transmitted to the DexCom receiver
The most important is the first one (because that is how quickly you are actually recovering). Obviously, you wouldn't blame your DexCom system if you were trying to raise your blood sugar by eating alfalfa sprouts, but so many people drink orange juice or, even worse, (as I used to do) juice boxes with high fructose corn syrup. Fructose, which is in both of these examples, is digested a bit differently and more slowly than other things that you can use. I just started buying Welch's white grape juice in 10 oz bottles. "Grape sugar" is glucose and this is a great tasting fast way to get usable sugar into your system. I get white because my wife would not appreciate a purple bedspread or carpeting if I am so low I drop the bottle.
The #2 item is one of the main reasons I chose DexCom over the Medtronic system. The sensor tube length is shorter and so it responds more quickly. They also appear to have done a better job of prediction in their software. (I am 7+). I found, as I evaluated the two side-by-side, that the rapid changes were MORE accurately reflected by the DexCom system---at least for me.
The #3 item is just what portion of the 5 minute reporting period your uptick is in, between updates to the receiver. Since it updates every 5 minutes, there is a 5 minute variation on when your receiver will know when things have started to climb.
At any rate, yes, it is not instantaneous, but the most important thing is to ingest something that, as close as possible, is.
By the way, it is very natural to over-compensate when experiencing a low.
a) part of the adrenal reaction is to become voraciously hungry
b) we don't see an instantaneous change and that can be worrisome
c) we want to get back to normal quickly, and that means "flooding the market".
I always take insulin when I am eat - even if it is for hypoglycemic compensation. The insulin won't hit until well after the sugar does and will help to ensure that I don't go TOO high.
Sorry for the long harangue for my first tudiabes post. Good luck, Natalie.
Jeff,
Do you use a pump ? Or are you on MDI ? When I treat a low I usually have some glucose tablets to bring my blood sugar back up to a normal level. I don't then compound the problem by taking some insulin to cover the glucose I have ingested to reverse a low. I always take some insulin before I eat, but I don't count as "eating" some glucose tablets or some juice I have had to drink. I think knowing how many grams of carbs are required to bring your blood sugar to a normal state, and then consuming that number and only that number is a better way to avoid the post hypo highs. JMHO.
And a good HO, at that. Your's is probably the best/safet approach, always, and the one I take most of the time, but I got the impression Natalie was talking about the WAY LOWS. When I get caught WAY LOW (and am maybe a bit less than totally rational) I will down the glucose in that liquid form and take the catapult up, rather than just taking the escalator. You're right, it's probably not the best advice to be giving to someone else.
Taking insulin as soon as possible is a critical thing to do, though, if you are ever visited by a paramedic on a 911 call. I remember when that happened to me a few years back. It's a good thing they came, but I was pumped with enough glucose to turn me into frosting and then they wouldn't leave until I ate a pb&J ssandwich, on top of that.
In answer to your question, I am a pumper, by the way.
I do what Clare does -- if after 15 minutes my blood sugar hasn't risen (according to fingersticks, not the Dex), I'll eat more carbs. But sometimes I'll also do what Jeff does and cover that second helpful of carbs with a half or full unit of insulin, because more often than not, those extra carbs will eventually cause my blood sugar to go higher than intended.
I'm eating what I think are "fast" carbs -- juice or little gummy candies by the bed -- so I'm often perplexed at why my blood sugars do not rise in 15-20 minutes. (Again, I'm testing at that point using fingersticks, ignoring the Dexcom.) I'll have to go look at my fruit juice boxes after reading Jeff's comments about high fructose -- I always thought juice was juice.
Bottom line is, don't trust your Dexcom to tell you in a very timely fashion when you've recovered from a low.
I kind of figured you were a pumper because you wrote about always taking insulin which for someone on MDI actually means pulling out a pen and needle or a vial and syringe and injecting, not pushing a button. And thankfully the last time I had a paramedic in my bedroom my husband had already given me glucagon and I was already coming around so there was no need to make me into a piece of cake. But the whole point of this site is to get multiple opinions and then make up your own mind. Having dealt with D for 37 years I have a wealth of experience with both highs and lows. But I only have a few months with the G4 so I would yield to someone with more experience with it. I appreciate your willingness to share what works for you because there is always something to learn, and as with everything in D, YDMV - Your Diabetes May Vary
It depends - if you have a lot of active insulin it can take longer to 'come up' than with very little active carbs. All other things being equal, jelly beans (approx 96% simple sugar by weight) will take 5-10 minutes, but it may take 15 minutes for you to feel normal. If you are on MDI, a system like ManageBGL.com can tell you exactly how many jelly beans (or your preferred hypo treatment) to have for correction, and also warn you about active insulin and what that will do if left uncorrected.
thanks!! that is really helpful!
thanks jeff, all good points!
we will try the while grape juice!!! forgot about the fructose/glucose differences!!