Hypos are killing me

[JustDomUK]

Hi

I know I asked about hypos before but has anyone else had this problem with hypos? I've just completed my first full week low carb. I'm on less than 60g carbs a day and for the most part feel great, healthy and energetic. I've reduced my insulin to a third of what it was before and at the moment am still struggling with hypos. I've not been able to lift my blood sugars above 3.9 since 4AM today. I'm currently 3.6. I'm type 1 (30+ years) and on a pump. I'm taking lucozade for my hypos at 10g a hypo and normally this lifts me out up to the 5.0 mark. I'm not eating a jam sandwich as before but have fruit instead. I'm in touch with my dsn but she only works Mon, Wed and Fri. She has told me to do fasting tests but I have to scrap the tests if I have a hypo!

How best do I cope with the dramatic insulin changes? If anyone else has gone through this what did you do? My insulin has gone from 84 total units per day to 33 and its still too high. Any help would be appreciated

Dom


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[noblehead]

Your obviously still taking too much insulin if your having frequent hypo's Dom, you need to reduce the dose further to prevent them happening.

 

[Solestar]

Hey JustDomUK

I'm also type 1 and I follow a ketogenic diet. I eat less than 30g of carb and day and I know the problem you're facing well. I've been eating this way for nearly 4 months now and I have seen an overall reduction in total daily insulin of nearly 70% and it's still going down. Before I started I was on 20 units of Lantus in the morning and 10 in the evening. I would take anywhere up to 15 units of Novarapida day to cover carbohydrate intake.

Now, I take just 14 units of Lantus in the morning and between 2-4 units of Novarapid. My glucose control is getting much better and i'm no longer having the huge range of swing in levels that I was getting before. They could be anywhere between 2-30! But, as my sugars are stabilising, I think my insulin sensitivity is increasing. So, this morning was my most recent adjustment when I took the Lantus down by another 2.

As Noblehead said, your insulin dosage is still too high and you need to keep adjusting until you find the optimal level for you. Don't be afraid of taking a smaller dose of insulin, after all, less is better. As long as your glucose levels are low and you have some circulating insulin in your system, you shouldn't have to worry about DKA. Good luck.

JUlie

 

[iHs]

If youve only just started low carbing, it might be that the bolus for protein is a bit too much especially if the lows are happening within 2 - 3 hours. Some add up the protein and divide by 2 to work out insulin in the carb ratio and some divide by 3 or 4. Another option besides basal testing is to use a TBR like 80 or 90% to see if that helps and if it does then basal test again

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[Solestar]

iHs

Bolusing for protein was one of the things I found the most difficult about going low carb. I've got it in hand now but it took a while. Dom, do you bolus for protein and if not, as you get your background levels right it may be something you need to consider to stop post prandial glucose rises. This is from the How-to section on the Joomla site, How To: Know How Proteins, Fats, and Carbs Affect My Blood Sugar http://www.dsolve.com/content/view/108/2/

Julie

 

[JustDomUK]

My hypos occur mainly in the early hours so it seems my problems were to do with my overnight basal. I need to get this one sorted. I kinda learned a bit about protein rises when doing my fasting tests during the day. I would always rise after a plain omelette. Not much though. I haven't really got a system as such as I just take 0.1 when eating just protein. This has worked so far. I will read the link provided and thank you for posting it.
Dom


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[char87]

Hi - i was just wondering if you had managed to stop the hypos at all?! I have been low carbing for a couple of weeks and keep having overnight hypos- am steadily dropping my overnight levemir dose but the hypos just keep coming! I know the answer is to drop it some more but I don't want to reduce it too much at once and start going high- have been reducing by 1 unit a time but that is having no impact so far!

 

[Lucie75]

This sort of rings bells with me. Although I'm not generally low carbing I do have minimal carbs for 2 days per week and I nearly always hypo during the night following a day of low carbing. Yet when I eat more carbs during the day my night time basal is perfect (even without eating carbs since early evening). It's odd and I haven't yet worked it out other than doing a TBR of -50% in the early hours of the morning.

 

[JustDomUK]

It's funny as I thought I'd solved it but I'm finding that as I lose weight I am needing less insulin.

I've had two hypos today. One in the morning and one this afternoon. Both times I didn't have my usual warning signs. Normally I feel hungry as I treat my hypos but again this didn't happen today.

 

[noblehead]

It's funny as I thought I'd solved it but I'm finding that as I lose weight I am needing less insulin.

I've had two hypos today. One in the morning and one this afternoon. Both times I didn't have my usual warning signs. Normally I feel hungry as I treat my hypos but again this didn't happen today.

Stands to reason that you'll need less insulin when you lose weight Dom, today's lack of warnings for the hypo's might just be a one-off but just the same I would keep a close eye on your bg levels if you start to lose your hypo awareness symptoms.

 

[char87]

This sort of rings bells with me. Although I'm not generally low carbing I do have minimal carbs for 2 days per week and I nearly always hypo during the night following a day of low carbing. Yet when I eat more carbs during the day my night time basal is perfect (even without eating carbs since early evening). It's odd and I haven't yet worked it out other than doing a TBR of -50% in the early hours of the morning.

I experienced this before I officially started low carbing too- i tended to eat less carbs during the working week and then have more on the weekend and found that while on weekdays my basal was ok, on weekends even if I went to bed fine/ lower and didn't have a high carb dinner, my levels tended to rise overnight - i think this may well have been due to having more carbs in my body during the day which were still at work in my system.