dose adjustment if eating when hypo/very low

[the_anticarb]

Hi - can anyone answer this? I'm sure it has been mentioned on the dafne course but I'm a bit rusty. If you eat when you are hypo or near hypo, and eat your meal or a big snack as meal time is due or you are really hungry, how do you adjust the dose? I was thinking to knock 15g off the carbs total as that's the amount of carbs I'd eat to get out of hypo-land, and then do my normal ratio to the new total. Eg just ate 30g of carbs on a bg of 3.7, as that's a bit low I knocked 15g off and then injected one unit to cover the remaining carbs(as on a 1:1 ratio but not counting half units). Is that the right approach?

Thanks for any replies

 

[jopar]

Personally I would treat the hypo with fast acting carbs, then eat after injecting the normal dose. As the biggest problem with eating a normal meal/snacks takes longer to adsorb and impact on the BG, your BG will continual to drop until the food catches up.

If I'm near the hypo just above the 4.1 or 4.2mmol/ml I eat my meal/snack but delay my bolus slightly so that the carbs have a chance to start to adsorb before my insulin starts to kick in, I make no reductions..

This is what I was taught at DAFNE

 

[ebony321]

If i tested before eating and i was hypo i would also have some fast acting carbs like jopar says. and i would also reduce my insulin slightly too as it's easy to slip back into a hypo a few hours later if i covered all the carbs i ate with insulin.

If i tested bfore eating and i was in the low fours i wouldn't have any fast acting carbs i would reduce my insulin like you said about 10-15g. The only time i wouldnt do this is if i was having a meal with a high fat content which delays the absorption of carbs. So i would go back to the plan above and have a little fast acting carbs to prevent me from going low later on

If your a little rusty with DAFNE principles maybe you could ask for a small refresher with a diabetes specialist that had been dafne trained if there is one in your area, as in my case my diabetes nurse is also the DAFNE trainer for my hospital so if im unsure about anything i usually drop her an email and she replies usually an hour or two later.

hope this helps

 

[JayC]

You must treat the first signs of a hypo with fast acting carbs. This might be able to cause coma if you continue eating those foods. However, you know that you don't need to eat more that can affect with it.

 

[the_anticarb]

I guess if I am just borderline hypo is more what I meant - obviously if I was proper hypo I would have glucose.

I must have done the right thing in subtracting 15g carbs as when I tested an hour later I was 5.8 which is more where I wanted to be.

It's easy to overtreat a low blood sugar if you get an attack of the munchies so this approach seemed to work for me. Sometimes it's easier just to bring the next meal/snack forward if I am not too low just yet.

Thanks

 

[Debloubed]

I remember being told on DAFNE to correct the hypo as you normally would and then bolus for the meal or snack as normal. It's not always convenient to do this but needs must! it's a personal thing and perhaps a quick drink of something quick acting before the meal so you don't ruin your appetite if you are borderline low (3.8 - 4.1) If I was way, way low my meal would have to wait :wink: don't know about anyone else, but I tend to get nauseous when low so can't face lots of food anyway!