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[IP] bolus for a low blood sugar

Sylvia asked earlier this week:

>>	does anyone bolus when their blood sugar is low?  do you bolus for what you 
eat?  my blood sugar was 26 and i ate 1 strawberry cheese cake snack bar.  
it has 21 carbs in it 15g of sugar.  two hours later i was at 345. i have 
been on the pump of two weeks and still learning.	<<


I see that you have gotten quite a few responses to your question from last

I have been negligent in answering because I have been playing too much and
working too little. 

I found out years ago that if I did NOT give myself between three and five units
of regular insulin when I found my sugar to be below fifty it would soon be
above two hundred and fifty. Actually the numbers are just guesses, but the
general tendency is real. If I am hypoglycemic (for me that is a sugar between
fifty to as low as fifteen) I will rebound with a vengeance and the sooner there
is insulin circulating the lower the rebound will be. I don't know whether I
have insulin antibodies that "eat" the circulating insulin when my sugar is low
or whether it is just my liver releasing loads of glucagon (which is merely
polymerized glucose--also called starch) but I now ALWAYS give myself about five
units of insulin (regular or lispro) when I am hypoglycemic. In addition I will
often bolus again in an hour to cover whatever "extra" food I ate to "treat" the
low blood sugar.

What many people fail to realize, both those of us who ARE diabetics and those
who treat us and live with us, is that we have TWO very different metabolic
abnormalities going on in our bodies at all times. One, the blood sugar swings,
is pretty well realized. The other is our circulating INSULIN level. In my case
I have absolutely NO endogenous insulin (I produce NO insulin in my own body) so
I can easily find myself without circulating insulin half an hour before my
blood sugar starts going up. If I do not treat this hypoinsulinemia I will pay
exorbitantly for a couple of hours after my cells start starving to death. Serum
potassium starts to raise rapidly, cell respiration declines precipitously and
in general I just feel like crap. I think that this is what people may
experience when they become ketoacidotic. So whenever I "feel" my serum insulin
level falling I take a bunch of insulin. The trick, of course, is learning to
recognize the symptoms of low INSULIN levels which are not necessarily the
symptoms of a high blood SUGAR. I may be an extraterrestrial and it may be that
no other individuals have this abnormal condition, but I rather suspect that is
not the case.

Nick Trubov
email @ redacted
Fort Smith, Arkansas
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