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[IP] Re: Bolusing before eating

In a message dated 12/5/00 4:56:55 PM Eastern Standard Time, 
email @ redacted writes:

<< Dave,
 Two glucose tablets only have about 4-8 grams of CHO.  Not enough to do much
 for your low of 21.  If you were able to swallow, 2 tubes of glucose gel (or
 6 tablets) would give you about 30 grams of quick acting glucose.  If you
 were not with it enough to swallow, it would have been a good time for your
 wife to break out the syringe of glucagon.
 Bonnie Stone (CDE and mother of a pumper)
 David Strandlien wrote:
 >       I thank all of you for welcoming me to pumpers:)
 > This past weekend I had a serious insulin reaction, my wife had to call
 > 911....and of course the whole city of Minot (at least it seams that
 > way:) had to come.  My BG was down to 21 after my wife had forced two
 > glucose tablets into me....the ambulance and rescue crew had a heck of a
 > time getting my glucose level back up.  Why did this happen?  ...kind of
 > a long story...but it was ALL my fault:)  My 11 year old daughter had a
 > friend spend the night, in the morning they wanted to make pankaces and
 > I said sure, and I took a bolus.  Well, we were out of milk, so I ran to
 > the store to get milk, then while my daughter was making breakfast, I
 > crashed.  It was a good lesson for me though, I am new to Humalog since
 > starting on the pump.....make sure you are a very short time from eating
 > before bolusing:)
 > ---------------------------------------------------------- >>


My son is 10 and diabetic, and we have had this problem too, in the beginning 
with pumping.  We would have him bolus for let's say his dinner, and maybe 
things weren't quite ready at the time, or for one reason or another we 
didn't start eating immediately after his bolus.  So, of course he would 
experience a low and bottom out.  We now do not give him his bolus until 
after he eats.  We calculate his blood sugar minus his target, then divide it 
by the number of points per unit is body uses.  Then we figure that his carb 
count was for the mean and we take the total carbs and divide that by either 
15 or 20 depending on his activity.  Then we take the number  from the BGs 
and his meal and we determine what amount of insulin to bolus AFTER his 
meal... Doing this after the meal has helped so much.  Fewer Lows.  

Take care
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