Hypo from Hell and no idea why

[Omnipod]

I have had a hypo from hell. For the last hour, I have stayed between 2.6 and 3.4.
I was 5.3 before dinner at 7pm. I had 40 grams of pasta for dinner. I decided to extend my bolus by half an hour as I was 5.3. Half way through dinner, I started feeling hypo so I tested and was 3.2. I then cancelled my extended bolus and suspendid the pump. i had some lucozade and finished my dinner, 20 mins later, I tested again and was 2.6. I have now drank a whole bottle of lucozade. its been an hour and I am still 3.6.
I have not had any bolus since 3pm. I had a correction bolus of 2 units as I was 18.
I have not eaten since or taken more insulin.
I am sure my pod / pump malfunctioned as I removed the pod 10 minutes ago and only now, have my levels gone up to 3.7.

I just dont understand why I hypo'd for over an hour and I ate a whole plate of pasta and drank a whole bottle plus of lucozade.

 

[logindetails]

Could the pump be malfunctioning and pumping when it shouldn't?

 

[donnellysdogs]

I think this is more like your correction at 3pm and basal not quite being correct.

 

[CarbsRok]

I have had a hypo from hell. For the last hour, I have stayed between 2.6 and 3.4.
I was 5.3 before dinner at 7pm. I had 40 grams of pasta for dinner. I decided to extend my bolus by half an hour as I was 5.3. Half way through dinner, I started feeling hypo so I tested and was 3.2. I then cancelled my extended bolus and suspendid the pump. i had some lucozade and finished my dinner, 20 mins later, I tested again and was 2.6. I have now drank a whole bottle of lucozade. its been an hour and I am still 3.6.
I have not had any bolus since 3pm. I had a correction bolus of 2 units as I was 18.
I have not eaten since or taken more insulin.
I am sure my pod / pump malfunctioned as I removed the pod 10 minutes ago and only now, have my levels gone up to 3.7.

I just dont understand why I hypo'd for over an hour and I ate a whole plate of pasta and drank a whole bottle plus of lucozade.

Suspending your pump because you are hypo wouldn't have helped because the lack of insulin would take at least an hour before any effect was felt.
As DD say's basal and correction needs looking at. Pasta takes forever and a day to hit your system, which is what you are seeing now. I suspect you are going to go very high with a few hours. Pumps do not just malfunction, 99.9% of hypos like yours are user error or basal rate needs a change.
Been there and worn the Tshirt

 

[Omnipod]

Suspending your pump because you are hypo wouldn't have helped because the lack of insulin would take at least an hour before any effect was felt.
As DD say's basal and correction needs looking at. Pasta takes forever and a day to hit your system, which is what you are seeing now. I suspect you are going to go very high with a few hours. Pumps do not just malfunction, 99.9% of hypos like yours are user error or basal rate needs a change.
Been there and worn the Tshirt

I am going higher. I have increased my temp basal by 20%
Normally my basal is good. 2 units correction surely couldnt have given me such a severe hypo?
Im putting it down to a one off and unexplained hypo.

I always suspend my pump for 30 mins when I have a hypo. That way, I recover quicker. Usually 100ml lucozade does the trick.

 

[CarbsRok]

I am going higher. I have increased my temp basal by 20%
Normally my basal is good. 2 units correction surely couldnt have given me such a severe hypo?
Im putting it down to a one off and unexplained hypo.

I always suspend my pump for 30 mins when I have a hypo. That way, I recover quicker. Usually 100ml lucozade does the trick.

Well if you bolused at 3 and ate at 7 then you obviously still had IOB and dropping you then bolused for your evening meal and had a very slow onset meal so bam you had a hypo.
Have you actually covered your whole meal plus the excess lucazade needed to treat the hypo from H*ll? If you haven't then watch your blood sugars to make sure you now don't go through the roof and start a yoyo effect.

 

[donnellysdogs]

I don't understand why you suspended basal either, as this would do nothing to stop a hypo, all it should have done is shoved your readings up 2hours later...

 

[donnellysdogs]

Did you do any physical activity after your 18 bg?

 

[donnellysdogs]

I think seriously your inderstanding of recovering quicker from a hypo by suspending pump is a bit off target.

A hypo if treated correctly should be pretty quick recovery. quick acting insulin in pumps is not acting immediately-at the earliest 1 hour after so suspending your pump has no effect at all on actual timings of hypo treatment, it will only affect you by going higher, later.

 

[Danaemac]

I was told only suspend your pump for a download no other time due to insulin going back up tubing etc seems like a few things together have probably contributed to your hypo

 

[iHs]

Was there a chance that yr finger had somdthing on it when you did the bg test and got the reading of 18mmol? Ive had times like that myself and when running hand under the tap, doing the test again, the reading has been lower.

See tomorrow if the same thing happens and if it does, then you'll know that you've got to adjust the settings on the pump.

Pumps.......who'd ave em lol PITA at times

 

[donnellysdogs]

Good point iHs. Been there done that myself!! Corrected, but finger had been foodified hours before and went out like a light!!!!

 

[donnellysdogs]

Always wash and recheck now before giving any correction..

 

[Omnipod]

Well if you bolused at 3 and ate at 7 then you obviously still had IOB and dropping you then bolused for your evening meal and had a very slow onset meal so bam you had a hypo.
Have you actually covered your whole meal plus the excess lucazade needed to treat the hypo from H*ll? If you haven't then watch your blood sugars to make sure you now don't go through the roof and start a yoyo effect.

I extended the bolus by 30 mins for my evening meal so my bolus had not been given by the time i hypo'd. I cancelled it as soon as i tested.

I had to test throughout the night. woke up every 2 hours and took 2 units of insulin.

Its just weird that all I had was 2 units at 3 pm but then they hypo lasted over 1 hour at 7pm. I had no other IOB. Even if my reading test at 3 was wrong, 2 units could never have given me such a severe hypo 4 hours later. I had a whole bowl of pasta before the hypo too.

My readings at 3 werent wrong because i just got the new freestyle libre so I was checking the reading from the libre and then pricking my finger to compare readings.

 

[livitridge]

I had the exact same thing happen to me. It was horrible, blood was 2.3 before bed, I drank half a bottle of lucozade and 1 hour later was 3.2. Drank the rest of the bottle and came up to around 4. I thought it was shoot my sugars up! I didn't have any IOB so was very confused as to what was bringing them down. Scary stuff, not going to lie it has scared me a lot im very cautious about giving insulin now.!

 

[azure]

Did you bolus for anything like a snack in the afternoon? Sometimes when I've misjudged the carbs in a snack, even if only very slightly, the ensuing hypo can persist far longer than seems normal. I'll have glucose, eat and it still goes down. Again, a correction dose can sometimes do that too, even if I've calculated it correctly. I find certain times of day are worse than others for that effect.

When you said you extended your pasta bolus by half an hour, I wasn't sure if you meant half an hour on top of your normal extension, or just half an hour. Pasta is something I absorb slowly so I tend to give a third of my insulin immediately and give the other two thirds in an extended bolus over two hours. Once when I was tired, I messed that up and had too much insulin immediately, and I had a hypo then.

When my blood sugar is quite low before a meal, I sometimes delay the bolus so I can get the food eaten first ( or do it halfway through). Could the bolus have worked superfast? Could your cannula be touching a muscle and the insulin be being absorbed quicker than normal?

I guess your weird lows might be a combination of different factors, but it's definitely scary when your blood sugar refuses to come up and stay up. It always seems to happen at night too, which adds to the anxiety as it means hours of testing afterwards and not much sleep!

Hope you're sorted now and it's not happened since.

 

[Bebo321]

I had the exact same thing happen to me. It was horrible, blood was 2.3 before bed, I drank half a bottle of lucozade and 1 hour later was 3.2. Drank the rest of the bottle and came up to around 4. I thought it was shoot my sugars up! I didn't have any IOB so was very confused as to what was bringing them down. Scary stuff, not going to lie it has scared me a lot im very cautious about giving insulin now.!

Hi @livitridge,
Had you been more active than usual during the day or done some strenuous exercise? Remember when you exercise you deplete the glycogen (glucose) stores in both your muscles and liver. These can take a while to re-stock and so blood glucose levels can begin to fall some hours after you have finished your activity. (Apologies - you probably already realise this, but it's always good to just check!)

 

[livitridge]

No exercise just completely out of the blue. It happened on a Wednesday night and I had my foot tattooed on the tuesday.. But I don't think that would have had any effect? They say stress can cause a hypo. But I don't see how it would cause such a horrible low... Plus I have plenty other tattoos and had no problems.

 

[Bebo321]

No exercise just completely out of the blue. It happened on a Wednesday night and I had my foot tattooed on the tuesday.. But I don't think that would have had any effect? They say stress can cause a hypo. But I don't see how it would cause such a horrible low... Plus I have plenty other tattoos and had no problems.

Logically it would make more sense to see a blood glucose rise, not fall from a tattoo (if your body responded to it as say an 'injury') - though others may be able to advise on this based on experience.
Stress again typically would cause a blood glucose rise - basically the stress response is the 'fight or flight' response, where hormones released cause the liver to release glucose into the bloodstream. (Sorry - you probably already know all of this!) Perhaps if you had the tattoo (causing BGs to elevate and deplete your liver glycogen stores a little on the Tuesday), then follow that with a day of not really eating anything and I guess it's possible you could get a delayed blood glucose fall as the liver re-stocks itself - but it's a bit of a stretch.
Sorry it's a tricky one! I bet you can usually figure out why you've hypo'd so it must be very unsettling not being able to attribute anything in particular to the low.
Stay confident and keep faith in yourself - the fact that you know you shouldn't have hypo'd indicates that you have good control of your BGs. x