Cannot stop pattern of hypos

HasanG

Member
Messages
22
Type of diabetes
Type 1
Treatment type
Insulin
I usually have breakfast at 7am and I split my basal and I carb count. Around 11-12ish every day my sugar drops to around 3.7mmol/L and I cannot figure out why. I've increased the carbs per insulin unit from 12:1 to 15:1 and decreased my half basal from 8 to 6 and it just ends being very high in the morning between 10-11. Currently on lantus and novorapid and I have a bfast ratio of 12:1 and all other times 15:1 and take a shot of 8 and 7 basal units.
 

TheBigNewt

Well-Known Member
Messages
1,167
Type of diabetes
Type 1
Treatment type
Insulin
You didn't say how much Novorapid you take for breakfast, or what you eat then. You're consistent, so it sounds like you need to decrease the breakfast bolus you take. Me, I have the same cheese omlet for breakfast at work at 8 every day, and take 4 of Novorapid right after I eat it, and at lunch I'm almost always 4.5-5.0 which is fine. You aren't what I'd consider horribly hypo at 3.7, but you don't have much cushion either.
 

HasanG

Member
Messages
22
Type of diabetes
Type 1
Treatment type
Insulin
You didn't say how much Novorapid you take for breakfast, or what you eat then. You're consistent, so it sounds like you need to decrease the breakfast bolus you take. Me, I have the same cheese omlet for breakfast at work at 8 every day, and take 4 of Novorapid right after I eat it, and at lunch I'm almost always 4.5-5.0 which is fine. You aren't what I'd consider horribly hypo at 3.7, but you don't have much cushion either.

Thanks for your reply, I eat rice krispies with milk everyday which total upto around 60g of carbs. I have tried decreasing from 5u to 4u for my breakfast bolus but I ended up having a b/g of 10 mmol/L. I tried each for 2 days each (lower just Bolus, lower just Basal).

Edit: As for the hypo, if I was to no treat it, it would continue to drop and has been as low as 2.2mmol/L.
 

DunePlodder

Well-Known Member
Messages
861
Type of diabetes
Type 1
Treatment type
Insulin
Hi HasanG, I would reduce the basal by just one unit & give it 2 or 3 days - your reduction from 8 to 6 is a substantial 25% drop. Leave the breakfast bolus as is for now.
My only other thought is that 60g is quite a large amount of carbohydrate, perhaps consider a smaller portion or an alternative?
Everyone varies, but your body can only absorb a certain amount of carbohydrate per hour. It depends on the type of carbohydrate but my body, for example would probably take 2 hours to absorb 60g.
Lots to think about..
 

catapillar

Well-Known Member
Messages
3,390
Type of diabetes
Type 1
Treatment type
Insulin
@HasanG when are you bolusing for breakfast? If you move your bolus further in advance of eating you might find 4u will be sufficient to keep you out of double figures but not an over bolus to send you hypo. Consistently hypoing 4-5 hours after breakfast does suggest it's a bolus issue.

It sounds like a faff, but are you weighing/measuring your cereal portion so you can be sure of the carb count? "Around 60g" of carbs could end up varying by quite a lot everyday if you aren't weighing it out.
 

TheBigNewt

Well-Known Member
Messages
1,167
Type of diabetes
Type 1
Treatment type
Insulin
Can you get access to pens that do 1/2 units? I've heard of Type 1's using half units of short acting.
 

noblehead

Guru
Retired Moderator
Messages
23,618
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
Disrespectful people
Thanks for your reply, I eat rice krispies with milk everyday which total upto around 60g of carbs. I have tried decreasing from 5u to 4u for my breakfast bolus but I ended up having a b/g of 10 mmol/L. I tried each for 2 days each (lower just Bolus, lower just Basal).

You could try just having your basal on a morning and missing your breakfast (and bolus dose) out and see what happens later in the morning, if your bg goes low then you know it's your basal insulin that needs adjusted. it's what they call a Basal Test/Check and if you have a read of the following it explains things further:

https://mysugr.com/basal-rate-testing/
 

iHs

Well-Known Member
Messages
4,595
Insulin like Novorapid has an acting time of about 5-6 hrs and tends to have a sting in its tail towards the end resulting in low bg levels. Although adjusting the basal might help, often it's easier to just eat a small snack to prevent the low and use bg testing and trial and error to fix the problem.
 

HasanG

Member
Messages
22
Type of diabetes
Type 1
Treatment type
Insulin
@catapillar @TheBigNewt @DunePlodder I do admit that I eye out the 60g, buy I've measured it previously so I think there isn't much room for error. I will try a smaller portion of carbs and breakfast and I don't think I can get 1/2u dispensing pens.

@noblehead I will try this test next week thanks.

@iHs that does seem interesting as 5 hours after my advanced bolus at around 6:45 am is 11:45 which is when this hypo pattern occurs.
 

1abRat

Well-Known Member
Messages
248
Type of diabetes
Type 1
Treatment type
Insulin
@catapillar @TheBigNewt @DunePlodder I do admit that I eye out the 60g, buy I've measured it previously so I think there isn't much room for error. I will try a smaller portion of carbs and breakfast and I don't think I can get 1/2u dispensing pens.

@noblehead I will try this test next week thanks.

@iHs that does seem interesting as 5 hours after my advanced bolus at around 6:45 am is 11:45 which is when this hypo pattern occurs.

If you're using Novorapid your GP or Diabetic Nurse should be able to sort you out with the Novopen Echo which is a half unit pen. It also has a memory function that tells you how much you last injected and how long ago.

I agree that you might want to try bolusing for the Rice Krispies further in advance. I have to bolus 45 minutes before I eat in the mornings because I'm very insulin resistant. You might not need to bolus so far in advance but you can experiment by moving your bolus back incrementally by 5 minutes every day until you find what works.

Definitely get some scales to weigh out your cereal, it's not a big hassle and will help you work this out properly.