Question of the Week | Premeal Glucose is Too Low

RL carb counts and takes 1 unit of insulin for every 10 gms of carbohydrate. RL also uses a correction ratio and takes 1 unit for every 40 points above their glucose target of 120.  RL’s asks you what to do if their premeal glucose is less than 70 before their lunch meal at work. RL often has blood sugar drops right before lunch and usually eats a sandwich, chips, berries and some sparkling water for lunch.

Given the situation, what is the best recommendation for JL to do if their pre-lunch glucose is less than 70 mg/g?

  1. Immediately eat 15gms of berries and recheck glucose in 15 minutes.
  2. Decrease usual insulin carb coverage for this meal by 1 or 2 units.
  3. Encourage JL to eat lunch immediately and give insulin afterward.
  4. Discuss which strategies would work best for RL in this situation.

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Solving Glucose Mysteries for Type 1
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Why do the blood sugars keep dropping after meals? Is the basal insulin set correctly? What adjustments are needed for exercise?

During this webinar, Coach Beverly addresses each of these glucose mysteries and more, using a person-centered approach.  She describes a stepwise approach to evaluate glucose patterns and correct common issues encountered by people living with type 1 diabetes.


  1. Describe common glucose mysteries encountered by people with type 1 diabetes.
  2. Using a stepwise approach, evaluate factors affecting glucose patterns.
  3. State interventions to increase time-in-range and improve quality of life.
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Coach Beverly Thomassian, RN, MPH, BC-ADM, CDCES

Author, Nurse, Educator, Clinician and Innovator, Beverly has specialized in diabetes management for over twenty years. As president and founder of Diabetes Educational Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes.

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