Help my Pancreas have woken up!

Sanober

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Not really knowing what's going on inside my Endocrine system!!!
Hi all, I'm confused and to be honest really fed up these days.

I found that about 2 weeks ago I was going into hypo territory within 2 hours of eating, so thought my basal actually needed to be reduced (for a change) dam this honeymoon!

I take Lantus at set time each morning. (Novo to cover meals).

I'm only 10mths into insulin usage and so far, I've had a few months stable, then wobbles then increase in insulin, then stable and then wobbles etc, it all at least seem to be consistenly progressing i.e Pancreas giving up bit by bit, but I now think I have the opposite problem.

I tried morning fast and noted that I woke with 5-6, rose to 7s within 2 hours and then at the 4 hour mark I was <4 so I guess my basal needed adjusting.

I pared back carefully, 1u reduction every 3 days. I went from 15u Lantus, to now 13u for past 3 days now.

However am now left with e.g 5-6s in the morning (which is fine), 2 hours later and after breakfast I seem to be 8-9s (fasting in the 7s) and within an hour or two after that into <4s so I'm eating sweets constantly these days. After lunch I get up to 8-12, and then guaranteed hypo within 2 - 3 hours after lunch.

I've had some unforseen levels of 2.7 - 3.5 too which came on without the normal hypo signs.

I've not altered my bolus as am on 1u per 10g of carb, so small amount. I'm already going too high post meal sometimes from 5-6s up to 12 within 20mins and as you can imagine I feel :sick: And then slump too quickly another couple of hours later, so have no idea what to do next.

It's not the time of month, it's not a change in exercise, it's not stress, and I'm not a big carb eater, it could be other underlying health issues (will get my Thyroid and female hormone results back tomorrow) but my levels have started wobbling for 2 weeks really whereas the symptoms have been going nearly 6-7weeks. I have continued to have a low grade urine infection but again that's been happening for nearly 2 months.

Any ideas, what I should do? I would greatly appreciate any suggestions because I do feel rather ill these days and trying to work like this is frustrating.

Thank you.
 

Mileana

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553
Just a ponder...

If you think about it, do you think it would make any at all difference while you adjust your basal if you took your insulin slightly earlier in relation to your meal?

I think in that situation I would try taking half my bolus 20 minutes before the meal, and the rest at the meal. I am guessing for you on a low-moderate carb, that would mean 1 unit before the meal, and 1 at the meal or something in that area.

To me it seems that your panc is working 'enough' to detect the rise in blood glucose after the meal, slightly before the insulin takes effect, but is too slow to release said insulin. Thus you are getting a double effect.

In myself, I find that I can override this if my timing on insulin is changed a little. It's something along the lines of 'avoid the spike, and the panc won't notice' although that is entirely simplified and purely anecdotal.

If you're on novorapid or the like and your starting point blood sugar is above 5, I would say rate it safe for myself to change the timing around this much. It depends how familiar you are with how the insulin reacts in your body, though.

Has the weather where you are changed a lot? When we have humid and hot here, my insulin peak time moves from 2 hour range to around 3 hours. This could also have something to say. I think I would use roughly the same approach.

It's super difficult though when things don't behave.

I'd want to discuss it with the nurse or endo (yours are fairly sensible, aren't they?) and await the test results, but if they don't say anything against (carefully, with some gluco tabs on hand) changing the timing around a tiny bit, that might just work.

Take care and good luck.
 

iHs

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Hi

All what you have stated Sanober is fairly common I think for most insulin dependant diabetics using bolus/basal. I too used to be just like you but sorted myself out not by fasting as that was never recommended to me by my consultant, instead I just altered my insulin to carb ratio so that I injected less bolus at lunchtime so that I didnt go hypo and injected more bolus at breakfast time so that my bg levels wouldn't go too high. This then did a fairly good work around the action that the basal insulin had.
 

Paul_c

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432
Type of diabetes
Type 2
Treatment type
Diet only
Sanober said:
Hi all, I'm confused and to be honest really fed up these days.

I found that about 2 weeks ago I was going into hypo territory within 2 hours of eating, so thought my basal actually needed to be reduced (for a change) dam this honeymoon!
[...]
Any ideas, what I should do? I would greatly appreciate any suggestions because I do feel rather ill these days and trying to work like this is frustrating.

Thank you.

have you lost weight?

if so, you may have become less insulin resistant and the insulin has a greater effect as a result.
 

Sanober

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Not really knowing what's going on inside my Endocrine system!!!
Oh I think you're on to something there Paul, I managed to trim 2 inches off my waist over a 4 week period before all this started. I'm not overweight but want to get trimmer and reduce a dress size from a 12 to 10.

I was doing super duper fitness. Then it was just my once a week swim lesson for 2wks, because of a short break and a wedding, that's when I noticed I kept going into hypos too often.

It was like after I stopped exercise my Pancreas had either re-activated and/or my insulin usage had become more efficient.

I've upped my basal today back up 1u and I already feel a bit better, also took 0.5u correction as my wake up sugar was 7.4 (and I know this will rise easily into the 9-10 mark later because Dawn Phenomenon has returned with my reduced basal.

I also took my morning insulin in advance of eating 20g carb granola, which helped to curb the rise (thanks Mileana) and now on a 10g carb lunch because I hit 3.8 - that was 4 hours since finishing breakfast - so still slipping to hypo area too early, but will need to let the basal increase settle, then do a part and part bolus me thinks.

Work in progress! But thanks to you lovely Ds for shedding new light on things.
 

anna29

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Sanober...
I have found when hot,warmer weather eaten lot less as feel queasier with the heat...
Reduced my insulin and go faster into rapid lower bG's...
Have to eat teeny portion to keep me topped up and not drop too fast.
Just an extra thought with you in mind! Its a pain to keep the balance steady I 'know' .
Hope this helps.
Anna.
 

Sanober

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Not really knowing what's going on inside my Endocrine system!!!
Hey there Anna, how's you?

Yeah it's really been frustrating, thought I was winning, and had a great few months but wobbly at the mo.

I'm in Scotland :lol: the weather hasn't been too great the last couple of weeks, in fact chilly this week so I don't think it's that. In Portugal in July with temps in high 30s and I only near hypo twice in the 2wks spent there, oh how I wish I was back there.
 

anna29

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Hi sanober...
Hang in there it isnt easy I 'know and understand' sometimes it takes us
a bit to work out what needs tweaking up or down.
Its always a learning curve when titrating things and its frustrating when settled things
go awry I "know" ... :crazy:
Once we have figured things out and are settled - we smile again eh :D
Cor blimey how did you cope with them high temps? in portugal lucky you !!!
I prefer the cooler weather and adore the autumn its my 'fave time of the year' :thumbup:
Anna.
 

Pneu

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689
Sanober..

Weight lose, increased exercise and the weather can all effect blood glucose! If its a short term thing then its best to probably check bg's regularly and inject / eat to keep them under control. I would suggest if after a couple of weeks things haven't settled down then you look at a re-assessment of your background insulin and then ratio's.. a pain in the bum but about all you can do.