Pre-meal lows

[type1tenorlady]

Hi all...

I haven't posted in a while and thought I might see if I can't get some suggestions for an issue I've been having.

I am very brittle, and though I have been pumping for almost a year now I've found that I still have a lot of lows. Probably mostly due to the fact that my schedule is nowhere near regular and the daily changes in my activity level tend to (predictably) throw a wrench in the works.

At any rate, when I get below 60 I normally do the glucose tab thing and sometimes supplement it with a fairly low GI snack if I know I won't be having a big meal anytime soon. However, if when I go to test for lunch/dinner and it is that low (which happens quite often) it's not as clear what I should do. Generally, in addition to feeling like I need to eat because of the low, I am also hungry because it is a meal time, meaning that I'm more likely just to want to just eat all my food and give a smaller bolus rather than correct the low, wait a bit, and then eat my meal.

I've tried some other things--having OJ or something else with the meal to bring up my BG but not waiting to eat the rest of my food or eating and delaying in addition to lowering my bolus--with varying rates of success depending on what I'm eating and what caused the low in the first place.

I am just curious what other pumpers might have done to deal with this problem. Any comments are welcome. Thanks!

[tanyatype1]

If I'm really low, I'd treat the low first, then eat. If I'm bordering on low, I'd just eat and bolus as usual, maybe reducing the amount of insulin just a tad. I could also use the CarbSmart feature on the Bolus Menu of my pump which factors in your current bg. If you're frequently low before dinner, maybe you need to lower your afternoon basal a bit or change your insulin/carb ratio at lunch. Cheers!

[Emm]

As you're already 'brittle' I imagine you don't want to add hypo-unaware to the mix - so I'd suggest treating the hypo first. And treat it with something fast acting. The more you get used to being low (this includes using slow-acting hypo fixes) the less your body reacts to them.

If it was me I'd just eat the meal if I know there's carb involved... or have a quick sip or two of a sugary drink. You'll have to figure out what feels right for you.

If you don't mind me asking... what 'qualifies' you as brittle? How brittle do you consider yourself to be?

[ant hill]

Type1tenorlady, How long are you a diabetic? This must be so frustrating for you. :( You have the right idea to treat lows as this is so importaint that you know what to do!! :)

I am also hungry because it is a meal time, meaning that I'm more likely just to want to just eat all my food and give a smaller bolus rather than correct the low, wait a bit, and then eat my meal.

Do you count your carbs as this will get a better idea on what your Bolus should be, It's not perfect as you will know if it's a hit or a miss if you test 2 hours after the first bite. ;)

[xMenace]

You sound like a candidate for superbolusing. Try a temp basal drop after eating these meals. http://www.diabetesforums.com/forum/pumping-insulin/25508-super-bolus.html

[Cyborg]

Sounds like it's time for some basal testing. You should never have to feed the insulin, especially on a pump.

[mortis505]

I would have to agree with Cyborg. Sounds like your basal rate needs adjusting. What are you currently set at now???