15/15 rule outdated? if so, what is better way?

Hi All, i’m on the tandem T-slim, use Dg7, i’ve been reading through a post on the mobi - the 15/15 rule was mentioned and I want to know from the veterans of T1d on your treatment if you don’t follow this 15/15 rule treating a low? are you preventing lows or what is your revision to this rule? More than not, my lows are by mistake or just unforeseen circumstances, not because of imbalance carb/veg/protein ratios.

I’ve only ever used 8oz bottles of apple juice to treat. If i’m slow low will just start out with half-bottle, if i’m arrow(s) down low less than 70 bg, I chug the whole 8oz bottle then see. It goes without saying, I could live the rest of my days without ever looking at another bottle of juice - and the glucose tabs? forget it - more effort in my opinion. Thanks in advance for sharing a different experience to treat lows. M

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For me it was a starting suggestion I’ve long since moved past. Calling it a rule is super problematic because I’m a rule follower, and like you, I know there are times I need less or I can do the math* and see when I’m going to need more. I’m also willing to deal with complications of ice cream/cake/cookies/fruit/granola if I get the carbs I need when I need them in addition to the joy I get from enjoying the food.

*Not literal math, just estimate the change from the last 3 readings, IOB, activity, you know, all the usual diabetes stuff.

Welcome back, Mary @Disco2 , I’ve missed your comments.

The general 15/15 rule proved very useful in the 1940s when it was developed, at a time when getting a blood sugar reading took days and managing diabetes was more “in-the-dark” guesswork than today’s more enlightened guessing. Now with almost instantaneous BG availability we have the ability to intelligently customize our hypo and “down-trending” conditions.

Knowing one’s own body, and with knowledge of recent activity can be key to adjustments we make; such as over-dosing a recent meal [i.e., over-counting carbs] or greater than usual activity. Keep in mind too, that certain CGM will, in addition to current BG levels also indicate predictive. For me, a 4-gram tablet is the most common correction needed especially when a meal is close on the horizon. A sharp and unexpected late-evening downtrend may get a treatment of 20 grams of mixed duration carbs. As Chris @spdif said, always use 3+ CGM readings to guide your calculation. Ah, the juice boxes you mention [24 grams each] were common for me on bike rides, worked wonderfully, but now relegated to the storm grab-bag.

Awe. thanks Dennis yeah it’s been a while since i’ve checked in. I’m on my second Tandem T slim pump - four years to go - then see if a change is desired. I prompted the 15/15 question hoping for some magic trick to avoid juice…but i’ve discovered pineapple juice in little cans so i’m getting creative…lol. hope the mobi is working out well for you.

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Mary, I continued with another t-Slim 2 years ago, the MOBI just wasn’t for me. And with Medicare I need to keep a pimp for 5 years, extended waranty.

Hi Mary @Disco2 I discovered early on in my diagnosis that the 15/15 rule shot my blood sugar up so much that I needed insulin to bring it down. I originally switched to hard mints (5g of sugar each) and would have 1 for a low. I now use fruit snacks. I can open a bag and eat 1-4 pieces depending on how low I am. The gelatin in the snacks gives it more staying power than juice. That said, I do have a juicebox on my nightstand for those rare middle of the night low blood sugar numbers.

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