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frquent bs low

R

rugbygirl

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7
hi I was diagnosed with type 1 diabetes 4 weeks, I am 25 abit overweight and quite active. I am on insulin injections 3 times a day.
At first I started off haveing like 6units before each meal and this was gradually raised to about 10-12 before each meal.
I have started cycling to work so have knocked my morning insulin down to 9 which worked well, but recently i have been having frerquent low bs levels - 3.5 in at around 11 and 3.30 ish and in the evenings. so i knocked my insulin down to 7 before all meals and it still happened. Do I need to knock it down further? is there something i cud be eating at my meals that would make it better?
also with my cycling on the way there its nearly all up hill but i eat breakfast just before so my sugar levels are fine, on the way home it takes about 10 mins and i pedal for prob 3-4 mins of that so its not a lot of effort but afterwards my sugar levels are like low 3s and 4s even if they are 8 before i begin i had a snack yesterday before riding and home and my sugar was still low.
anyone got any advice?
 
Hi rugbygirl,

someone will be along any minute I'm sure to post the standard info 'for new diabetics' which will give you all the details, but in the meantime....
...sounds to me as if you are on the right lines - if your insulin dose is giving you hypos, lowering the dose (and checking your blood to make sure it isn't going too high again) is the right thing to do.

You don't say what you've been taught so far about carbohydrate and insulin, and I don't want to tell you things you already know, but basically insulin works by helping your body to store carbs. You eat carbs, they turn into blood sugar, the insulin stores the sugar in the liver. If you are eating a 'meal' or a 'snack' but it is low in carbs, the insulin you've injected will make your blood sugar drop and drop.
So one solution is to eat a snack that is higher in carbs. Another is to inject less insulin. You may even decide to do both in the end. Keep testing to see what happens. Experimentation is a good way to understand how YOUR body works (we are all different after all).

The other thing is that different carbs act at different speeds. And different insulins work at different speeds. They can get out of kilter.
So, a mars bar will convert to blood sugar very fast, while a slice of wholemeal bread will convert to blood sugar much more slowly. Something like a flapjack, with (slow release) oats and (quick release) sugar/honey, can be ideal as a snack if you are about to do some exercise, in my experience.

What kinds of things are you eating for breakfast and for your snack? And what insulins are you using?
 
Just a point....a Mars bar, although high in carbs has 17.6 gm per 100 of fat. So it does not convert very fast. It used to be an old treatment for hypos but has since been superceded in favour of much quicker acting carbs. However, it can be used later as the 'carby snack' to bring levels up.

Here is the advice that Snodger mentioned which may be of help to you.

Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Sue/Ken.
Click to expand...
 
Hi Rugbygirl
as a comparicement have you tried walking just to see the result?
 
Snodger said:
someone will be along any minute I'm sure to post the standard info 'for new diabetics' which will give you all the details, but in the meantime....
Click to expand...

Hi rugbygirl and welcome to the forum :) Snodger has already given you good advice and mentioned the information for new diabetics that we usually post for new members. Here it is. Have a good read around the forum, a read of this advice and then ask any questions you may still have - we are all here to help you.

ASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS.
Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l........(Type 1 & 2)
2 hrs after meals......no more than 8.5 mmol/l.....( Type 2)

2hrs after meals....... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Sue/Ken.
Click to expand...
 
sugarless sue said:
Just a point....a Mars bar, although high in carbs has 17.6 gm per 100 of fat. So it does not convert very fast.
Click to expand...
It does compared to a slice of wholemeal bread - which was the point I was making. And maybe it doesn't shoot *your* sugars up, but it would skyrocket mine pretty much straight away, however much fat it has!
 
rugbygirl.
As this thread is about frequent low Bg levels it is probably a good idea to point out that Mars Bars are not very quick acting carbs. Some people think that they are a good and recommended treatment for hypo levels where this isn't really the case. One HCP I know was telling me about how years ago they used to treat hypo's with a glass of milk, they now know it is much too slow acting.

I once tried the Mars Bar treatment......it had no real obvious effect on my Bg levels until about half an hour or so had passed, then it started to climb. So the advice that they are not recommended as quick acting carbs for hypo treatment seems to be correct. I also tried it with a slice of bread which somebody once recommended as hypo treatment too. Neither are very quick acting. They get there eventually but take *much* too long when you need a quick fix. Might be useful to 'fuel' you up for the exercise sessions though ? :)

On the other hand 3 Glucotabs put my Bg levels up within 10-15 minutes, a much more effective way to raise Bg levels quickly and predictably by about 1 to 2 points.

Just shows how we are *all* different. :)
 
Sorry rugbygirl - I see I was posting the basic information simultaneously with sugarless sue so you got it twice. Still, twice is better than not at all :D
 
thanks for all the info!
so to answer ur questions for breakfast i usually have porridge or shredded wheat bitesize and then for snacks cereal bars or crisps before i cycle.
as for what insulin its humilin not sure what type that means it is.
I havent leant to carb count yet but i think that will be my next step.
my sugar went low again 2day at around 10.30 so would it be best for me to eat more 4 breakfast or have a snack later on around like 10ish?
 
Hi rubygirl

Some things that might be useful for this one case.

1. If you're having unsweetened porridge, it's possible that it is being absorbed slower than your insulin, which could quite possibly cause a low blood sugar 1-3 hours after eating.

2. If you have gastroparesis, you may experience 'delayed stomach emptying' which can cause people to have frequent lows 1-3 hours after meals.

3. I notice you say you cycle in the mornings. Do you inject short acting insulin into your legs in the morning? If you do, it's likely that the exercise your legs are doing will cause your insulin to be absorbed significantly quicker, which could well be a factor in the low blood sugars.


Going back to 2. If you experience going low after many meals it may be worth speaking to the doctor to see if gastroparesis may be occurring. This isn't an area I'm much of an expert on though.
 
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