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Can anyone help me out?

K

KimSuzanne

Well-Known Member
I'm having some changes in my diabetes behaviour I think its going through teenage tantrums but its worrying me - I feel silly saying that after 18 years. I'll try and explain:

About 3 months ago I began having 'episodes' when my sugars drop too low in my sleep - I wake up not knowing who I am, where I am or whats happening and I get very cross with myself because my brain but 'connections' seem to have gone. I'm always freezing I will fall asleep anywhere even on the kitchen floor, the only thing I can do is ring my Mum. I seem to lose fractions of time during these episodes where I remember some parts ( I remember making a phone call to my Mum but don't remember where I leave the phone, in the fridge before).
The reason this worries me is before this I've always had fits when my sugars go below 1.5 and warning signals when it drops below 3. Also I can have one these episodes at 2.2 yet I woke up 3 days later with sugars of 2.1 and I didn't feel a thing it was quite a shock.
I just wondered if anyone else had experienced this before. I take Lantus 16 units 8am and 8pm, Novarapid 3 times a day between 12 - 16 units with meals dependent on what I'm eating.
I apologise if I'm not making sense - feel free to ask questions but hopefully someone can help.
p.s tried contacting nurses and got no response from the hospital so far!
 
Hi Kim,

From your description you seem to be hypoing but you have lost the hypo-awareness that you had before. That would indicate that your insulin needs adjusting, but I am not an insulin expert so hopefully one of our type-1s will be along soon to offer advice.
 
Hello Kim,

It may be worth getting your thyroid function checked out.
An underactive thyroid would certainly explain why you're feeling cold and tired a lot.
It may also explain why your insulin has been working more aggressively lately.

All the best,
timo.
 
Kim,

You need to cut your basal rate now.

What I think is happening is that your growth hormone is switching off through the night.

You may remember that when you were younger eg ten or so, you needed much less insulin and your blood sugar levels especially in the mornings were a lot more predictable.

The comes puberty. Your sex hormones and growth hormones counteract the effect of insulin making you very insulin resistant. Your dosage rates go right up and you start getting much higher blood sugars first thing in the morning.

When you are towards the end of your growth spurt, around the age of 20, your growth hormone stops being secreted overnight. Insulin requirements typically reduce by a third virtually overnight. They can reduce more than this.

By sticking to your usual insulin doses you are giving yourself an overdose because you need much less.

The good news is that your blood sugars should be much easier to handle once you have adjusted your insulin. The 'roid rage that is part of adolescence will soon be over. You can expect to have much more predictable blood sugars except for the usual hormonal upheaval at period time, pregnancy and then again at the menopause.

I would suggest you :

Give yourself half your usual insulin doses and then adjust upwards according to your bs results.

OR

Give yourself 2/3 of your usual insulin doses and then adjust (probably downwards) according to your bs results.

Is is possible for you to go home and get some help from your mum while you sort this out? It could take a week.
 
Thanks for the advice everyone,

Katharine I'm not sure whether it would still apply I'm 25 stopped growing a long time ago only 5ft 2" have been since I was about 15. My doses have reduced significantly since I was 21 I was only double the doses I've reduced them over time.
I'm going to see about changing the Lantus to Porcine Isophane, things have not been quite right since I was told to change to Novarapid and Lantus much to my protest. Doctors always know best eh?
 
Yes, you are a bit old for the growth hormone thing at 25, I saw the 18 and assumed that was your age!

Loss of hypo warnings that return on moving to animal insulin has been reported.

I'm so pleased you are well enough to respond. I was in a fair tizz when I thought you would go to bed with too much insulin on board.
 
Hi

If your BS is fine all day then it can only be the evening Latus that is the problem. Do you have a snack before bed? Maybe try a couple of pieces of toast or digestives. Might just keep it up that little bit if you are not confident about reducing your insulin anymore.
Hope that helps.

Ed
 
Many of us find that when taking Lantus or Levemir twice a day, one dose needs to be bigger than the other. Maybe you just need less Lantus at night than in the morning. Alternatively Levemir tends to have a more 'even' profile of action than Lantus so may reduce the risk of night hypos.

If you're having problems overall with Lantus & Novorapid though (assuming thyroid etc are ok) its defnitely worth pursuing a switch to porcine insulin. Doctors know best, unfortunately we're all different and its our quality of life that suffers when they get it wrong.
 
Hi Kim,
I had similar problems when I first changes from Actrapid onto Novorapid.
My own experience is that Novorapid acts a bit too quickly for some types of slow acting carbohydrates. I still use Novorapid throughout the day & I usually eat first & then inject depending on what I have eaten. However, I switched to Humulin S, a slower acting insulin, in the evening when I always eat slow acting carb's. Humulin S seems to work in tandem with this type of evening diet better for me. The problem is that you might be injecting with a dose that should match your carb intake but might peak too quickly.
I'm not clinically trained in diabetes but just have 36 years personal experience. Always talk to your specialist before making changes.
Best regards,
Chris.
 
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