Help/ Advice Needed Please!

[louiseg2202]

Hi all

I'm a 28 year old type 1 (since I was 8), and this is the first time I've ever visited a site like this, as I'm in desperate need of some advice.
In September of this year, I had an extremely severe overnight hypo, that required paramedic assistance to 'bring me back'. Even after discussing it with my specialist nurse, no real cause or logic could be idenitified. However, earlier this month, it happened again and I was hospitalised.
In all of he years since my diagnosis, this has never happened. Hypo's, yes, but never with this severity.

I have discussed it at length with my consultant and followed their advice stringently; lowering my basal dose, making sure I am at least 10 before bed, eating a late night snack, but it's not having much effect. For example, a few nights ago I was 16.3 at 11pm, and awoke (just!) at 6am the following morning to a reading of 1.3. I am terrified of the consequences of this, and was wondering if anyone had any advice or been through a similar experience?

Thoughts greatly appreciated

Louise

 

[LoisCoxx]

Hi Louise!
yes this site is a great help
I'm a 16 year old type one, 4 years. In January this year i had three severe night time hypos where i couldn't be risen in the morning and my parents had to give me my glucagon injection and one hype when i woke up and couldn't function, within two weeks. i know how terrifying it is..
i discussed with my DSN, consultant and dietician after each severe hype but we couldn't establish a cause either. however, after the last hypo my consultant suggested that i split my night lantus night time insulin dose and eat a snack before bed. i now have half my dose before bed and half in the morning and i haven't had a severe night time hypo since. i have quite a few early morning lows but none where i couldn't be risen.
obviously you should discuss with a consultant or DSN before changing any insulin dose but it worked wonders for me!
i hope things get better soon,
Lois

 

[Fallenstar]

Hi Louise
I used to get very bad night time hypos on Lantus...convulsions the lot..very scary.It did not matter what I tried with my regime on it...split doses ,different times of the day, reduced doses ,snacks ,LOTS of night time testing...they came when they wanted on Lantus and it could be out of the blue for no obvious reason...or sometimes thick and fast :***:
Since changing to Levemir. I have not had ONE. I can go to bed now and after years of being scared really, I can trust this insulin and now can sleep:shock:

On Levemir I don't need to even have supper if I don't want it,and I can do a correction dose of Bolus if I need it right before bed to give me a morning reading in the 5's . I would not have dared to do this on Lantus. I had to get my BG well into double figures on it..maybe it would stay there ,maybe it would drop down to 1 :***: I just never knew on Lantus.

Levemir is now acting like a "background" insulin ,Lantus just did :***: what it felt like!

Anyway, just wanted to let you know, yes, I have been there. Don't know what insulin you are on....maybe it's Levemir or one of the others..then maybe a change may work for you. We are all different ,and different insulins work differently for all of us...some good ,some bad.
Its just sometimes tweaking this by a few units, or splitting this, or having more food....just ain't gunna cut it. You may need a whole new regime.

Anyway, I wish you all the best with it. Because it is a horrible place to be,so I hope you find a solution Good luck

 

[noblehead]

Louise,

Night-time hypo's are predominantly caused by the basal insulin dose being to high, it could be that you need to lower your dose further but failing that you could ask your DSN to change your basal insulin for an alternative.

I use lantus and generally go to bed on 5-6mmol without any need to snack and stay within this range by the next morning, when I do experience hypo's or night-time highs I test thoroughly for the next few nights to see what my bg is doing every 2 hours....... it's a pain but checking this way does pay dividends so is worth the price of a few restless nights.

The only other causes of night-time hypo's apart from your basal dose being incorrect is exercise or active quick-acting insulin still circulating in your system, if you can rule these out then you really do need to look seriously at your basal insulin again.

Best wishes!

 

[louiseg2202]

Hi all,

Thanks for the advice, it's really appreciated! I was switched temporarily to Levemir, and although everyone else has had nothing but glowing reports about it, I found it was leaving me in the 30's, no matter what I did to bring myself down. However, it might jus have been teething problems so will definitely try and get it changed again. Pretty scary....

Thanks again,

Louise x

 

[Fallenstar]

Hi Louise
When I switched from Lantus to Levemir, I have found I have had to double my dose from 12 units of Lantus to 24 units of Levemir taken as a straight split . I think most people find they need to split Levemir...which to me has made it all the more controllable, so a good thing.
Maybe try the reduction in dosage of your Lantus first as NH has suggested, it may be a dosage thing, but if you find nothing works and you are still living in night time Hypo land :shock: A change and an increase in dosage of a new insulin may be what you need.
It's all trial and error I'm afraid...but good luck with it all and I hope you get sorted out.

 

[noblehead]

Hi all,

Thanks for the advice, it's really appreciated! I was switched temporarily to Levemir, and although everyone else has had nothing but glowing reports about it, I found it was leaving me in the 30's, no matter what I did to bring myself down. However, it might jus have been teething problems so will definitely try and get it changed again. Pretty scary....

Thanks again,

Louise x

I too changed to levemir some time back and couldn't get my previously good control back despite switching to two injections a day, before switching I was on 20 units of lantus but needed 40 units of levemir just to get anywhere near normal numbers.

On reflection I maybe didn't give it enough time as I was only on levemir for 10 weeks, what I like about lantus is it lasts the full 24 hours in a single dose and is a steady.....reliable basal insulin.