Strange severe Night Time Hypos

[itconor]

Hi Guys, Im hopping for a little advise. Ive been Type 1 now for around 12/13 years.

Last week i had the worst Hypo ive ever had.

I Woke up out of sleep around 2am feeling very low. i tested my blood sugar and it showed a reading of 2.1, i panicked woke my SO and started eatting haribo that i had on my bedside table she went and got my a bottle of coke and i had a glass or so of the coke. waiting another 15 minutes i start to see blue patches in my eye sight and i feel worse i check my bloods again and im still 2.1 in an utter panic i downed around 1 liter of full fat coke wait another 10/15 mins and i have gone up to 4.5 another 10 mins and i was 8.0 i think im out of the woods and make myself some toast, as im making toast i check my blood sugar again to find myself at 3.5 which is a dramatic drop so quickly which i cant understand after all the sugar so again i grab the nearest thing to me with sugar in it. which was some more sweets half a large packet later and im coming up again.


this is the closest i have ever come to loosing consciousness and i cant understand why. my last dose of novorapid had been around 7pm and was 8 units. i ate around 40G of carbs for dinner. Around 11 i had taken my levimir of 30 units. these are the doeses ive now been taking for over a year and not had any issues. i cant work out what caused a low like that, ive never had one outside of accidentally taking to much novorapid for the amount of carbs ive eaten and normally just a little sugar brings me back up.

Now for the last week i havnt really been sleeping because im afraid of it happening again and not catching it in time, i really believe i caught it and no more last week my control has been suffering because ive been purposely running myself high at night because im afraid of this.

i really dont know what to do or what even caused this .

 

[Jaylee]

Hi itconor,

With regards to the eyes during hypo.. Especially a night time episode with a BG of 2.1, even looking at an ipad screen is a blurred blinding light..
The blue patches you mention? I've occasionally had this too during night hypo. Though mine are more green In hue which could be an aqua marine? Like a butterfly wing? I put it down to light sensitivity with the pupils dilated.. When my BGs normalises or at least coming up to about 4.5, it disappears....
But someone else may suggest otherwise..

Personally I fancy the coke & Haribo mix may have acted on your hypo short term for a short fix..
Longer acting carbs may have levelled your blood as opposed to a spike & drop that is normally the nature & reason why stuff like coke/Haribo sells so well...

 

[robert72]

Is it possible that you might have taken 30 units of Novorapid instead of Levemir?

 

[itconor]

Hi itconor,

With regards to the eyes during hypo.. Especially a night time episode with a BG of 2.1, even looking at an ipad screen is a blurred blinding light..
The blue patches you mention? I've occasionally had this too during night hypo. Though mine are more green In hue which could be an aqua marine? Like a butterfly wing? I put it down to light sensitivity with the pupils dilated.. When my BGs normalises or at least coming up to about 4.5, it disappears....
But someone else may suggest otherwise..

Personally I fancy the coke & Haribo mix may have acted on your hypo short term for a short fix..
Longer acting carbs may have levelled your blood as opposed to a spike & drop that is normally the nature & reason why stuff like coke/Haribo sells so well...

I had already been sitting up in bed with the light on for some time it happened for a while after i stood up. possibly caused by low blood pressure ? it was large patches of my vision but seemed to go away when my blood sugar came back up

 

[itconor]

Is it possible that you might have taken 30 units of Novorapid instead of Levemir?

This was my First Thought but i have a insulcheck on the Levmir pen and confirmed it was that one that i took. (i took it while in bed Novorapid isnt alowed in the bedroom to prevent this)

 

[robert72]

I also get the blue patches when my BG is very low, almost like circles in the central vision

 

[robert72]

This was my First Thought but i have a insulcheck on the Levmir pen and confirmed it was that one that i took. (i took it while in bed Novorapid isnt alowed in the bedroom to prevent this)

Good plan

 

[Jaylee]

I also get the blue patches when my BG is very low, almost like circles in the central vision

More like maps of France while I think about it...

Seriously I've had a hypo while retiring for bed light to dark & seen these things & had to change my plans on sleep...
Also "back stage" after finishing a set...

 

[robert72]

More like maps of France while I think about it...

Seriously I've had a hypo while retiring for bed light to dark & seen these things & had to change my plans on sleep...
Also "back stage" after finishing a set...

Dang - I just get plain blue circles whilst you get iridescent butterfly wings and maps of France

 

[Jaylee]

This was my First Thought but i have a insulcheck on the Levmir pen and confirmed it was that one that i took. (i took it while in bed Novorapid isnt alowed in the bedroom to prevent this)

Indeed a good plan... I use two completely different pens. For basal a Clikstar. For bolus a Novopen.
Back in the late 80's they looked the same, rather like those old windows PC hard drive cases in colour.. However Novo Nordisk used to have a peel off sticker on the cartridge box to fix to the pen for a discrepancy...!

 

[Jaylee]

Dang - I just get plain blue circles whilst you get iridescent butterfly wings and maps of France

Lol. Maybe my eyesights better...?!!

 

[robert72]

I once (unwittingly) put a Humalog cartridge into the pen I used for Lantus (Autopen) and subsequently had a surprise hypo, pretty much as described above, a couple of hours after taking what I thought was a Lantus shot.

 

[Jaylee]

I once (unwittingly) put a Humalog cartridge into the pen I used for Lantus (Autopen) and subsequently had a surprise hypo, pretty much as described above, a couple of hours after taking what I thought was a Lantus shot.

Due to cartridge & corresponding pen design it's impossible to load my Lantis in my Novo pen & visa versa....

But in the old days before they got funky? Yep, I've grabbed the wrong pen....

 

[noblehead]

Could you have mistakenly taken your levemir twice? The insulcheck wouldn't record that (if I'm right) and only records your last dose.

If not then not sure what caused it, to consume all that glucose and get a reading of 8 only for it to drop down again 3.5 is a mystery, could the 8 reading have been due to some glucose on your fingers contaminating the test result or did you wash your hands first, I'm just thinking that perhaps the 3.5 reading (although still lower than the 4.5 reading before it) was your actual bg result.

Other than that just monitor things for a week or two and if things are fine just put in down to a bad experience, hypo's are scary and understand your concerns but you still need to get a goods nights sleep otherwise it will all catch-up you eventually.

 

[itconor]

Could you have mistakenly taken your levemir twice? The insulcheck wouldn't record that (if I'm right) and only records your last dose.

If not then not sure what caused it, to consume all that glucose and get a reading of 8 only for it to drop down again 3.5 is a mystery, could the 8 reading have been due to some glucose on your fingers contaminating the test result or did you wash your hands first, I'm just thinking that perhaps the 3.5 reading (although still lower than the 4.5 reading before it) was your actual bg result.

Other than that just monitor things for a week or two and if things are fine just put in down to a bad experience, hypo's are scary and understand your concerns but you still need to get a goods nights sleep otherwise it will all catch-up you eventually.

Thanks, I'm pretty sure i didn't Double inject, i guess its possible the higher BS could have been something on my finger at somepoint i started cleaning my fingers with baby wipes but i think it was after this test.

i may not have been 8 but i know i went up, as i felt myself drop down again and the shakes set back in.


i managed to get though to my diabetic nurse who has bumped my appointment to monday. she also suggested it may have been the needles im using (ive recently lost a good amount of weight) being to long and hitting muscle im currently on 8s they come in a blue box, she has suggested changing them out to 6s

 

[noblehead]

Better to use the 4mm needle if you don't carry any weight.

 

[Jaylee]

Could it have been a fresh cartridge loaded into the pen the night before the hypo?

 

[itconor]

Could it have been a fresh cartridge loaded into the pen the night before the hypo?

it had been in a while already i replaced it the next day just encase.

 

[itconor]

So it happening again last night just as i was going to bed at around midnight i started to drop and drop hard.

was 11.0 after cleaning my fingers and testing my blood sugar 20 min later as im lying down i feel like i may be dropping and check again and find im 5.6,
i drink 250ml of lucosade and wait around 10 mins to test again. when i test im 5.5, i drink another glass of lucosade wait another 10 mins test again and im 6.6,
wait another 20 mins to test again and im down to 5.3 so i drink another glass. wait 10 mins and im at 6.4 decide ive had enough and just need sleep and dont mind being high for the night just drink another glass there and then.
wait another 10 mins and im only 7.0, so this would now be 4 glasses totaling around 30g of carbs a glass meaning ive drank 120 carbs (which is more than i would normally eat in an entire day)

wait another while and im 11.3 have a round of bread and decide to sleep.

wake up at 3:30 am (about an hour and a half later) with a BS of 18.4, decide to take 4 units of insulin so i am ok for the morning. when i get up at 7am im 13.0.

due to the last incident i made sure my fingers were cleaned every time i was testing. i was about 4/5 hours since i had last taken a dose of NovoRapid (about 13 as i had been a little high going into dinner) and about an hour since i had taken my dose of lemir (24) i know i didnt double inject or take the wrong insulin as ive been keeping a log of everything since this last happened.

this is really effecting my confidence and control as ive been purposely sleeping high to stop this from happening and also really effecting my sleep.

i was at my check up appointment the other day and they basically said it was a one off and not to worry. but now i dont know, this is the first time ive had things really happen to me with no explanation, does anyone have any advice ?

 

[noblehead]

Does it only ever happen on a night itconor? Dropping 5.4mmol in the space of 20mins is extremely fast, it's all the more baffling considering your Novorapid was all but exhausted, which does point to your levemir dose, but why it would work so quick and plummet your bg is a mystery.

Poor insulin absorption due to injection site problems can result in hyper's postprandial then a sudden drop in bg many hours later, you should ask your diabetes team to check your sites and make sure they are fine.