Advice please!

Sounds like he's on too much insulin? What is his medication? Does he have background insulin? He could be taking too much of it, or taking too much insulin for what he eats... Or not having something sweet when he exercises?
:sick: I felt bad enough at 2.9 yesterday, i'd hate to think how i'd feel at 1.9, poor bloke!
The thing is, if his sugars are constantly running too low, he's less likely to have symptons and warnings of going even lower. See if you can get him to test more regularly or does he already??
Well done for caring tho - sounds like you're his guardian angel xx

Vickyp, what a shame, it is scary when your hypo awareness slips down, but fortunatly mine has recovered to a decent level (around 3.9). Maybe worth checking, if he gets strange things occuring before the sweating and wobbles start, things such as a strange taste in the mouth? eyes going a bit funny, it maybe that his hypo awareness has changed but he's not picked up what it is.

It sounds as if he is on to much of his basal insulin (long acting)
I hope from what you have said he doesn't drive.

Vicky he could do with lowering his basal long acting insuling (He will know what this is) BEFORE he sees the dietician. A bad accident could happen before then with him going to low all the time. Do you know what his dosages are?
x

vicky, i went from nearly 40 units of basel insulin to 20 when i discovered i was taking far too much insulin (although i wasnt having the same trouble as your partner is), as the above posts suggest the basel may be the key to get it sorted, good luck, keep us posted!

Hi Vicky


There is no harm in your partner enquiring about having a pump as some hospitals are supporting them much more now than a few years ago. It's true to say that a lot of diabetics do get pumps eventually because of hypos, but, before a consultant will apply for a pump to be funded, people do have to agree to alter, sometimes their basal insulin and sometimes their meal bolus just to see if that makes a difference to their bg levels. Pumps can be hard work and usually involve doing a lot of bg testing throughout the day and then looking at the results and deciding whether the basal rate needs to change or the meal bolus needs altering. The good thing is that they do make hypos less of a problem but wont get rid of them altogether though. Exercise is also easier to sort out with a pump and calculating insulin to eat fatty type foods is easier to do as well.....

I would say from reading your message that it does sound as though your partner is using too high a dose of basal as that seems to be controlling his bg levels more than what it should do. Does he use Lantus, Levemir or another type of basal insulin. Has he found out about using an insulin to carb ratio? If not, looking at the BDEC website and also google 'carb counting'. There are also loads of threads on this forum alone all relating to carb counting and how to use carb ratios.

Vicky - defiantly need to lower basal, as others have said, and start testing on a more regular basis.

It sounds like he's got himself set into a comfortable regime with his diabetes, and resistant to changing it because he's used to it, and its a hassle to change it. Have been there until recently - having more hypos, losing awareness and getting 1.8 on the meter didn't phase me, because I thought I knew enough about how my body worked to catch it in time and compensate. Changing seemed a little too much of an hassle, because I'd have to interrupt my routine and start actually looking at what I was doing. "Too much hassle and 1.8's not really all that low is it? " :roll: Have just changed my medications and trying to get more control, and yes, its a bit of an hassle, but I know its going to be worth it in the end, so I don't mind too much.

If you have an hypo that gets to those levels, but you don't have any symptoms, you tend to brush it off. You know its bad, but in a logical way, you don't have the emotional impact a really bad hypo gives you when your body reacts normally and you can't test because your hands are shaking too much. Had my first bad one after changing my medications 2 days ago - 'only' 2.8 but full symptoms, and it shook me up in a way the 1.8 never did. I needed to lower my basal too, its surprising how much of an effect it has, you sometimes don't realise it.

what will get him to snap him out of it is hard to say. For me, it was a case of having already made a few changes in my life, and felt I had sorted out the rest of my life enough to have the time to concentrate my efforts on getting my diabetes under more control.

For him, well, I don't know what his life's like, but it might help to have a think about what his routine is like and what sort of things you could both do to make it easier for him in the period when he is adjusting. If you broach the subject and he complains that such and such a thing means he can't test, or that he's too busy, then you can tell him some of the things you could do that means it shouldn't be a problem. When he goes to the dietician he's going to be getting a lot of advice. Whether he actually takes it or not may be hard to say, but if its not too hard, and he knows he has the full support of you and his medical team, he might be more receptive.

As far as the pump - as iHs says - worth it but can be a lot of hard work, he probably isn't really in the frame of mind right now to have to make such a major adjustment.

Its probably going to be a team effort to get it sorted, but you sound like you really want to help, and you are doing the right thing by coming and getting advice. I think you will manage if you can get your parter on side. So best of luck.

hi... I'm on insulin myself and hypos can be scary. Mind you I'm usually having a hypo anywhere under <4.5. I get quite bad when I'm in the low 3's. I was thinking the same as everyone else has mentioned.... basal insulin probably needs to be adjusted. Although I've found myself that I still hypo from lowering my basal too. I have other medical issues though which come into play. All the best

You know, another thing, I'm just wondering if he's ever had a blood test to see what his cortisol levels are like. I've been having frequent random hypos for a while and on my last appt with my DSN they found my cortisol levels are pretty low. I have to go for a synacthen test next week. So, I was just thinking I wasn't getting my insuling/carb intake right but it seems like there has been a contributing factor all along.

Good luck :thumbup:

Although Addison's disease (low cortisol levels) is a possibility I doubt whether it is that which is causing your partner's hypos. It will be more to do I think with the way he is calculating his meal time bolus insulin and the amount of basal insulin he is using.

You need to ask him what insulin to carb ratio he is using? I expect he will say ' what's that' as I expect he is using guesswork and failing some of the time causing the hypos. Just how often does he test his bg levels? He really needs to test at least 6 times a day which will then tell him how high or low he is 2-2.5hrs after he has calculated his bolus and eaten a meal. Do you know if he is over correcting at times to deal with high bg levels as that can cause hypos as well?

I think it might pay for you to go to the hospital appt with your partner if possible.

I've never read this book myself but many people on the forum found good info on carb counting and using a ratio from reading 'Think Like A Pancreas'. I think you can buy it on eBay and Amazon so suggest you get hold of that as it will probably help you to help your partner.

Hey my mums just found a website that might help with the carb counting. it's an online thing which teaches you how to count carbs, and they're doing a year's free trial as it's new and they just want to get people's feedback!!!
http://www.bdec-e-learning.com
Give it a go!