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Feeling low when not

Supramate

Newbie
Messages
3
Type of diabetes
Type 1
Treatment type
Pump
Hi my fellow diabetics. Forgive my english as its not my native tongue. So I've been having an issue with the diabetes lately which I haven't told my endo yet, but was hoping someone could help me or relate to this.
Ok so basically I'm type 1, I use a pump with Novolog (Novorapid) and my BGs are around 150 mg/dL (hba1c 6,8-7%).

Lately, I've been experiencing some fast drops of my blood sugar, (most of the time before lunch, or before dinner). For exemple, when I eat my breakfast (oatmeals with fruits, or toasts), my BG will be fine 2 hours post bolus/meal, but after 3-4 hours, it suddenly drops a LOT, like 0,50 mg/dL in 20-30 minutes. I'm not necessarly pretty active when it happens but the most annoying thing about this is that I feel extremely weak and hypo-like when it happens and that my bloog sugar is actually 85 or even 100 mg/dL. I feel starved, shaky, confused (cannot handle a conversation), about to pass out and anxious obviously as I don't understand why I feel that way.


I reckon my bolus must still be active, and that maybe Novorapid peaks later for me... that would explain why it drops like this so fast. I don't think it could be caused by my basal rate as it would be suprising that it makes my BG drops like that.

Can anyone relate to what I'm experiencing or give me some insight on the matter ?

thanks in advance,
Supramate.
 
Hi Supramate, just to make sure we get it right: You describe that your bg suddenly drops fast, and quote "like 0,50 mg/dL in 20-30 minutes". You meant to write: " 50 mg/dL ". Correct?

How we feel is most often connected with how rapid the bg change is happening, not necessarily determined by exactly where on the magic bg scale we are. So e.g. a slow drop over 5 hours from 90 mg/dL down to 40 mg/dL will feel much more gentle (if anything at all is noticed) than a very rapid drop from 120 to 70 mg/dL.

Please notice that Novorapid has quite a long effect tail at peak effect:
Onset: 10-20 minutes
Maximum effect: 1-3 hours
Duration: 3-5 hours
So post 2 hours past bolus, it will still drive your bg further down. That may explain why you still drop quick 3+ hours after your meal and why you often are very low when getting to next meal time.
 
Hi and welcome to the forum @Supramate.

It's really important to do some basal testing first before looking at your bolus doses, if you find that your bg is dropping during a fasting check then your basal rates need adjusting, if it your bg stays pretty stable throughout the test then it likely is your bolus dose, if your unsure how to do a basal check then take a look at the following, it was written for people like you who use a insulin pump:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007
 
welcome to the forum
as you are pumping @noblehead 's advice is critical to getting your overall control right.
do have a look at the link and let us know if you think all your hourly basal rates are correct !
 
I've been having this experience quite a lot lately. I think it is because I have increased my exercise routine and my insulin sensitivity keeps changing. So even though I haven't got much insulin in my system, I am too sensitive to the 'tail end' of the Novorapid. Could your problem have anything to do with that?

When you say your blood sugar is "fine" 2 hours after eating, is it at the top end of fine (140-ish) , or the bottom end of fine (85-ish)?

Also, where you live, has the weather suddenly warmed up? With me that drops my Total Daily Dose needs. Could it just be that?
 
Yes I meant 50 mg/dL, Celsus. I think I'm going to bolus a bit less or eat a little snack to see if that changes anything.
Also, I'm going to try the basal testings to see whats hapenning with my BS before lunch and dinner when fasting.
Thanks for all the great pieces of advice everyone, it's good to know I'm not alone out there.


Hi Ruth, no I haven't increased my exercise routine lately but it seems like these episodes mostly occure when I'm busy at work or outside and not at home. So that could be a hint... and yes it may be related.

Also when I say my blood sugar is fine, I mean its around 130-150ish and then suddenly drops. The weather has warmed up indeed (I'm from Paris, France) but these events already happened to me during the fall and winter season, so not so sure about that one.

Do you instantly get better if you snack on something ? I also wonder if I'm just not eating as much as I should. I'm 6'4 (192cm) and weigh 175 pounds (around 80kg). In the morning I'm already starving by 10-10:30... Do you guys mind sharing with me what you eat in the morning for breakfast ? And does that fill you up for the next 4 hours without snacking?

Again, many thanks.
Supramate
 
Wow Supramate, you are a big guy! I am myself just a mini in comparison, on 67 kilos.
Breakfast depends a bit on how hungry I am, but typically:
1 big cup of steel-cut or rolled oats (cooked in the microwave with the milk or raw)
I add 0.5 cup of milk into my bowl of oats.
Flavours depending on mood and day. Cinnamon + butter in the warm variation, berries and/or plenty of mixed roasted nuts in the cold served version. Have a couple of bodybuilder friends who are bulking up lean muscle on this, eating like 3-4 cups in the morning, keeping them full till lunchtime, so ought to be able to do the trick for you also. ;o)
Extras would be 1-2 boiled eggs, cheese. And exceptional sometimes a slice of toasted low-carb bread.
In weekends I enjoy scrambled eggs, sausages and bacon.
Tea or coffee ad libitum.

At times I take Weetabix or classic All bran for a break away from the oats. But to keep you full, the oats wins all hands down.
Btw mind you - I am not a low carber.

Bon appétit monsieur!
 
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