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Advice Appreciated

irishrichard

irishrichard

Well-Known Member
Messages
61
Type of diabetes
Type 1
Treatment type
Diet only
Hello All,

Am type 1 diabetes for 17 yrs, Bloods have always been pretty ok until last 3 weeks where I've had maybe 15 night hypos and maybe 5 in day time!

My hab1c never been over 8 since diagnosed and usually between 6.5 and 7!
On lantus and apridra! Lantus 30 units for past 5yrs but have reduced to 24 units now but still seem to get hypos but not as often! over past week thankfully

Any advice appreciated?
Have tried most things to keep in control but have got pretty heavy hypos below 1.5 over last 2 weeks and lucky I have understanding GF :D Ony things that usually trigger hypos before was stress from work!Any abvice appreciated
 
hi,
silly to ask but are you now more active or have you changed your food. The only other thing that comes to mind is wether you may be intolerant to the insulin you are using.we did have this a few weeks ago but not night hypos. Then it just corrected itself .


steph
 
Thanks for the reply Steph :)

I have'nt been more active really, only 1 day i could give myself a valid reason why it BG dropped as I was travelling and although there was only an hr difference in times from Paris to Ireland, it was stressful!
It hopefully will sort itself out but I've had more hypos in last week than I've had in last 17 yrs and my GF anf family are supportive but wrecking my head trying to "sort" out my problem even though no one listens to be :evil: and they understand me better than I do
I go to Diabetic Clinic on weds so hope I can sort things!
I used to take my Lantus during day time years ago and never had a hypo so maybe could try this again? Just looking at all possibilities and hope to point them out to Nurse
 
Do you keep a diary of your readings? You need to look back at when the hypo happened. Knowing what you'd eaten, what insulin you'd taken, what time of the day it happened will help. There might be a pattern that you can identify as a trigger for the hypo happening.
 
Thanks for the reply Sophia :)

The night hypos tend to occur from after 4am! I've stayed up a couple of nights and took hourly reads, everything stays static betwwen 6-8 until maybe 4am, then drops to 3 :? I'm pretty regular with what i eat
I used lantus before in morning and never had problems so maybe just need to switch back to taking it in morning and not evening?
 
It looks like you've pretty much identified the problem :) Jess can't take a full dose of basal (Levemir) at night otherwise she goes hypo throughout the night and then high through the day. Because of that we split her dose into two, one in the morning and one at night. It pretty much solved that problem so that might be another option for you to consider. I've read quite a few people on this forum having problems with Lantis (unexpected hypos), so that's another avenue to consider and perhaps have a go at Levemir if you're going to change your insulin routine.
 
Hi Richard,
Sophia is right, many people have problems with Lantus; nothing wrong with those people (except diabetes of couse :D ), but there is a lot wrong with Lantus. You will remember the good old days before analogue insulins, what insulin were you on prior to Lantus and why were you changed?
I'd been type-1 for 15 years, and never had gr8 control, too many hypos and swings, so my clinic recommended Lantus. I was told it would give me flat 24 hour basal coverage. It seemed to work at first and when things started to go pear shaped it I asked my DSN if it could be the Lantus, and I niaively trusted my DSN who reassured me it couldnt be. I had many days when Lantus didnt appear to be working at all, other days when i'd go as low as 2.4 with NO humalog and having to eat like a pig to keep it above 4! There was no pattern to it whatsoever and one days BGs were rarely resembled the next's.
I hate the stuff with a passion for what it did, and probably is still doing to me. I was so ill on it, like a zombie, and since joining this forum had PMs from so many people reporting exactly the same problems/Lantus side-effects as me. It's not you, it's the Lantus, trust me.
I urge you to do a search on the net and this forum on Lantus problems, and look up the IDDT website.
As Sophia said, you should probably try another insulin, but Levemir is another Analogue insulin-there are better,safer options. You can get a full list of what's available on this website.
My second reference to pigs in this post! Myself and many others on this forum changed to porcine insulin and achieved stable BG control, I'd give that option some thought.
Jus
 
It does seem as though you are going to have to rethink, your insulin regime but the body does occasional take it upon itself, to throw a spanner in the works and change how it uses and reacts to your insulin...

The rethink could entail, changing does, splitting Background insulin etc to bring everything back into control.. It might be that you need to change to a different brand of insulin which might work with your body chemsity better..

The only real way to find out, is collecting the data which is Blood glucose levels, carbs eating, exercise etc to see if any patterns appear to suggest where changes should be made...


As to safety of Human Insulin, they are just as safe as using Animal insulina, remember there are people who are allergic to animal insulins as there are to human insulin, Janabelle is basically scaremongering over this...

I've used both types of insulins without any problems, on the other hand my husband (also a T1) had problems many years ago with an Animal insulin and changed to another Animal insulin to over come the problem he was having, he has since moved onto human insulins, with no difference or problems..

So I would look at your control, before swapping insulin unless of cause your clinic feels otherwise, the biggest downfall with Animal insulin is the requirement to inject 1/2 before you eat, which personal I found it to interfered with work and normal rouitnes etc... Hence the reason when Humalog came onto the market, I changed to it which I found to be a great improvement
 
Jopar,
I wasn't questioning the safety o9 Human insulin, I was referring to analogue insulins, and these are not proven safe under every circumstance, eg Lantus in pregnancy, and for children under 6. Neither are they proven superior to animal or synthetic human insulins in regard to diabetes control.
It's hard for people who've suffered not only ill health on these new insulins, but breakdown in relationships, loss of jobs, and not have there problems recocgnised or accepted. Side -effects from these insulins are a problem for a significant amount of people, and patients on these insulins need to be aware of it.
Saying that, I never had a prob with Novorapid or Humalog, too many hypos perhaps, but I feel safer being on a drug that's tried, tested and proven safe over 80 years. Animal insulins are highly purified these days, so the problems associated with reactions is minimised, if not erradicated.
It's important that patients have choice;choice of insulins in not offered to some patients, as is sadly frequently reported on this forum.
With regard to splitting Lantus or Levemir, These insulins are marketed as 24 flat basal profile if the charts are to be believed. Many people are finding this not to be the case, and splitting the dose. Under those circumstances it doesn't seem like there's much benefit of these long-acting analogues over human OR animal insulins.
Jus
 
Thanks for the replies :)

I'll speak with the diabetic nurse on weds and see what she thinks about switching the lantus to the morning as i prefer this type of insulin for work! I hated the old monotard and actrapid i was on when first diagnosed as I work in bar/restaurant sector!

I checked bloods last night at 4am and it was 3.1 but felt good so just ate a little snack and went back to sleep, in morning bloods were 6.8

Was great to ask other peoples advice/opinion on here as don't know any other people with diabetes and again thanks for replies
 
Hi Richard, do you eat anything before you go to bed, because i found that if i have a small bowl of cereal of a night it keeps me going through the night, but if i have nothing my sugars tend to drop, i had a bad night hypo last week my husband luckley noticed that i was sweating so much that the bed was wet through (Yucki) he brought me round with some lucuzade and he made me eat some cereal which to truthful i did'nt really want at 2am in the morning but he took my reading after he had given me lucuzade and it was 1.6. I don't tend to get many night hypos mine are mainly during the day and i also have tried many things to stop them but at the moment nothing seems to work. I have been type 1 for 27 years it don't seem to get any easier. Hope you manage to get it sorted

Tracey167
 
Although there are many other factors that can cause hypo's, basically the main factor is a mis-match of insulin to the food you consume.

I looked for every reason under the sun to try and explain my frequent hypo's up until 6 months back, but since learning to count carbs correctly, identify how much insulin I need per 10g or 1cp of carbs at each mealtime (insulin to carb ratio) and understand how insulin works beyond injection (insulin profiles) has help me to reduce my hypo's to no more than 2 a week, some weeks non at all.

This was thanks to the DAFNE course I completed, and a little research of my own. Guesswork and estimations are the biggest cause of both high and low blood glucose, anyone who has not done such a course, and are struggling to manage thier diabetes, would do well to enquire about one in thier area.

Nigel
 
Thanks for the replies Tracey167 and Nigel,

Had another hypo this morning but at 10am :evil: , bg levels this morning was 6.1 so had breakfast cereal and took 2 units of apidra at 8-45 as was planning to go for run! Checked blood level before going for jog, checked bloods 1.1, thought no way as should be higher due to amount of apidra? Again checked 1.6, drank lucozade and had toast, half hr later 1.2, luckily my sisters turned up, 1hr later still only 2.3, no weird feelings, knew everything that was happening!no signs as normal like sweating 5 minutes after bloods at 2.3, checked again and they were 25.8!

Stabilised them during the daytime so running 8.2, 7.5, 7.9!
Sooner weds comes the better as am losing my cool :lol: ,
 
just as a thought my son is on the stage a lot and does a lot of dancing. when he is on stage we have to drop his lantus to compensate for the exercise. It might be worth a try when you are going for a run. The other thing we were told was to have a 2 finger kitkat before exercise then check after 1 hour. If really energetic he may need another finger of kitkat to see him through.
 
Dropped lantus amount last night to 26 as knew I'd be going for run! did'nt end up taking it due to hypo though!

I know how I need to drop insulin amounts when running and to take sweets etc to compensate!
I"ve run the Paris Marathon 4 yrs back so you can imagine the prep I had to do with the training :)
 
Docs reduced and split my lantus from 28 units at night to 6 units in morning, 16 units at night!
First day all went well, no signs of hypos so will keep you posted
 
Richard,

Looking good so far! :)

Remember to keep testing during this transition period to make sure that the dose is split correctly.

Good luck!

Nigel
 
Its been a week since I"ve been put on a split dose of Lantus and I'm happy to say I'm getting a good nights sleep and no night hypos :D

I'm still adjusting to it as I've nearly gone hypo twice during afternoon although still with no warning signs!

The diabetic Nurse has advised me to keep blood levels up around 10-13 mmll to try and trigger the signs to return when my bloods drop so am waiting to see if anything happens

Never realised how much I missed a good nights sleep :D
 
Wow, I've only just read your post about your bad hypo experience! I'm glad the new split dose seems to be working out well for you.
 
Just to let everyone know that my bg levels seem to be sorting themselves out fine now after splitting the lantus dose! I've only had 1 hypo in past 5 weeks which is huge difference :)

Still have no signs of hypo happening but docs say that they may never come back?

Richard
 
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