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First hypo

J

jalu47

Member
Messages
15
Type of diabetes
Type 3c
Treatment type
Insulin
I’ve been diagnosed a couple of weeks and started on long acting insulin (14units) morning and night but was still having highs so started on some rapid yesterday. Long acting dose was also dropped to 12.

For the rapid I was quite conservative on units to carbs (20g to 1 unit to start as per the nurse) and still had a low about an hour after dinner of 3.7. Four jelly babies and I was then at 10.7! I took my long acting and went to bed. Took reading at 3am as I woke up and was 6.5. Got an alarm from my libre at 5 for a low - 3.7. Had 2 jelly babies and back up to 7.2 after 15 mins.

The ups and downs have confused me a lot and worry me. Is this usual or is it my body just settling? I’m going to talk to my nurse but interested to know if this is common when starting?

Thanks
 
Are you checking your Libre lows with a finger prick before treating the hypos?
It has a tendency to under report lows and, at night, experience compression lows (report low when you apply pressure).
As for your post meal low, this may be because the insulin worked quicker than you digested the carbs. Therefore, the carbs you ate were active later and pushed your levels up (although not as high as the Libre said because it can also over report highs).
 
Thanks - I didn’t check with finger but I do have a kit will do if it happens again. Chatting with my nurse on Friday so will go through it all with her too!
 
How many carbs/how much insulin did you take for your dinner? If the quantities are large then any inaccuracies in carb counting/insulin absorption/carbohydrate absorption will have a larger effect.

The overnight downward trend, which is what it sounds like, might be too much basal, or it could be that your dinner was eaten late and you've been correcting for the tail of the insulin (what type is it?)

Do you have an app on which you can plot blood glucose, active insulin (short acting) and carbs - I used XDrip+, there are no doubt other options. Seeing the data in front of you makes it much easier to understand the links between the different variables.
 
I was doing 15g to 1 unit and rounding down as needed. I’m on humulin i long acting.

I’m using carbs and cals app to calculate but I didn’t know about any other apps that integrate everything. Do you have to enter blood sugars separately or does it pull it in from libre?

Spoke to doc this morning as loads more lows overnight and dropped my basal.

However chemo starts again today with steroids so actually upping it for next few days - lots of trial and error at the moment!
 
jalu47 said:
Do you have to enter blood sugars separately or does it pull it in from libre?
Click to expand...
When calculating your bolus with your meals, you need to take into consideration any correction from your current BG level.
Let's say your target is 6mmol/l.
If you start at 10 mmol/l and correctly count your carbs and calculate the bolus for them, your levels would return to 10 mmol/l not the target 6.
Likewise, if you start at 4mmol/l you may way to reduce your bolus.

Do you have a dose calculator or are you using mental arithmetic to calculate your dose? I always did it in my head but then I am an engineer so numbers come easily. If you use an app for your dose calculation, you will need to tell it your level - Libre doesn't pass on this information.

These little tweaks often need half units. Do you have a half unit pen? They are really useful for bolus injections.
They are usually only available as reuasable pens. NovoNordisk do a rage called NovoPen Echo for their insulins (sadly different insulin manufacturers have slightly different shaped cartridges so they are not interchangeable).
The Echo are great: not only are they more robust than the single use pens, and better for the environment and take up less space in the fridge, they have a "reminder" at the end of the pen so you can check you took your dose and how much "insulin on board" (IOB) you have.

Finally, don't get too hung up on these tweaks. When there are so many things beyond food (such as illness and exercise and stress) which can affect our blood sugars and meters are inaccurate and carb counting can be an art, I find it very rare that I rest on my target level.
 
jalu47 said:
I was doing 15g to 1 unit and rounding down as needed. I’m on humulin i long acting.

I’m using carbs and cals app to calculate but I didn’t know about any other apps that integrate everything. Do you have to enter blood sugars separately or does it pull it in from libre?

Spoke to doc this morning as loads more lows overnight and dropped my basal.

However chemo starts again today with steroids so actually upping it for next few days - lots of trial and error at the moment!
Click to expand...

It was more a question of what the total bolus was, bigger quantities of insulin with a given error on the carbs counting (for whatever reason) -> larger resultant changes in blood sugar, the actual ratio is not really important (re my question) as long as you're happy it's about right.

I use XDrip+, it pulls data from the libre device directly, this means I don't use the app, which may cause you issues if your consultant wants the data presented using it - I would look around/ask questions and then do what works for you, including (nicely) telling your consultant how you will be presenting your data. Mine is happy to use Tidepool, to which XDrip+ will upload. As a random point, it would be nice to have more openness on data so that the best tools can be used to make life easier for us users and for the consultants who are time limited (tidepool isn't ideal for MDI data presentation for example).

Interesting you're on Isophane, it has a relatively short activity for a long acting insulin and has a marked peak. I'm no expert on what should be given to newly diagnosed diabetics though!

Good luck with the chemo.
 
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