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type 1 using weight watchers - how to handle low blood sugars
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Marcus_Aurelius; posted:
Hi, all. need some advice. I've been type1 for 20 years, on a medtronic pump with CGM. My wife has been using the online WW system for a while and I was thinking of doing it along with her (could stand to lose a bit myself). Anyway, one big question that I have is how does something like that work when I have to adjust for a low blood sugar? For example, the other day I was bouncing around low and had several times when I ate a small snack to kick my sugars up (still trying get the sugars dialed into the smaller range the sensor allows me to track). Obviously sugar level trumps daily points. I'm just wondering how others have handled this, what works best for snacks to treat lows (gum drops vs. cookies, for example), etc. Any thoughts or advice appreciated.
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mhall6252 responded:
I'm sure an insulin user will respond shortly. I haven't done WW, but my opinion on treating a low is to eat or drink something to bring the glucose level up (such as 4 oz of orange juice or glucose tabs or your quick sugar candy of choice), then eat a small protein or fat (such as a handful of nuts); or if it's time for a meal, go ahead and eat normally. Adding a protein or fat will prevent the yo-yo effect that you will want to avoid.

When I am starting to feel shaky, or if I want to play golf late in the afternoon, thus delaying dinner, I will drink a 6 ounce can of V-8 and eat a 1 ounce bag of peanuts.

Michelle
 
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auriga1 responded:
Marcus, you've been doing the insulin thing far longer than I have. What do you normally do when you run low?

I'm a type 2 insulin-dependent diabetic, using both the Lantus and Humalog. The Humalog is just for meals or any carbs I may ingest with a ratio of 1U to 12 grams of carbs. That's been changed up and down because of physical activity.

I know how you feel when those lows hit. I find it best to use a fast acting carb, such as juice or glucose tabs. I prefer juice because those glucose tabs are just pure sugar that makes my tongue curl. LOL. Plus, it's fast acting more so than cookies or anything else to eat.

I am totally unfamiliar with the WW system. Do they cut carbs drastically? If so, you might run into a problem. Do you have a dietician to help you out with this? If not, ask your doctor for a referral. Hopefully, another Type 1 will come along to let you know what works for them.

It gets frustrating when you want to lose weight and have to combat the lows with more carbs.
 
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Marcus_Aurelius; replied to auriga1's response:
My understanding, based on watching my wife do the program, is that you get a set number of 'points' to use each day. you get more with exercise. So, if I plan out my meals accordingly I will use X points and then some snacks I will use some more points. Higher fat things are more points, etc. You should try to use all of the points (not using them all can be as bad as going over). In theory, if I stick to the plan you eat heathly, exercise and lose weight. Now, my question stems more to if I have to treat a low blood sugar three times in a day for some reason (without an offseting exercise activity), and lets say that I eat a 20carb cookie each time, those points accumulate. I have to treat the low but that throws off the point system (it's not like I was planning on being low!). So I was just wondering how someone on the plan handled this. Likewise, if I'm really high I normally clamp down on my eating and treat with insulin until I'm back in range. Frankly, I hate being at 240 and eating a full meal (holy spike, Batman!). That means that I might leave a significant amount of points unused. I know that there is nothing that "makes" me use points or not, etc. But if I want to commit to using the system, I'd prefer to try to stay true to it; I can loosely follow something and not really care on my own without paying someone
 
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mhall6252 replied to Marcus_Aurelius;'s response:
Well, I would guess that a 20 carb cookie would not be the greatest choice for a low under the WW point system. And if you are having these lows 2 or 3 times a day, then you've got bigger problems than counting points. Since you are "paying" for the system, why not ask the WW Counselor for some advice. I have to think they've had participants with similar issues.

My other thought is when you are low, to eat a small portion of what you would eat at the next meal, then eat the "remainder" at the normal meal time. Would that do the trick?

Michelle
 
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mrscora01 responded:
I can give you a hand with this as I'm a T1. It takes a bit of time to adjust the increased exercise (necessary) and lower food. Once you get your insulin adjusted to the new regime, you won't be experiencing any more lows than you did before. Don't forget that your ratios may change as you lose the weight as well. In the meantime, just use a small amount of what works for you to bring your glucose back up. Best of luck with readjusting.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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auriga1 replied to Marcus_Aurelius;'s response:
Marcus, I think your best bet would be to contact your doctor's office to see if this type of program is safe for one using insulin 24/7, since you seem committed to trying it.

I understand about the accumulation of points over a period of time. Maybe someone at Weight Watchers can help you out if you give them a call and express your concerns before you start.

I would forget the cookies, though. They are not as fast acting as some sort of juice. How do the points rate for OJ, for instance?
 
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arealgijoe replied to mrscora01's response:
WELCOME back MrsCORA.!.!.!

Nice to C u here. I hope you are doing well now.

How about an update?

Gomer
 
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laura2gemini2 responded:
When I was in WW, there were a set number of points per week that you could go over (I think it was something like 14). I used those when I hit a low. With the new program I dont know if they still have the overage points, but as long as you dont go over by a lot, it should affect your weight loss.
 
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Laurie Anderson, MSN, RNP, CDOE responded:

Hi,

Since you are experienced at managing your blood glucose while eating a usual diet, I am sure you can get a handle on this! As someone else pointed out, once you make some adjustments in your basal insulin for the lower carbohydrate intake in the WW diet, you'll have fewer lows. You will also have to make the suggested adjustments in basal insulin as you lose weight. I'd look for some points options that are about 15-20 grams of carbohydrate to use when you are low, but as you point out, low trumps points. Juice and lifesavers are both rapid acting options when you are having a low, and I agree with the suggestion that you follow a rapid glucose source with a meal or snack that includes a little fat and protein to help sustain your blood glucose. Your best bet would be to meet with the person who helped you to start your pump management so you can review your current glucose trends and make the necessary pump adjustments.

Kind regards, Laurie