Going low

Lisaopp

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10
Hi
I'm new to type 1, or LADA. I'm honeymooning and trying to gather as much info as I can.
If someone is taking fast acting, meal time insulin, would they go low in their sleep?
Why do people go hypo, and how can you avoid it?

Thank you.
 

urbanracer

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Hi, it is possible to hypo whilst sleeping and it happens because you have too much insulin in your system.

You will get used to the way your own body responds to carbohydrates and insulin. It can be harder to control during the honeymoon when your body is still trying to do it's own thing.

Accept that a hypo probably will happen at some point and be prepared. Keep a sugary drink (regular Coke, orange juice, Glucojuice if you can afford it) nearby. And a source of longer acting carbs like a biscuit of some description is always useful.

Check your blood sugars regularly, and be prepared. Be lucky!
 
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Daibell

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Hi. Yes you can go hypo whilst sleeping so ensure you have been told about carb-counting and injecting the right amount of meal-time insulin to cater for that. If in doubt go a bit lower for the last injection before bed-time and obviously test before bed. The liver is quite good at dumping emergency glucose when needed but not if you have been drinking alcohol.
 
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michita

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to avoid having a low while asleep (or in general) i eat low carb (less insulin, smaller error also shorter time fast acting insulin is on board ) and eat dinner early in the evening so I don’t go to bed while fast acting insulin is still in board.

I’m adult onset type 1 diagnosed 3 years ago and low carbing since. In my case, eating low carb works well, hypos are mild and rare.
 
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Lisaopp

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Thank you for the replies. It feels like not much is written in stone when it comes to diabetes.
But it's safe to say, if I took meal time, fast acting insulin with dinner at 6, I can be positive that at 12 or midnight, I'm not going to drop in my sleep, assuming I haven't exercised that night.
It should be completely out of my system 6 hours later so it the insulin would not have any more effects on me while I'm sleeping. right?

If I have that down, it takes away some of the fear with starting insulin. Thanks again! :)
 

Scott-C

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It feels like not much is written in stone when it comes to diabetes.

Hi, Lisaopp, yep, that's a fair assessment of it.

Good advice above, and your own thoughts, about having little "iob", active insulin on board", when going to sleep.

But...

There can still be a residual action from fast acting which can last longer than expected.

Also, if your basal, background insulin dosage is too high, that can drop bg quite a lot, but tends to do so slowly. It's worthwhile spending a bit of time doing basal testing. It can be as easy as having a good long lie in on a Saturday until late afternoon - bg should stay more or less the same for the duration, if it goes up or down too much, think about changing the dose. Get your basal right, it makes the rest of it a lot easier, because you're not having to sort out with fast acting insulin what your basal should be doing.

The liver can also be a flighty wee thing. It releases stored glucose to power your energy needs between meals, and your basal takes care of that, but it can also grab back glucose from your bloodstream because it likes to keep stocked up with stored glucose, and that can lead to a hypo too. Which is why some cheese on toast is a good idea after a hypo - putting more carbs in so that the liver can restock without depleting your bg too much.

You have one hormone which reduces bg, insulin, and you now have to inject that. But, you have several hormones which raise bg - adrenalin, glucagon, cortisol, growth hormone - and your endocrine system still makes those.

So, even though it is highly likely you will make a mistake in your insulin dosing decisions at some point - we all do - you've got a whole host of hormones which will still be kicking in there to tell the liver to release glucose to raise your bg again.

It won't always be nice - night hypos can be very unpleasant - but your body will keep you safe.

And there's the cgm angle too - nothing better than your phone ringing to tell you your bg is getting too low at 3am.

Good luck!
 
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Lisaopp

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Oh my gosh .... SO informative. I actually teared up a bit because you, as well as the others have put my mind at ease somewhat.
I have already had my issues with basal. I was on 2 units, and being uneducated I thought, how about another 1 or 2 units more? Big mistake I was also away and the temperatures were hot, and I was exercising more. I was shakey at 100, and continued to drop to 60 even though I had 11 ounces of orange juice and chocolate. I didn't come back up for an hour, which freaked me out!
I am trying to gather as much information as I can before I make anymore decisions.
Again, thank you for the words of wisdom!:happy:
 

ert

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Oh my gosh .... SO informative. I actually teared up a bit because you, as well as the others have put my mind at ease somewhat.
I have already had my issues with basal. I was on 2 units, and being uneducated I thought, how about another 1 or 2 units more? Big mistake I was also away and the temperatures were hot, and I was exercising more. I was shakey at 100, and continued to drop to 60 even though I had 11 ounces of orange juice and chocolate. I didn't come back up for an hour, which freaked me out!
I am trying to gather as much information as I can before I make anymore decisions.
Again, thank you for the words of wisdom!:happy:

That drop sounds more like short-acting in your system rather than due to your basal. I find that if I exercise in the four-hour window of taking short-acting, my blood sugars will drop like you've stated unless I have some extra carbs.

The basal is background insulin and takes up to four hours to work. I'm on low amounts like you and have added more basal to my system and found that over eight hours it may drop my blood sugars by 10 to 20 mg/dL when I'm not eating, so I've gone back to my original dose of two units. I can exercise on basal and my blood sugars stay constant.
 
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