Advice needed

[klh63]

I struggle with lows and I am trying to navigate them as I go on this journey...Lows are usually in the night, when I wake up between 3 and 4 am and I drink a little bit of juice and eat a few crackers and wait for it to get normal and sleep once it is normal range and get a couple hours more sleep, usually low late afternoon to early evening...They have lowered my insulin to 30% of what it was a few weeks ago due to the lows....The lows scare me.

I keep orange juice, honey and hard candy around...I get up between 6 and 7 am and have to bring it up again because it will be slightly low, because I have to do chores and bring it up with those listed items. I have a horse farm and labor intensive am and and pm chores. I get it up enough in to normal range to not worry about having a problem whilst doing chores I live rural so if I go down in the barn no one would notice and you cant see my truck stuck at the barn so it would not be until work got nervous if I did not show.. I drive to my work only 20 minutes away and pick up Breakfast on the way... Test before I eat breakfast and usually in normal range because I bring it up to normal range before doing am chores. I work all day and before the drive home I test and if low I drink a tiny bit of orange juice and some crackers or a candy because rush hour can make drive time triple so I want to get there safely...I test when I get home before going in the barn to do pm chores and if low normal or low by this time it usually is, I continually suck on candy until chores are done that takes me an hour to an hour and one half once again because the lows can sneak up and present pretty quickly and I have to get through the chores.

After chores it is the time of my evening meal and I have driven the numbers up via candy whilst doing chores that compounds with the evening meal and has the two hour post meal reading higher than It would had I not sucked on the candy to get it out of low or make it higher until chores are done....

What food would be a good choice to get the lows up pre pm chore and not cause the rises that I experience because of the candy and meal all within an hour and one half to two hours...I actually hate sucking on the candy but worry more about the lows or driving a low normal into lows whilst doing chores..I tried the be kind bars but got higher numbers after the meal than with the candy which is a quick jump up.. So the highs after dinner are inflated from dealing with the moderately lows before chores...

Weekends I spend most of the time in the barn stripping stalls to the ground, hauling shavings and moving the hay into position for the next week and trimming hooves and whatever needs to be done with the horses....I need a food that keeps me out of the lows, that I can carry with me in the barn and use moderately to keep out of the lows but try and slow down the forced highs after dinner... weekends almost always I am low or low normal and keep food going in and suck on candy....but the candy I want to use more on an emergency basis and have something else I can snack on between meals that will keep it normal...any ideas for a food that will rise it enough to get and stay normal during the chores but not compound with the follow up meal?

 

[EllieM]

any ideas?

Phone your team and ask them how to manage a further reduction in insulin so you stop getting the lows....?
Being permanently hypo is no way to spend your day and strongly suggests to me that you are having too much insulin. Let me assure you that it is not normal for diabetics on a correct insulin dose to be getting hypos all the time (or at least not in any of the three countries I've lived in. or the 52 years I've been taking insulin.)

Do you have access to a continuous glucose monitor (eg freestyle libre or dexcom)? That would at least alert you when you bgs start to go low (day or night). Are you doing a blood test before you drive to breakfast or when you get to breakfast. Getting behind the wheel and potentially hypoing is very very dangerous and you are right to be scared of these hypos.

As regards the food, I'm at a bit of a loss, because most of the new diabetics I've heard from have their insulin gradually increased from a lower level until their bg levels come down, rather than the other way round. They carry glucose as an occasional hypo cure, not as something they have to consume 24/7.

How high are your levels going after dinner? To be honest, I wouldn't worry too much about temporary highs while your issue is the lows. In the long term, highs are damaging, but hopefully in the medium to short term you will get your insulin adjusted so that you aren't permanently hypo.

Normal hypos (ones that aren't happening every day) are conventionally addressed by fast acting carbs (glucose is the fasting form of these) plus something a little slower acting to pull up your levels in the medium term. So your night time regime sounds good to me, though it were be better if your insulin could be adjusted so you don't get night time hypos.

Lots of virtual hugs. Things will get better once you are on the right medication.

 

[klh63]

= Are you doing a blood test before you drive to breakfast or when you get to breakfast. Getting behind the wheel and potentially hypoing is very very dangerous and you are right to be scared of these hypos.

I test every time before getting in a vehicle due to the lows I experience...even if in low normal I raise it to get me from point A to point B since I know it can drop fast. I spend more time forcing a raise to insure I am safe on the road or in the barn and the numbers are represented higher in the meter history than would be because I have to make them higher unnaturally. But I am super careful about testing before I drive...If I go to the market I test before I head out then do my shopping and test before I head back home. Any time when it is low or low normal I raise it to mid normal to high normal to make sure it is safe for me to drive. I have pushed it over 200 a few times when it wasnt coming up fast enough I rushed the process and added too much sugar.

How high are your levels going after dinner only a few times in the last month a little over 200 mg/dl but mostly 130-180 which is in the normal range according to the paper they gave me, but it is a fake normal when I am sucking on candy to get through chores.

 

[miahara]

I'm not sure if you are only on long-acting basal insulin alone or also inject before meals too, but here's what I'd suggest.
1. If you are going hypo in the night your basal is too high and it would be worth trying to lower it slowly over a period of a few weeks.
2. Fixing hypos with a quick intake of sugary stuff works, but it is just a quick and usually short duration fix. If you want to either prevent the hypos or maintain the correction due to the intake of sugars eating a snack that is slowly digested such as a sandwich or cereal bar would be worth experimenting with.
From my own experience:
I was getting lows in the early morning in bed, but reduced basal insulin and it helped but I also found that a sandwich before bed helped too. If I'm going to drive I check my glucose and if 5 and heading down I eat about 15 gm of glucose sweets and this stabilises the fall.