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Bolusing On A Low <3.5

O

O_DP_T1

Well-Known Member
Messages
458
Location
United Kingdom
Type of diabetes
Type 1
Treatment type
Insulin
Hi all,

What is the best way to bolus if BGL are <3.5 at meal times, I don't want to end up consuming extra sugar and getting it in range beforehand as it often goes over and then you have to pre-bolus and faff about waiting for it to all align again.

Should I:-

A) Minus my correction dose from the bolus for the meal and take it 10-15 mins before meal as usual
B) Eat and take the bolus about 10-15 mins after

Currently I've been experimenting with option B and there are times 2 hours post meals where I need to have a carb top up in order to prevent a low OR a larger spike then normal.
 
I would probably take the dose at the moment of eating but just do a negative correction......

my pump has the bolus wizard to help me with those calculations however it can be done manually...
 
Hi @O_DP_T1,
The tricky part is that you may already have the liver being triggered by glucagon to release stored glucose.
I tend to do negative correction and have some quicker acing carbs but not an overall greater than normal carbs.
I find it can take up to 3 hours for the liver glucose spike to reach a maximum. Further small correction boluses may be needed at that time.
 
Hi @O_DP_T1 Same as @novorapidboi26 I would take the bolus for food at the time of eating minus a deduction for the low blood glucose, but there are a few things to consider..

I would also be mindful of how long i'd been at this level so would only do the above if i'd been hovering at this level for a while or if it was a rapid descent, as otherwise I would treat the hypo first then eat food and bolus.
 
Cheers guys, would you take the reduced bolus 10-15 mins before eating as usual, or inject and eat straight away?
 
How long at this level ? If you're dropping quickly then you need to treat the hypo first as your food could take a while to bring your levels back up and you'll end up stuck at 3.5 for longer and possibly go lower too.
 
Oh *** had a low before breakfast and corrected all was well, just before lunch 6.1 no insulin on board walk outside and get lunch come back check BGL 4.8 ***, anyway take reduced dose and wait 10 mins as usual eat lunch and low levels are 2.2 and crashing. ***!!!!
 
When and how much depends on a bunch of factors, if you're currently at 3.5 the most important thing I think is what you are about to eat. If you're about to eat a delicious chocolate cake or whatever that will go up quickly, inject before you start eating. If you're about to eat something that goes up fairly quick but not right away, inject when you're done eating. If it's something very slow acting like fish, wait to inject, if at all.
 
O_DP_T1 said:
Hi all,

What is the best way to bolus if BGL are <3.5 at meal times, I don't want to end up consuming extra sugar and getting it in range beforehand as it often goes over and then you have to pre-bolus and faff about waiting for it to all align again.

Should I:-

A) Minus my correction dose from the bolus for the meal and take it 10-15 mins before meal as usual
B) Eat and take the bolus about 10-15 mins after

Currently I've been experimenting with option B and there are times 2 hours post meals where I need to have a carb top up in order to prevent a low OR a larger spike then normal.
Click to expand...

It's trial and error and depends on what you are eating and your body, like everything else with this disease. If I was eating something slow-digesting I would probably wait 10-15 min to bolus, otherwise I would bolus right when eating. I usually subtract half a unit to a unit, I find if I rely on my correction factors I will often end up high.
 
JP808 said:
Regardless of what you are eating bolusing before food when at 3.5 is just increasing the risk of things going wrong. Personally I can do without those risks and the possibility of others having to assist me. But guess everyone is different.
Click to expand...

You have to know your body. If I was eating something like a Subway sub, that will hit me really fast so I might bolus a few minutes before even if my BG was in the 3s. I know I will be okay from experience though, and have never required assistance from anyone no matter how low I go. If this were not the case, I would be more hesitant.
 
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