I'm experimenting with the "uncovered snack" route

[Nancy in VA]

We have been fighting the lows. Endo gave us a new basal program for the afternoons today to combat the lows.

But, we are headed out to the soccer field shortly and she always goes low out there- even before her perpetual lows.

So, she is having a 15g uncovered snack right now. I'd rather her be a little high than really low! We'll see how it goes.

[frizzyrazzy]

good luck! I know for us it's always a combination of things that works best - a little temporary rate, a little snack and generally we're good.

[RosemaryCinNJ]

I do not cover snacks yet...(15 carbs ) snack here too...Good luck ....

[Nancy in VA]

Well, it worked - thankfully.

Here are the results of my uncovered snack test:

Snack at 5pm - 15g uncovered
5:45pm - get in car to go to soccer game
6:45pm - test BG - 154
7:45pm - test BG - 93

AND this is WITH a lower basal rate down 2-3 notches from where it was.

So imagine where she would have been WITHOUT the uncovered snack and the higher basal rate. And she still has a risk of going low because she seems to get the activity lows later.

[Donna C]

Hi! I'm newer to this than many as my 12-yr-old daughter was diagnosed in November and is still honeymooning. We have seen, though, that when she exercises (i.e. 20 minutes of rigorous basketball with a friend or even a 35 minute steady walk, not jog or heavy exertion) her sugar drops A LOT! Our endo told us that if we know we're going swimming or spending the day walking around an amusement park, etc. to cut back the nightly Lantus. She takes 19 units nightly, but the night before these events we will try Lantus at 15-16 units. We haven't tried it yet . . . maybe next week after school is out. She wants to start volleyball next year, so we KNOW we'll be in for some adjusting to prevent those lows. We checked her sugar before a 45 minute walk (I think it may have been 115 or so), had her eat 5-6 pb crackers, and her sugar was between 80-90 after the walk . . . even though it still dropped...that was with about 15 carbs. I've seen her sugar drop 40 - 60 points with exercise, so we definitely do "uncovered" snacks before exercise. Volleyball should be really exciting . . . fun! fun! I've realized on this wonderful forum that the children's ages certainly do seem to play a factor in their "predictability" if there is predictability. I'd imagine a very young child is much trickier. But, I'd much rather have highs than lows! So, I'm going to do the extra uncovered snacks rather than the alternative! :cwds:

[Nancy in VA]

Oh yeah, I've seen huge drops.

Last weekend, she was 215 at a check, and then 45 minutes later, she was 35. That's a 175 point drop in 1 hour! :eek:

[Amy C.]

Sometimes when I know that my son will be active, I have him eat and give insulin when he starts to go up. He tends to go low at night after an active day, so he will have an uncovered snack before bed.

[Mary Lou]

My CDE always jokes that she spends the fall turning all the kids' insulin regimes up and the spring turning them down.

good luck!

I'm right there with ya!

[Nancy in VA]

We had one SLIGHT low after dinner - 79. But she had 2.35 units on board (she usually only has about 3 for dinner but we had a high carb one. So, we treated the low to ward off the lower. She went up to 140 and stayed there all night.

So this "pre-snack" to ward off the lows might work. I have found if I give a snack AND insulin, even if I back off on the I:C for the snack, she goes low quickly.

[Amy C.]

I have used food as a tool to ward off lows for quite a while. Food works faster than lowering the basal.

[sammysmom]

I know that a lot of people just tweek the pump settings so that no uncovered snacks are needed but that just does not always work. We have finally figured out that on sparring night at karate, Sam has to have 1/2 cup uncovered milk before class. Works like a charm! Glad that the uncovered snack worked for you.

shannon

[Nancy in VA]

I have used food as a tool to ward off lows for quite a while. Food works faster than lowering the basal.

I think that's the key. We did lower her basal rate permanently yesterday during this time but usually by the time I find a low, setting the temp basal is only gonna deal with the extended low not the immediate

Again, I'd rather prevent them from coming in the first place and it looks like this will work

[twodoor2]

Nancy,
Do you check the IOB relative to the BG? I do this, and it works like a charm. For example, if Elizabeth is say, 86 and she has .7 units of IOB left, and her carb ratio is 1:20, then .7*20= 14. Therefore, I give her around 10 grams just so that I don't overcorrect. This always works. She has no hypos because I catch them before they might occur. With a BG of 86 and .7 units of IOB left, she would go hypo. The 10 grams is just enough to cover it.

[Nancy in VA]

I have used food as a tool to ward off lows for quite a while. Food works faster than lowering the basal.

Nancy,
Do you check the IOB relative to the BG? I do this, and it works like a charm. For example, if Elizabeth is say, 86 and she has .7 units of IOB left, and her carb ratio is 1:20, then .7*20= 14. Therefore, I give her around 10 grams just so that I don't overcorrect. This always works. She has no hypos because I catch them before they might occur. With a BG of 86 and .7 units of IOB left, she would go hypo. The 10 grams is just enough to cover it.


Yeah, I dial it all into the pump. We put all readings in the pump and when we treat a low with carbs, we also dial in the carbs that we treated with. It uses those carbs with IOB and BG to calculate. I can look and see if I've given enough or too much based on that.

[saxmaniac]

Do you check the IOB relative to the BG? I do this, and it works like a charm. For example, if Elizabeth is say, 86 and she has .7 units of IOB left, and her carb ratio is 1:20, then .7*20= 14. Therefore, I give her around 10 grams just so that I don't overcorrect. This always works. She has no hypos because I catch them before they might occur. With a BG of 86 and .7 units of IOB left, she would go hypo. The 10 grams is just enough to cover it.

Yeah, you can "bolus tip" (see Walsh) to have the pump do it for you. Keep upping the carbs until it just breaks 0.

But, it doesn't "always work" for me. I wish it was that predictable.

Sometimes lows are just going low, despite the IOB. Last night Alex dropped 130 to 40 between 12am to 2am. No IOB at all. Totally unknown why, no unusual activity. Whereas the previous bunch of weeks he'd be steady or creeping up slowly! Had to give 15+15 in order to get him back up. The first 15 stopped the low from getting worse, and the second 15 finally brought him back up to 150 (15g = 100 points almost always).

[twodoor2]

Yeah, you can "bolus tip" (see Walsh) to have the pump do it for you. Keep upping the carbs until it just breaks 0.

But, it doesn't "always work" for me. I wish it was that predictable.

Sometimes lows are just going low, despite the IOB. Last night Alex dropped 130 to 40 between 12am to 2am. No IOB at all. Totally unknown why, no unusual activity. Whereas the previous bunch of weeks he'd be steady or creeping up slowly! Had to give 15+15 in order to get him back up. The first 15 stopped the low from getting worse, and the second 15 finally brought him back up to 150 (15g = 100 points almost always).

Are you sure your basals are correct? The IOB provides a better estimation if the basal is correct.