You may need to take a few days and focus on helping the iLet learn about your meals. Here are a few tips:
- Be consistent with how you decide the meal type and size. Only select Breakfast if you are eating breakfast, Lunch for your lunch and Dinner for your dinner
- Only think about the carbs in your meal when selecting the size, NOT total size, fat, fiber or protein.
- Try to eat meals that have carbs in the “Usual for me” range
- Wait at least 4 hours before eating and announcing again
- After a few days, your meal dose(s) should adapt. Consult your healthcare provider and/or certified iLet trainer with questions.
CAUTION: Announcing a larger meal than the actual size could lead to severe hypoglycemia and confuse the iLet System, causing future meal doses to be less effective.
When your Glucose Level is Low
Your iLet System will reduce or stop insulin dosing in response to low or falling CGM glucose levels. Always make sure to have rapid-acting carbohydrates and emergency glucagon available to respond to low glucose levels. Make sure your CGM alarms are turned on and you can hear them.
Your iLet System has four different alarms for low CGM glucose readings:
Alert
Urgent Low Glucose
Meaning
CGM glucose < 54 mg/dl
Response
- Check a fingerstick blood glucose reading to confirm hypoglycemia
Alert
Low Glucose
Meaning
CGM glucose < 75 mg/dl
Response
- Treat with up to 15 grams of rapid-acting carbohydrates. You may need to treat with fewer carbs than you are used to, because your iLet System will have already decreased and/or stopped insulin dosing
- Always wait and give your glucose level a chance to respond to the rapid-acting carbohydrates before treating again
- Check a fingerstick blood glucose reading approximately 15 minutes after treating. Your fingerstick glucose reading may show a rise in glucose level before your CGM glucose rises
- Treat again with rapid-acting carbohydrates if your glucose level remains low
- Continue to monitor until your glucose remains above 70 mg/dl
Alert
Glucose Falling Quickly
Meaning
CGM glucose < 100 mg/dl and falling 2 mg/dl/min or more
Response
Treat with rapid-acting carbohydrates to prevent a hypoglycemic event from happening. You may not need the full amount of carbohydrates you would usually use to prevent this low glucose event from happening
Alert
Urgent Low Soon
Meaning
CGM glucose will be < 54 mg/dl within 20 minutes
Response
Treat with rapid-acting carbohydrates to prevent a hypoglycemic event from happening. You may not need the full amount of carbohydrates you would usually use to prevent this low glucose event from happening
If you see your CGM glucose level dropping, but your glucose is still above 100 mg/dl:
- Do not treat with rapid-acting carbohydrates right away
- Monitor your CGM glucose levels and be patient. Let the iLet System respond to your falling glucose levels
- Make sure your Glucose Falling Quickly and Urgent Low Soon alarms are turned on. Consider treating with some rapid-acting carbohydrates when those alarms are triggered
Do not take too many carbohydrates to treat a low glucose level. This can cause your glucose to respond too much, leading to a high glucose level and triggering more insulin dosing from the iLet System. This may end up causing a “roller coaster” effect while your iLet System responds to both rising and falling glucose levels.
How to Treat Low Glucose Levels
- Make sure to treat low glucose levels with only rapid-acting carbohydrates. These include juice, glucose tablets, Skittles, fruit chews, etc. These will provide the quick rise in BG that you need and, if taken in moderation, will not cause your BG to go too high or stay high for a long time.
- Do not use slower acting carbohydrates to treat a low glucose level. These include things with more fat or protein, such as chocolate, peanut butter, crackers, etc. These types of foods will cause your BG to rise more slowly, leaving your BG too low for too long, and may cause higher BGs later when you don’t need it.
- Do not take too many carbohydrates to treat a low glucose level. This can cause your glucose to respond too much, leading to a high glucose level and triggering more insulin dosing from the iLet. This may end up causing a “roller coaster” effect while your iLet responds to both rising and falling glucose levels.
- NEVER announce a meal for carbohydrates used to treat a low BG.
- If your BG is low before a meal, treat the low glucose with rapid-acting carbohydrates and allow the glucose to rise before you eat and announce for your meal. Once your glucose is within range, eat and announce the meal as planned. Choose the meal size based on the carbohydrate content of the meal, and do not consider the carbs used to treat the low.
- Do not include carbs used to treat lows in your meal announcement size. This will cause additional hypoglycemia.
- Do not announce your meal as smaller than what it actually is to get less insulin as a “reverse correction”. This will cause hyperglycemia because you won’t get enough insulin for the meal you are eating now. It may also cause the meal dose to adapt upwards, delivering too much insulin the next time you announce a meal and causing future hypoglycemia.
- REMEMBER: Your CGM glucose may lag behind your blood glucose level when you are treating lows. Consider checking a fingerstick blood glucose level using a meter 15 minutes after treating and before deciding to treat again, as your glucose may have already returned to range.
