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High BGL since hypo. Please help

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ChinchillaMum80

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Hi - sorry if this question has already been asked.

I believe I have Type 2 diabetes (hospital says Type 1; GP says Type 2). Diagnosed in 2008 and been on Lantus for the last 8 years. In August/September last year, I started on long-acting Metformin and a low-carb diet - nothing extreme: 30-60g carb a day. Managed to get my Hba1c from 9.1 to 5.8 and lost 2st 9 lbs so far. BGL has been between 4 and 6 in the mornings and not more than 7.9 during the day so I started phasing out my insulin.

Been getting on really well with the new diet - until pancake day. Tried a small gluten-free pancake (low carb was just vile) which pushed up my BGL to 10.4 (highest in months) so I took 40 units of Lantus. Woke up in the middle of the night feeling terrible: sweating, shaking, breathless, heart racing, confused etc and my BGL was 3.1. Luckily, my mum was there and got me something to eat and I was fine (BGL a bit high next morning).

Since then, I have resumed the low carb diet, but my BGL in the mornings is now between 7.2 and 9.1, which I don't understand as my BGL in the evenings is between 5.1 and 5.7. I have also noticed my urine in the mornings smells dire. Eventually I can get the BGL to go back down during the day and by night-time they are in the low 5s but come morning they are high again. I don't know what to do as I am scared to take insulin given my last experience, particularly as the BGL is reducing just before bed but I can't keep having high sugars in the mornings. Any advice?
 
Sorry to read about your problems.

It may help to understand how much Lantus you are supposed to take each day.
Was the 40 units after pancake more than usual?

Lantus is a slow acting insulin. It's purpose is to act as a background insulin to work with the glycogen which is released from our livers throughout the day and night. It is not usual to take it to bring down an unusual high from eating something with higher carbs than usual.

If you have stopped taking it (I think that is what you mean by "I am scare to take insulin"), you no longer have the slow acting insulin to maintain low BG levels. This may explain your high levels in the morning.

I think it would be useful for you to talk to your doctor about your recent experience and to ask him how your medication is supposed to work for you.
 
helensaramay said:
Sorry to read about your problems.

It may help to understand how much Lantus you are supposed to take each day.
Was the 40 units after pancake more than usual?

Lantus is a slow acting insulin. It's purpose is to act as a background insulin to work with the glycogen which is released from our livers throughout the day and night. It is not usual to take it to bring down an unusual high from eating something with higher carbs than usual.

If you have stopped taking it (I think that is what you mean by "I am scare to take insulin"), you no longer have the slow acting insulin to maintain low BG levels. This may explain your high levels in the morning.

I think it would be useful for you to talk to your doctor about your recent experience and to ask him how your medication is supposed to work for you.
Click to expand...


Hi Helen

I used to take 40 units of Lantus every day for years although my control was still terrible. When I started a low-carb diet and Metformin, I gradually started tapering this down, depending on what my BGL were doing. As a rough guide, if they were over 7, I'd take 40; between 6-7, I'd take 20-35 and if in the 5s or under, I wouldn't take anything (don't ask me why but this used to work and get my BGL down to 4-6 in the mornings). Eventually my BGL in the evenings was always between 4 and 6 so I didn't need to take any insulin in the evenings and my BGL were still 4-6 in the mornings. Since the hypo the other day however the BGL seem to be going up overnight and I don't know what's causing the change. I think you're right though, I think I need a chat with my GP...
 
You also need to find out which type you are Type1, Type2, LADA (since you said your hospital and doctor have different ideas to each other), this is a vital piece of information that is needed.
 
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