Do you ever go low right in the middle of eating?
This morning I woke up at 4.1 (74) and bolused 2.2 units (to cover 20g of breakfast) and then ate breakfast right away. About 25 minutes after waking up, and halfway through breakfast (I guess I'm a slow eater), I started feeling low and tested at 2.2 (40).
I never know whether I should treat this or not. I did swim last night so reduced my usual breakfast ratio (from 1:7 to 1:9) and had my overnight basal rate reduced to -10% for eight hours (which was still running).
In this case I did eat some Skittles since my mouth/tongue was starting to go numb which always freaks me out and makes eating a bit unpleasant. I always get annoyed when this happens because it's not like the insulin has had time to kick in much after only 20-30 minutes. Often I pre-bolus by that amount of time and my blood sugar hasn't even budged when I start eating.
Just wondered if this happens to other people, as this definitely not the first time it's happened to me, and I find it pretty annoying!
It's had to tell what's happening in your body. It's getting better with a CGMS to see what's going on behind the scenes.
You could be at 74, and dropping rapidly. Or you could be at 74 and steady. That would make a big difference in how your body handles the food and insulin. I've noticed for myself, in the morning when I have no insulin in my system, Novo takes effect rather quickly. So I will eat, or start eating and dose about 10 minutes in. We'll see how that changes once I start up my Omni system next week.
I've had this happen a few times when I was running or swimming. Could be the basal on board going into overdrive or less likely an injection too close to a vein. But seems like being on a pump this would be made apparent otherwise. As for the numb mouth (that one made me laugh) I used to notice it happened after a long hypo and a large meal.
I'm on the pump, and my pump does take off a bit off the bolus if you are below target. But I find if I follow that I tend to go high after meals, so unless I've been running low a lot, I usually just take the full amount and eat right away (as opposed to pre-bolusing by 20-30 minutes, which I try to do otherwise). I'm using Apidra, but even so I don't think the insulin really starts to work much before half an hour (at least for me). I think most likely, as someone else mentioned, my blood sugar must have already been dropping ... I think a lot of my "mysteries" would be solved if I had a CGM.
If I get low while I'm eating, I'd usually attribute it to an "error on board" extra bolus, extra exercise, overbasaled, etc. My BG doesn't usually run low unless I do something to it but I do a lot of stuff to it. When that happens, I usually try to fix the mistake, while I'm eating by eating something quick. I usually have a variety of carb load beer around my house for dinnertime excursions or something like milk for breakfast or candyish things I keep at work. Nothing too exciting, just an extra nudge of something that works quickly.
I have had this experience. Usually, I am at or near my low threshold of 70. I never get why this happens either. I have had it happen in restaurants and at dinner parties, which kinda freaks my guests out a bit.
This is just a crazy disease and there is a lot about it that doesn't make sense.
When I first started on the pump that would happen to me A LOT, but now that I have a CGM when my BS is below my target range I can tell wether its dropping or rising and adjust accordingly. Still sometimes I just eat first cause that seems safer than bolusing for a BS that is below target range.
Anything below 4.0 I NEVER bolus before I eat, I rather do a correction. I am not on the pump but my monitor keeps track of what i have on board and adjusts the recommended dose, however I am a bit of a control freak and I just wont take a shot until I know I am in a safe range to do so. 4.0 for me is my tolerance for lows....still able to take care of it but its scary just the same.
Usually if my blood sugar is below target range I will start eating and then bolus a few minutes after starting. In this case 4.1 is within target (though maybe borderline since the lower limit is 4.0), so I bolused and ate right away. If I'm over about 5.5 I will pre-bolus by 20-30 minutes or so to give the insulin time to kick in, otherwise I spike really high at one hour. It's not uncommon to be 12-14 at one hour and then 8-9 at two if I don't pre-bolus (which I can't correct or I go low since there is still insulin on board) versus being 9-11 at one hour and 5-6 at two if I pre-bolus.