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A puzzling start to the day

N

Nicklenocky

Well-Known Member
Hi all, I would like to ask some of the experienced and knowledgable diabetics to comment on my situtation this morning. Its not really a biggie, but I am trying to understand everything about why certain things happen to my blood sugar.

At midnight last night my blood was 6.4, this is great I know but I had been watching it fall since 10pm so know to have a snack. I had a small banana and 2 Nairns biscuits. At 2.21am I wake up with hypo feeling (shaky and trembling) and in my panic i reached for my gatorade and drunk maybe 180ml. It was after my panic I realised that I didnt actually feel that hypo at all and reached for my blood machine and i was 11.3! I cursed myself for drinking the gatorade and wished I could have better control of my anxiety at nightime...i had drunk the gatorade for nothing! In my sleepy state I just went back to sleep without taking insulin.

This morning I wake at 8.20am to find my blood predictabily high at 12.8 so I immedialty took just 1 unit of insulin and made my way to a hospital appointment. I get into work at 10.05am and my blood came down to 5.2. Now my blood is excellent, but I am confused...I never drop that much with just 1 unit of insulin that quickly...ever, I was just wondering why it may have dropped so much with just 1 unit. The only things I can think of is that maybe my background insulin is still too much, or the fact I had a 2 minute brisk walk across the car park to my appointment!

Ideas and comments would be appreciated!
 
Hi NN :D
Weird when Diabetes throws us a curved ball :roll: I was expecting a cold this morning as I had a high day in general yesterday and felt a bit rough...I didn't knee jerk and try and correct, I just went with it and thought I'll see tomorrow...as these do happen for no apparent reason from time to time and I have done it in the past where I try to correct the weird highs and end up with the pendulum effect in up and down sugars from it....now I just suck it up for 24 hours and see, longer sometimes.Today I woke up 4.5 mmol and I feel fine , good numbers now after breakfast and run.....so it was just one of those days, it happens :roll: :D

It may have been just one of those days for you ,I always think if a pattern occurs then start to look at a plan, so see what happens over today and tomorrow. If it carries on where you are up and down, it could be your Basal...I tend to think that most sugar troubles are down to Basal doses ,rather than Bolus..but that is based on my experience and what I have found over the years.

It could be that your insulin has "stacked up" . This can and does happen. It used to happen with me and the same for my DSN who herself is Type 1 ,and she also see's it a lot. This can cause sudden lows, or again low days for no obvious reason, even when the patient has not deviated from their regular routine.

I would say see what happens, maybe do a fasting test and see, test during the night for a few days to see what is happening? Do you get a lot of nighttime Hypos?
What dose of insulins are you on?

hope you have a better day today...and take it steady across that car park :wink:
 
Hi FAllenstar! Thanks for your message. I guess I am just curious to why it happened and wont lose sleep over it!

I agree with you about my basal and I would love to find out the exact amount I should be on and whether its working. I have done my research and know how to conduct the fasting experiments, its just that I think I am a bit traumatised after years of night hypos that I wont try! I am on Lantus (with no chance to switch anytime soon according to my doctor) and so need to try and work with it. I am currently on 17 units of Lantus and have always snacked before sleeping for the last 2 months or so which has helped the hypos (porridge mainly). I would however, love not to snack, and sleep peacefully and not be anxious about what happens to my blood in the night, but I dont seem to be able to get over this barrier in my head that I wont sleep without my blood being over a certain level. I have also been very poorly in the last 3 weeks where I have experienced a number of illnesses at the same time, so I have not been concentrating so much on getting my blood right and wouldnt be able to tell you if my basal is correct or not.

I would love any suggestions you may have about trying to work out if the lantus is correct specifcally trying to deal with this when I sleep and not getting too anxious about hypos.
 
I was just like that on Lantus, not daring to go to bed unless my sugars were well up into the teens because of sudden drops. I don't need to snack now on Levemir and can go to bed with my sugars at around 6 and wake up 1 or 2 units from this...I'm sleeping for the first time in years since the switch.

Can't really make any suggestions on doses ,its just too difficult , you and your DSN need to work that one out...but if you are struggling I can t see why if you have asked about a change they won't let you .I do understand your anxiety around nighttime hypos though as I had them terrible on Lantus and we could never get the dose right...it was that insulin with me.

sorry if none of this helps and the best of luck with it all
 
hi fallenstar! Oh i wouldnt expect anyone to make suggestions with doses...actually I was asking with reference to the fasting test you mentioned. For example is your blood sugar result in the morning a good indication of whether your background is working if you have snacked before sleeping? I imagine, though maybe I am wrong, that you shouldnt snack before sleeping to get the best idea of whether your lantus is working. And with that in mind, what kind of reading should you be aiming for before you sleep to get you on the best start with the fasting test? These are probably questions I should ask my doctor and not on the forum, but I live in the Middle East and feel me and the doctor are not very often on the same page and not so open to my techniques of experimentation!
 
Hey NN :D
I'm no DSN, and can only talk from my own experience and mine is different to yours but....When I was on Lantus because of the unpredictable night Blood sugars. I used to have my dose of it on a morning.
I would start my fasting test on a morning if and when I woke with in range figures, I would inject the Lantus and not eat most of the day and test...Sorry cant help you much ,as on Lantus I would not dare do it over night ,as it sounds like I had the same problem as you....To be honest it was alway unpredictable for me on it day or night, fasting or not.

I'm sure someone else will be along who can offer more advice applicable to your situation on when and how to do your fasting test.

All the best :D
 
well thanks anyway for your input fallenstar...i think we are agreed that the prospect of doing tests at night whilst on Lantus is scary and thats why I am feeling a little stumped!

Hey ho, will research more about fasting during the day for now.
 
Hi Nicklenocky and Fallenstar,

Nicklenocky, was just researching the site to see if anyone had posted something about whether Lantus dose was correct or not, and I came across your previous post about sudden and unexpected hypos.

When you'd reduced your dose by 2 units (after the increase of 3), did your bolus ratios return back to normal?

The reason I ask is that I've been having to "feed" the insulin after recovering from a throat and sinus infection, and over the weekend I was having to eat 25g carb for 1 click of Humalog, when previously I'd been 1 click to 15g???!!!! :|

Yesterday, I had a salad for lunch and 14g carb and took no fast acting as an experiment, and the basal took total care of it. That can't be right, can it, given that if you don't feel like eating carb you should be able to skip it. Like you, I daren't do a carb free test for fear of crashing.

Last night I had 35 g carb and 3 units bolus ( 1 to 10g ratio in evening), and two hours after meal I was hypoing. I would swear I was cured and didn't need any insulin at all (as if), but two jelly babies and a slice of toast later and I was 11.5!!!!

I'm on Lantus too, and have dropped it back by 1 unit this morning because I think that what might be what's causing it.

Sorry to take over your thread, but I can't believe how similar my current situation is. Quite envious of Fallenstar who is over the moon on Levemir.

Cheers

Paula
 
Hello NN
If you're still in your honeymoon maybe your pancreas has decided to put on a bit of a show? It's happened to my son quite often and makes things hard to control. If this is a pattern rather than a blip and your bg is regularly dropping after the effects of Novorapid have worn off, then it does suggest that the Lantus is too high (at the moment - nothing's ever fixed with T1 ha ha). I'd agree that a fasting test is probably the way to go, and as one of the posters here has said, it doesn't have to be at night if that's too worrying for you. Hope you get to the bottom of it.
 
Hi Paulaah....I have to be honest with you, I dont think my bolus ratios changed when I reduced my lantus, or maybe it did and I wasn't confident enough to recognize this nor did I know this could happen...it was another poster who suggested that your insulin to carb ratio may change as your blood sugars drop, this could indeed have happened and I was taking too much insulin for 10gms carb and contributed to the hypos...at this stage though I wouldn't really know and feel I have to start my experimentation again as I am now recovering from my multiple illnesses! In my experimental weeks prior to getting ill I did drop my lantus from 17 all the way down to 12 eventually, I can safely say that 12 units was not enough as my sugars were sky high and so I have made my way back up to 16 to start it all again as I just wasn't with it at the time. One thing I would say is that you probably wont feel the results of the decrease in lantus until a few days later, well at least with me that's the case. I am really hoping to tackle this basal insulin problem...i feel once I have this sorted this I can try to concentrate on getting my bolus right and experimenting with foods and their effect on my blood. I think I will have a go at a nighttime-morning fasting when I at least have someone with me (my husband on the weekends!) BTW I dont mind if you take over my thread, always interesting to see other peoples experiences....thats why we are on here right!?

To wsmum....if only I was coming out of my honeymoon phase! At least I would know whats going on...but I have been a T1 since 14 and 15 years on still quite clueless. I am however positive and determined to sort myself out and confident we can all do it if we apply ourselves.
 
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