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Blood sugars drop like crazy at 4:30-5pm.

Sideburnt

Sideburnt

Well-Known Member
Messages
124
Type of diabetes
Type 1
Treatment type
Insulin
I've been a T1 for 3 years, and over the last 4 weeks I've suddenly started to drop like a rock at about 4:30pm - 5pm.

At this point I don't take a daytime basal, my numbers don't rise without it. I take a nightime basal at 10pm of Humalin I which lasts between 12 and 18 hours, so by 5pm it should be well and truely out of my system.

I have soup for my lunch which I take 2 units of Apidra for at 1pm, so again by 5pm it's well out of my system.

I aways check my numbers before I go home, I can be anywhere between 5mmol/l and 7.5 mmol/l. I'll stand up walk down a tiny flight of stairs and leave the office, so maybe 5 minutes?. I'll check again and I'll be at 3mmol/l, if I leave it another 5 mins (which I have done by mistake) I'll drop even further 1.2mmol/l being the lowest so far.

At the point of this happening I can usually bring myself back up again with 4 or so glucotabs. But the weird thing is that if I cram those same 4 glucotabs in my system at say 4:30 expecting this to ofset the drop, they do nothing. I still drop like a rock and I get a very delayed rise about an hour later.

I'm really really confused, and I'm seeing my endio about it in a couple of weeks. I want to learn to drive and drive home, but I wouldn't feel anywhere near safe enough with this happening since I'm really hypo unaware now this is happening daily. I'm also concerned about brain damage or passing out on the way home and it's very cold/dark at the moment. I'm having to wait for 30 mins before I go for my bus every evening which is rubbish.

This isn't happening at the weekend or not that I've noticed, it crossed my mind that i'm storing bolus insulin, but I've only got one shot that would effect my number and that seems to do it's job in its entirety keeping my at a good level with lunch and I'm rotating my injection sites. Is there something odd going on with sitting down for a while then standing up? This can hardly count as exercise, so it surely can't be anything to do with insulin sensitivity.

Can anyone help or have they had similar things happen.
 
As you know you are dropping like a bomb then simple thing to do make sure you have a good snack at least 20 mins before you do drop, if you are not confident altering your insulin. As you say you are not hypo aware now, this means by law you can not hold a driving licence. So you need an urgent apt to sot out your doses. Hope it works out ok for you. My personal view is you have to much basal insulin. Perhaps think about lunch with no bolus and see what happens.
 
I had a problem with dropping around that time of day when I was on Humulin I but I took about 10 units in the morning and 8 units before bed so it was in my system around 5pm when it would always cause me to have a hypo. They weren't ever to bad but I mentioned this to my nurse and I was changed to Levemir and haven't had any issues.
 
CarbsRok said:
As you know you are dropping like a bomb then simple thing to do make sure you have a good snack at least 20 mins before you do drop, if you are not confident altering your insulin. As you say you are not hypo aware now, this means by law you can not hold a driving licence. So you need an urgent apt to sot out your doses. Hope it works out ok for you. My personal view is you have to much basal insulin. Perhaps think about lunch with no bolus and see what happens.
Click to expand...

But I don't have bolus in my system by that time. I don't take a daytime shot and my basal is a 12h insulin, not 24. I agree with what you're saying, I can't drive if I can't address this. Also, I can't seem to offset the drop with food. I ate 5 glucotabs, an apple and half a can of cola at 4:30 today, and tested at 5.5mmol at 5pm at my desk. 3 minutes later, at the door to leave work I've just tested at 2.5, I'm slowly coming back up now having taken another 5 glucose tablets. This is really unusual.
 
Sideburnt said:
But I don't have bolus in my system by that time. I don't take a daytime shot and my basal is a 12h insulin, not 24. I agree with what you're saying, I can't drive if I can't address this. Also, I can't seem to offset the drop with food. I ate 5 glucotabs, an apple and half a can of cola at 4:30 today, and tested at 5.5mmol at 5pm at my desk. 3 minutes later, at the door to leave work I've just tested at 2.5, I'm slowly coming back up now having taken another 5 glucose tablets. This is really unusual.
Click to expand...

Are you rotating your injection sites regularly, it seems like your lunch-time bolus dose is being delayed somewhat and is kicking in much later than it should, I've had this problems before myself, so if your injecting in the stomach all the time start using your arms, legs and bum too.

Although why this doesn't happen on a weekend is a mystery............
 
Hi Sideburnt, I had the same problem you are experiencing. My blood sugar dropped drastically after 5 pm. It was driving me crazy as it was just like my body didn't need insulin in the late afternoon. I had enough to eat constantly in the afternoon. Then i decided to move to an insulin pump and it solved all my problems as I can tailor my basal units hour after hour. My body needs after 4pm and till 8pm 20% of the insulin I need in other moments of the day, and, in my case, it was impossible to manage this with mdi. By the way consultants don't find a reason. That's just the way my body works....that's their answer.
 
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