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Re: [IP] low didn't respond to carbs

> for all of it.  This was at 5:30 pm.  At 8:30 she comes to me and
> tells me she doesn't feel good, tests at 45.  We stop the pump and
> give a tube of glucose gel.  She starts crying and her head is
> rolling back and forth.  We test again and she is 44.  This goes on
> for an hour where at each test she is anywhere between 38 - 44. 

> What happened?  Why did she drop so low and WHY didn't ANYTHING
> work?????
> This has been the most frightening episode for me since we began
> pumping 2 years ago.  This is the sort of event that prompted us to
> get a pump.  We would never give it up, but I have had my stress
> load of the week and don't think I can deal with anything else.  

This is not unusual, at least not at our house. This is the usual 
situation for a deep low if Lily has one -- usually in the middle of 
the night. With aggressive treatment, we've found it not to be a big 
deal. We do not suspend her pump unless there has been unusual 
physical activity earlier in the day (soccer tournament or such) 
since the insulin going in is for later -- after the low is 
corrected. Generally the low has been the result of a miscalculation 
of carbs -- not always obvious and not always something we can figure 
out; however, when we have figured it out the problem has always been 

What we do:

Step 1) Treat the low with enough glucose - orally by tablet to raise 
the target bg to 150 -- test in 15 to 20 minutes after last tab goes 

Step 2) Verify remaining insulin that is still active from the last 
bolus or boluses and calculate unused insulin if any.

Step 3) if 2 resulted in unused insulin, have a snack to cover long 
term problem and prevent a recurrance -- this is usually NOT the case 
but occasionally a snack is necessary if there was an indulgence just 
before bed time that resulted in the low.

Step 4) repeat step 1 until bg's test above 100 twice in a row -- 
then hit the sack. Usually by the 3rd or 4th iteration the low will 
be vanquished and we can all go back to sleep. Both of us sleep 
during the waiting periods so that we're not wiped out in the 

Don't fret, just keep plenty of glucose tabs around and shoot high 
for corrective bg reading.

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