Blood sugars dropping really quickly

[Lucie75]

Hi all, I've been going great guns on my pump for a few weeks now...until today. After an hour spent food shopping (oh joy) I got back to the car and tested and I was 3.1, so I treated and set a negative temp basal for half an hour to give my bloods chance to start climbing. About 45 mins later I was 9.7, had a snack which I bolused for (plus a small correction that my pump calculated) and 30 mins after that I felt a bit odd, tested and I was 2.6! I thought that maybe this was all caused by the extra 'exercise' (i.e. the food shopping). Anyway, treated that but obviously overdid it and 2 hours later I was 16.6. Did a correction for that and all was fine, had dinner, bloods again where they should be after that. Tonight I've had a yoghurt and an orange which I have bolused for. Tested beforehand and I was 6.8, tested an 1.5 hours after and I'm down to 5.7, plus I still have a couple of units of insulin on board so I guess it'll take me down even more. This is not where I want to be before bed.

My question is: do you think this is all related to the increased activity this afternoon (I'm usually sedentary at work all day) or is it more likely to be either my i:c ratio or my isf that has somehow changed? I have my pump on trial at the moment and my target is to have fewer hypos. So far I've probably had more hypos than on mdi but I guss it's still early days. By the way, I've done basal tests for both morning and afternoon so I know that they SHOULD be correct.

Please help...

 

[mrman]

with regards to the shopping, I ALWAYS now have a snack before I go, usually about 15~20 carbs. Thats doing a weekly 40~60 min shop. Tried temp basal but still hypo. As for after, probably overtrated the hypo,but, because you did hypo you may have had a liver dump,so, your liver is quickly replacing lost stores making your sugars drop faster. So can't realy say your having to much qa either,but, if it happens frequently then change your meal ratios. Wouldn't make any changes because of the hypo/shopping, just learn either to temo basal longer before shopping and less qa with meal prior. I always bolus less after a hypo cause of this. As for now depending on your sensitivity to carbs have a 10~20 carb snack to stay safe over night.
Hope that makes sense a bit

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[ElyDave]

The general principle is if you have a hypo, that you need to treat with carbs, you should not add a correction dose for any sunsequent highs.

The reason is when you have the hypo, the liver will also be dumping glucose into your system. You are effectively getting a double whammy, which will subside on it's own.

The other thing is that you are at increased risk of hypos after the first one for a day or so.

I think you're right though that the cause could be the shopping. I'm very sensitive to exercise as well and find that even as little as a bit of gardening, or a walk around town can induce a hypo if I don't reduce my dose