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Type 1 Diabetes
Hypo right after meals.
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<blockquote data-quote="kitedoc" data-source="post: 2023634" data-attributes="member: 468714"><p>Hi [USER=58213]@blueeyed81[/USER], Sorry to hear of your troubles.</p><p>Several thoughts based on my experience as a T1D on a pump, not as professional advice or opinion::</p><p>1) could it be that <em>the cannula has been inserted into muscle</em> rather than under the skin into what is</p><p>called the subcutaneous(s/c) tissue?</p><p>Insulin is absorbed more rapidly from muscle and can lower BSLs more quickly.</p><p>a) <em>The cannula could end up in muscle at the time of insertion</em>, with it causing stinging and pain more</p><p>widespread then the usual pain after insertion <em>or</em></p><p>b) maybe the tip of the cannula is close to the tissue layer between s/c and muscle tissue and with pressure</p><p>perhaps laying on the area at night <em>pushes the tip through into the muscle</em>?</p><p>When I have suspected one of the above has happened<em> I have changed the cannula and chosen a different site</em>.</p><p>2) <em>problems with Medtronic pumps have been reported</em> - including errors in infusion rates - could</p><p>your pump be inputting more insulin than programmed into your tissue?</p><p>Some of that may be excess insulin from the basal program giving you higher insulin levels before you eat</p><p>and maybe the bolus dose in excess tips you over the line for a hypo to occur.</p><p>3) as others have suggested hypos can be due to the described effect of <em>delay in absorption of food due to</em></p><p><em>gastroparesis</em> - where the stomach holds onto food and releases it very slowly so that the insulin is acting </p><p>well before the food reaches the small intestine to be absorbed. You would need to check that out with a doctor. </p><p>It is a known complication of diabetes but that is after many years of diabetes usually. </p><p>see mayoclinic.org gastroparesis - diagnosis and treatment</p><p>4) if the problem of hypos soon after eating is persisting and getting more common and worse - that has</p><p>happened to<em> people whose kidneys for some reason are not working well</em> and insulin is not being broken down.</p><p>That is an urgent situation and needs immediate medical attention. see https;//doi.org/10.1136/bmj.d567</p><p>5) I do not know what else - somebody else might !!</p><p>So please contact your health team asap to discuss your troubles and see what they have to say. </p><p>What do they suggest you do whilst the cause is being sorted? ? change cannula site? ? </p><p>What about insulin dose?</p><p>Check what the pump is recording as amount of insulin delivered? Are you having to change the pump's </p><p>reservoir more often than usual?</p><p>Best Wishes for an easy answer and solution.<img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite1" alt=":)" title="Smile :)" loading="lazy" data-shortname=":)" /><img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite1" alt=":)" title="Smile :)" loading="lazy" data-shortname=":)" /><img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite1" alt=":)" title="Smile :)" loading="lazy" data-shortname=":)" /></p></blockquote><p></p>
[QUOTE="kitedoc, post: 2023634, member: 468714"] Hi [USER=58213]@blueeyed81[/USER], Sorry to hear of your troubles. Several thoughts based on my experience as a T1D on a pump, not as professional advice or opinion:: 1) could it be that [I]the cannula has been inserted into muscle[/I] rather than under the skin into what is called the subcutaneous(s/c) tissue? Insulin is absorbed more rapidly from muscle and can lower BSLs more quickly. a) [I]The cannula could end up in muscle at the time of insertion[/I], with it causing stinging and pain more widespread then the usual pain after insertion [I]or[/I] b) maybe the tip of the cannula is close to the tissue layer between s/c and muscle tissue and with pressure perhaps laying on the area at night [I]pushes the tip through into the muscle[/I]? When I have suspected one of the above has happened[I] I have changed the cannula and chosen a different site[/I]. 2) [I]problems with Medtronic pumps have been reported[/I] - including errors in infusion rates - could your pump be inputting more insulin than programmed into your tissue? Some of that may be excess insulin from the basal program giving you higher insulin levels before you eat and maybe the bolus dose in excess tips you over the line for a hypo to occur. 3) as others have suggested hypos can be due to the described effect of [I]delay in absorption of food due to gastroparesis[/I] - where the stomach holds onto food and releases it very slowly so that the insulin is acting well before the food reaches the small intestine to be absorbed. You would need to check that out with a doctor. It is a known complication of diabetes but that is after many years of diabetes usually. see mayoclinic.org gastroparesis - diagnosis and treatment 4) if the problem of hypos soon after eating is persisting and getting more common and worse - that has happened to[I] people whose kidneys for some reason are not working well[/I] and insulin is not being broken down. That is an urgent situation and needs immediate medical attention. see https;//doi.org/10.1136/bmj.d567 5) I do not know what else - somebody else might !! So please contact your health team asap to discuss your troubles and see what they have to say. What do they suggest you do whilst the cause is being sorted? ? change cannula site? ? What about insulin dose? Check what the pump is recording as amount of insulin delivered? Are you having to change the pump's reservoir more often than usual? Best Wishes for an easy answer and solution.:):):) [/QUOTE]
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