Hypo query?

[chocoholic]

I don't quite understand how my reading went so low last night. My reading pre-evening meal was not low but as I had a virtually nil carb meal (cheese and mushroom omelette with green salad) I had no insulin.Had a stonking headache(seem to have constant headaches at the mo') about an hour after eating, so took myself off to bed. About 9.30 headache and vison got so bad I took a reading and it had gone down to 1.9. Had three glucose tabs. and followed it up with a crumpet with cheese.Took another test about 20 mins later to check it had come up and meter flashed 'Lo', which probably indicates my reading had gone down to under 1.1. I assumed that glucose tabs worked quicker than that. Was unsure what to do but decided to do an immediate repeat test and it was 8.3 and reading on waking this morning was 6.2, so only a bit higher than I like it in the morning.
Has anyone any ideas why my blood sugars would go so low after a nil insulin meal? Also, I'd like to know, if blood sugars go off the scale of my meter, does the liver alwaysdump glucose to help out?
Any advice much appreciated.

 

[china]

Hello Chocholic
What were your activity levels like during the day - had you been very active/done any exercising? Don't forget it's not just the food intake but also the physical output that needs to be taken into account.

I don't really know anything about Lada, so can't help you on that, but I'm sure someone will be along to give you advice. Meanwhile, if you are going through a period of headaches etc I suggest you keep a food/activity/symptoms diary for a few days and then go and see your GP if still concerned.

I hope things improve for you.

 

[chocoholic]

Hi China,
Thanks for the reply. Actually had no exercise that day.I'd had a very stressful day mentally but I would have expected higher readings, if anything.

 

[ham79]

stress can lower your sugars as well but I'd get checked cos thats low

 

[janabelle]

Hi Chocoholic,
Has this happened before that you can remember and what insulin are you taking?
Jus

 

[chocoholic]

Well, I've never been THAT low before. I didn't realise that stress could send me low too. If that is the case, that could well be my problem, as I am going through a very tough time mentally right now. I'm on Lantus and Novorapid but I'm on only small doses.

 

[phoenix]

Hi,

I think that your problem of glucose levels not rising quickly may have been due to the crumpet and cheese. The cheese would delay the digestion of the glucose, a crumpet with cheese is really just like a pizza.
Glucose tabs, normally work quickly; take 15 g (some tabs have only 3g each), wait 15mins (when low in the middle of the night 15 mins seems ages and I often wait less! ,) if not back in safe territoty take some more glucose, wait test again. When your levels are definitely back into non hypo territory use your slower carb. When someone has a hypo at the hospital I attend they invariably give a piece of fruit for the 'snack' as the most healthy option. The advice on one NHS site is milk, cereal bar, yoghurt, a plain biscut or piece of cake.

If you live with someone who can help you in the event of losing conciousness then Its a good idea to get a glucogen kit, to keep in the fridge just in case. I've had some very low glucose readings in the past and have never needed it but I'm glad it's there. You could also get some glucogel which can be absorbed quickly through the gums.(though should only be used whilst concious)

As to your liver helping out, fortunately for us, in most cases, especially in adults, it will. Moreover, many of those cases in adults where it hasn't come to the resue are cases when alcohol has been involved. If the liver is breaking down alcohol it can't release glucose this can cause dangerous hypos even in non diabetics.

This is quite a good article on hypos
http://www.diabetesselfmanagement.com/articles/diabetes-basics/understanding_hypoglycemia/5/

edit: another thought is , do you often eat a low carb meal at night? If not maybe your basal is a bit high and is 'covering ' some of the carbs in your meal . What level were you at bedtime?

 

[janabelle]

Hi again,
I suspected u were on Lantus, as I had this happen to me quite a few times while on it, and it was very frightening. When it happened to me, I hadn't taken any Humalog at all and could go down as low as 2 throughout the day. Like you, I had no idea why it had happened, as I'd not adjusted my Lantus dose. I've had no days like that since coming changing from Lantus to Porcine nearly to years ago. I'd been on insulatard for years before Lantus, and never experienced such 'out of the blue' hypos on that either-especially having taken NO rapid or short-acting insulin.
My husband is a scientist and has suggested that unexplained hypos may occur because of the acidity of Lantus. It is very acidic with a PH of 4 on injection. The body's PH is around 7, which enables Lantus to be neutralised and released slowly. However if the body's PH becomes more acidic due to stress, injury,etc, then it is possible that Lantus could be released quicker into the body, causing unexpected low blood-sugar levels.
As for the headaches,there could be many reasons for them, and you should get ur doc to check it out. However it is not uncommon for people to experience side-effects of Lantus and other GM analogue insulins from 18 months to years after starting taking them. Changing insulins, either to animal or even NPH, as another forum member recently reported, can result in a decrease or disappearance of such side-effects. viewtopic.php?f=26&t=2797&start=75
Jus

 

[chocoholic]

Thank you Phoenix and Janabelle for your replies. I saw my endo. only this week and (because of the concerns you frequently mention on this forum janabelle which I certainly have considered) I did query if my problems could be down to the insulins I'm on. I wanted to be sure it wasn't that before getting myself help of a different sort for the depression. As I've had severe bouts of depression most of my adult life, way before I had diabetes, I thought it unlikely but I never like to rule out ideas from others. Endo. said the only folks he'd known have problems with Lantus were those who had previously been on animal insulins and then changed to Lantus, not folk like me who went straight onto Lantus. IYSWIM.
I am very grateful for all your replies though, as I always seem to learn something new from you folk. I did yell for hubby to assist me mid-hypo but he seemed to go temporarily deaf......I think the film he was watching on telly downstairs held more interest than my calls for help!!! Fortunately, the glucose tabs were within my reach but I think the only crumpet that might have got hubby away from his film was not the sort that can be toasted! :lol:

 

[CarbsRok]

y

 

[iHs]

Choccie

Sometimes diabetes does do a wobble so I wouldn't worry too much unless it happens again. Obviously if you had eaten a bit of carb with your salad your bg levels would have probably been ok. A few times in my life I have reduced my insulin in order to make my bg levels rise up a bit but instead of a higher bg the opposite has happened and my bg levels have dropped even more :cry: :lol: In the end though after 2 or 3 days my bg levels have risen up so no big deal

With regards to Lantus, if you feel that because of daytime hypos you would like to use a different basal (probably Levemir first of all) and adjusting your bolus insulin hasn't helped, then just ask endo for a change or see dsn at the local hospital. I had no problem changing from Humalog to Apidra because of hypos. Probably if I had known a bit more about insulin to carb ratios in 2003, I would have been ok but still never .............. :wink:

 

[tigger]

Endo. said the only folks he'd known have problems with Lantus were those who had previously been on animal insulins and then changed to Lantus, not folk like me who went straight onto Lantus. IYSWIM.


I love this. Could that be because people who've been on animal insulin know what normal insulin control should feel like whereas those straight onto lantus can have any side effects laid at their door? That's what happened with the original human insulin in the 1980s and it's depressing to see that nothing has changed.

 

[chocoholic]

Had the same thing happen yesterday morning....scrambled eggs mixed with leftover meat for brekkie, no insulin and blood sugar plummetted. I don't see my endo. now for another year. I think I need to see if my blood sugars level out again when I'm through this current bout of depression and stress and can review if it might be the Lantus causing the problem. Certainly janabelle's hubby's thoughts are very interesting.

 

[iHs]

Had the same thing happen yesterday morning....scrambled eggs mixed with leftover meat for brekkie, no insulin and blood sugar plummetted. I don't see my endo. now for another year. I think I need to see if my blood sugars level out again when I'm through this current bout of depression and stress and can review if it might be the Lantus causing the problem. Certainly janabelle's hubby's thoughts are very interesting.

Not sure what this is all due to but firstly test out your Lantus basal rate by not eating anything just to see whether your bg starts dropping mid morning. Also, do you wake up with a lowish bg level?

 

[chocoholic]

Okay,thanks iHs, I'll give that a go. Morning readings vary. I like to wake up around the 5-6 mark and it often is, though sometimes a tad higher or lower.