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HYPOGLYCEMIA

timewind

timewind

Active Member
Messages
27
Location
Macclesfield, Cheshire
I'm typing this, in the hope that I might find an answer, to something which has been troubling me for a number of years now, and that is HYPOS.

First let me tell you what I am taking.

I'm a type 1 diabetic on the following.

5units Novorapid at breakfast (6:10am)
5units Novorapid Lunch time (1pm)
20units Lantus (glargine) mid afternoon (3pm)
5units Novorapid at tea time (5:30pm)

I only use needles that are 5mm in length, and I Inject usually 20min's before I have to eat at lunch time, and sometimes if my sugar levels are high at tea time.

I inject at breakfast just before my meal. And I have to inject my Lantus at 3pm. Here is the problem.

I can guarantee; with in an hour of injecting my lantus I will have a hypo. When I test my blood sugars, they are usually around 4mml or sometimes lower, and I have to have some Lucozade.

I also suffer with regular HYPOS during the morning, usually around mid morning or lunch time.

I have spoken with my Doctor here in Macclesfield, but he hasn't been very helpful. And I can not see a Diabetes Specialist Nurse unless my GP arranges an appointment.

I have a very active job. I work in Horticulture, but it isn't all that physical.

So I was wondering whether or not you could give me some advice please.
 
Hi.

The usual causes of hypoglycaemia are the following:
Too much Insulin
Not enough food
Unusual amount of exercise
Delayed meals
Stress
Hot weather (summer, whenever that is ?)
Hypo inducing medications

You may simply need to adjust your Insulin/Food levels and be able to avoid the 'drop.' Trial and error with a meter and doseage etc.

There are many previous posts on the subject, if you do a search top right on 'Hypoglycaemia' you should find over 200 references. Have a look there to see if there may be more information available.

In the meantime, take a look at this link.
http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/
 
Timewind,

As a fellow type 1, I shall offer some advice on what you have said, but you need to see a specialist consultant or DSN.

The amount of hypo's you are having daily is quite alarming, and probably causing you great concern and disruption in your working day. Having two hypo's pretty much at the same time each day should not be to hard to resolve.

Novorapid has a profile of no more than 4 hours, it is most active around the 1-2 hour mark, but can impede on blood sugars after this time when there is a increase of activity. So, your mid morning hypo's are most likely due to a mis-match of insulin and carbs for breakfast. Try cutting back on your insulin by 1 unit or increase your carb intake by 10-20g and see if this stops the hypo's. Should this not work, decrease your insulin by another 1 unit, and I would imagine this would be sufficient to stop your blood sugars running low.

Now your lantus injection. Why not move your lantus injection to a evening dose when you are less active, say around 7pm. Lantus should not cause a hypo, more likely you are running low from your dinner time dose of novorapid. Again, try reducing your dinner time dose by a unit or two, or increase your food by 10-20g, this should stop you running low 3-4 hours after.

I am on both lantus and novorapid, and have recently reduced my doses to match my carb intake, so far this has reduced my episodes of hypo's. Why don't you enquire about a DAFNE course at your local hospital. On this course they teach you how to count carbs and match food intake to insulin; I recently was on one and found it very informative, and have tighten my control as a result.

What is paramount when adjusting insulin is testing, you must test every hour to see how your blood sugars are responding. Write them down in a diary, and take this along to your next appointment so they may analyze your results.

Good luck

Nigel
 
Hi Nigel,

Thank you for taking the time to reply to my message. The Hypos that I am getting are very mild, and don't require any assistance from another person. How ever; I wish that they would stop.

I had high sugar levels this morning, which I think were caused by the hypos which I was having all day yesterday. I was getting fed up with drinking lucozade towards the middle of yesterday afternoon I can tell you :D

I only had one hypo today and this was at 3pm before my Lantus injection.

I think I will try doing as you have suggested, and move my Lantus injection to a later time say 4:30pm this is when I get home.

I will also continue to reduce my fast acting insulin during the day and also monitor my levels more often then the normal four times a day.

Tomorrow. I'll drop my lunch dose from 5units to 4units and see what happens. And also reduce my breakfast dose if I have any problems tomorrow.

It's going to be trial and error for the rest of this year, but I'm used to that. I've had T1 now for 31yrs and I was once told by my Diabetic Dr that I am a brittle diabetic.

When I go for my annual review next month I will discus these problems with my GP and see what happens.

Thanks again.
 
Timewind

Good luck and I hope you get there. Diabetes is a game of trial and error, and who better than you to comment after 31 years of diabetes. Let us know how you get on with your review next month.

Regards

Nigel
 
I increased my morning insulin dose from 5u to 6u, because it was high yesterday morning. This unfortunately, brought on a slight hypo at 9am. So tomorrow it's back to 5u at 6am.

For the rest of the day (touch wood) I've been OK. My lunch dose was reduced from 5u to 4u and this resulted in a 9.9mml blood sugar reading at 4pm. I arrived home at 4:25 and injected my night time insulin (Glargine), I did a blood test at 6pm before I sat down to have my supper and that was fine. 8.4mml and I injected my novorapid.

Fingers crossed now, for a hypo free night and a hypo free day tomorrow.

Wish me luck :D
 
Hi timewind

What might help you, is to get hold of insulin pens that deliver in 1/2 unit increments instead of 1 unit. Sometimes it can make a fair bit of difference.
 
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