Glucose levels dropping what to do?

[1505helen]

Ok so after a day of quite high averages yesterday (in the 15 range). Emma's results have dropped to 7.5 this is good I know but when she spoke to nurse this morning she said up the long lasting dose to 12 units (was 10) tonight.

She said she feels a bit hypo at 7.5 and I'm a bit worried that she's gone into the honeymoon phase and if she injects 12 units tonight she might go hypo over night.

My thoughts are that she should leave it at 10 tonight as she sees the nurse at the hospital again tomorrow. Am I right?

She injects at 10:30 so any reply before then would be helpful!

Thanks,

Helen x

 

[mo1905]

I would not have thought 2 units would make a great deal of difference either way with the long acting insulin. If you're worried, leave it at 10 and discuss with nurse tomorrow. Good luck.

 

[1505helen]

Thanks for the reply, new to all this so appreciate the advice.

Helen x

 

[hale710]

Ok so after a day of quite high averages yesterday (in the 15 range). Emma's results have dropped to 7.5 this is good I know but when she spoke to nurse this morning she said up the long lasting dose to 12 units (was 10) tonight.

She said she feels a bit hypo at 7.5 and I'm a bit worried that she's gone into the honeymoon phase and if she injects 12 units tonight she might go hypo over night.

My thoughts are that she should leave it at 10 tonight as she sees the nurse at the hospital again tomorrow. Am I right?

She injects at 10:30 so any reply before then would be helpful!

Thanks,

Helen x

Hmm it took me 6 weeks to hit the honeymoon period so I don't know about that. She will feel "odd" at 7.5 if she's been high for so long but that will pass.

As its her slow acting it shouldn't cause a hypo through the night. When she tests before bed if she is below 8 she should have a piece of toast or something similar WITHOUT any Novorapid. if she's worried about night hypos then she can get up at 2 or 3 am for a test. I do that when I change my background insulin. If she's low then she should have another wee snack then before going back to bed

 

[hale710]

I would not have thought 2 units would make a great deal of difference either way with the long acting insulin. If you're worried, leave it at 10 and discuss with nurse tomorrow. Good luck.

2 units is a HUGE amount for me, it would almost double my dose! Some people are very sensitive to insulin. But if the nurse has said to do it I imagine its a good idea to up it

 

[donnellysdogs]

Are you doing any tests over night?

Really would be a good idea on the night of any changes to test at 2.30-3.00am.

 

[1505helen]

But the nurse only knew about the 15 average, she rang before Emma's BG dropped to 7.5!

Ahhh wish I could call her now but it's too late

 

[1505helen]

Are you doing any tests over night?

Really would be a good idea on the night of any changes to test at 2.30-3.00am.

She hasn't been told to yet...

 

[mrman]

There is alot to consider here. What is her level before bed and how much does she drop from bed till waking. Also a 3 am test would be useful to make sure she is not dropping too low, then rising early hours.

Also, is there any qa working before bed, or foods eaten before bed.

Feeling hypo at 7.5 would be normal after having high readings. It will take time and probably why your dsn is doing things slowly. Ideally bringing levels down gradually so that she feels normal between 6~8 then hypo or low awareness kicking in 4~4.5

Your dsn is saying to up the long acting to reduce the 7.5 morning reading which makes sense. However, not if her pre bed is something like 10+, as it would be dropping by more than 2. This would only be a valid "test" if it was started after 4 hours of previous qa given and after 4 hours of last carbs consumed. Alot to considet but need the answers before doing anything in my opinion.

Hope this is of help.





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[mo1905]

Great reply Brett !

 

[hale710]

There is alot to consider here. What is her level before bed and how much does she drop from bed till waking. Also a 3 am test would be useful to make sure she is not dropping too low, then rising early hours.

Also, is there any qa working before bed, or foods eaten before bed.

Feeling hypo at 7.5 would be normal after having high readings. It will take time and probably why your dsn is doing things slowly. Ideally bringing levels down gradually so that she feels normal between 6~8 then hypo or low awareness kicking in 4~4.5

Your dsn is saying to up the long acting to reduce the 7.5 morning reading which makes sense. However, not if her pre bed is something like 10+, as it would be dropping by more than 2. This would only be a valid "test" if it was started after 4 hours of previous qa given and after 4 hours of last carbs consumed. Alot to considet but need the answers before doing anything in my opinion.

Hope this is of help.





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Brett I love that you sound like you've swallowed think like a pancreas haha! Always sound advice!

 

[mrman]

Lol, keep meaning to get that book.

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[hale710]

Lol, keep meaning to get that book.

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Don't bother. You're basically paraphrasing already haha

it is a great book though Helen if you or Emma are interested

 

[mrman]

Just learned loads on forums from others when I got diagnosed so happy to help in the same way if I can.

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[EmmRoseTat]

Ok so thinking like a newbie does that mean you think I should change my unit to 12 or keep it at 10 for the night till I see my nurse tomorrow.

Rather than thinking like a pancreas :lol:

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[hale710]

Personally at the stage you're at I would do what the nurse said, but set an alarm to test through the night tonight.

But seriously, think like a pancreas is a great book!

 

[EmmRoseTat]

I was thinking that, although it's the 2 tests iv done since speaking to her which have concerned me.
These are my levels for the past couple of days
20/4
Before breakfast 10.2
Before mid day meal 11.4
Before evening meal 9.2
Before bed 10.9

21/4
Before breakfast 11.5
Before midday meal 12.8
Before evening meal 11.4
Before bed 15.5

22/4 (today)
Before breakfast 15.3
Before mid day meal 8.5
Before evening meal 7.2



So my nurse knows up to the 15.3, but suddenly its dropped a fair bit and the only difference is having a fairly low carb day.

Is the best thing still just to do what my nurse says and change to 12 units and check at 3am or shall I keep it at 10 until I see her tomorrow and get her opinion and advice too.

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[EmmRoseTat]

Baring in mind I'm on a fixed insulin doses for my qa and just done as im told for my lantus.

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[hale710]

It's the before bed and morning readings that are really affected by your lantus. There is no drop overnight yet you're still running high on average so I'd make the change and do the 3am check

 

[mrman]

I was thinking that, although it's the 2 tests iv done since speaking to her which have concerned me.
These are my levels for the past couple of days
20/4
Before breakfast 10.2
Before mid day meal 11.4
Before evening meal 9.2
Before bed 10.9

21/4 1.3 from night to morning
Before breakfast 11.5
Before midday meal 12.8
Before evening meal 11.4
Before bed 15.5

22/4 (today)
Before breakfast 15.3
Before mid day meal 8.5
Before evening meal 7.2

This would suggest your basal at night is correct and would leave the same.

Take for eg last night to morning , before bed 15.5, and before breakfast 15.3. A drop of 0.2 perfect.

this would suggest to slightly increase your nova rapid as if you had been 7 before bed you would of woke at 6.8, with possibly dropping lower before 3am.

Increasing your basal would then be acting as a correction for a higher before bed reading for which qa should be used. Also you may then have too much basal working in the day causing all sorts of problems.







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