What kills is an unchecked persistent low blood sugar causing confusion, black out, coma, and eventually cardiac arrest.
A single unit of insulin in isolation, to a T1D with undepleted glucagon stores is going to cause a low but won’t result in a black out.
A single extra unit of insulin, to a small child, who just completed a long day of exertive activity, and who had lows earlier in the day which drew on their body’s natural glucagon store, and who is not being monitored by a third party, that could be dangerous.
Keep in mind the accuracy of dosing with a syringe is not much better than +/- 0.25 units, this is why continuous monitoring is so crucial. You never quite know how well the insulin is absorbing, how well the carbs are being digested, maybe even how many carbs exactly were ingested in the first place.
For a small child with a carb ratio of 30g/unit (1 unit of insulin “covers” 30 carbs) and a sensitivity upward of 200/unit (1 unit of insulin without any carbs lowers blood sugar 200 points), being dosed by syringe, without a CGM, you are fighting lows pretty regularly and have to be able to recognize and treat them (glucose tabs, juice, cake frosting when things get more serious, and glucagon injection when things get critical).
I’ve never had to gluke my kids, but the day will likely come. We carry glucagon, juice boxes, and tabs everywhere.
T1D is potentially life threatening pretty much every day. You do the best you can with the tools you have to keep blood sugars in range without too many lows (too high is long-term bad, too low is short-term bad).
A single unit of insulin in isolation, to a T1D with undepleted glucagon stores is going to cause a low but won’t result in a black out.
A single extra unit of insulin, to a small child, who just completed a long day of exertive activity, and who had lows earlier in the day which drew on their body’s natural glucagon store, and who is not being monitored by a third party, that could be dangerous.
Keep in mind the accuracy of dosing with a syringe is not much better than +/- 0.25 units, this is why continuous monitoring is so crucial. You never quite know how well the insulin is absorbing, how well the carbs are being digested, maybe even how many carbs exactly were ingested in the first place.
For a small child with a carb ratio of 30g/unit (1 unit of insulin “covers” 30 carbs) and a sensitivity upward of 200/unit (1 unit of insulin without any carbs lowers blood sugar 200 points), being dosed by syringe, without a CGM, you are fighting lows pretty regularly and have to be able to recognize and treat them (glucose tabs, juice, cake frosting when things get more serious, and glucagon injection when things get critical).
I’ve never had to gluke my kids, but the day will likely come. We carry glucagon, juice boxes, and tabs everywhere.
T1D is potentially life threatening pretty much every day. You do the best you can with the tools you have to keep blood sugars in range without too many lows (too high is long-term bad, too low is short-term bad).