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Hypoing after evening meal then High several hours later.
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<blockquote data-quote="kitedoc" data-source="post: 1926033" data-attributes="member: 468714"><p>Hi [USER=421720]@samowen268[/USER], Sorry to hear you are having such a terrible time! </p><p>My take on things from my experience as a diabetic, not professional advice or opinion is:</p><p><em>As [USER=479658]@Knikki[/USER], says you may be not having enough carbs to balance the amount of short-acting insulin you are taking. </em></p><p>But that might take some time ? ? 30 minutes plus to cause hypos. Perhaps you have become <em>more sensitive to insulin</em> <em>in the evening</em> and things like weight loss, increased level of exercise or reduction in kidney function (as the kidneys breakdown and eliminate insulin from our bodies) can increase that sensitivity. Many of us find the ratio of grams of carbs to units of insulin is different between morning and evening. So we cannot use the morning ratio as a comparison for the evening.</p><p>Also brands of short-acting insulin vary in how quickly they start to act. What short-acting insulin are you taking?</p><p>I wonder whether you are <em>accidentally injecting insulin into your muscle.</em> Insulin seems to be absorbed far more quickly from muscle than from under the skin (subcutaneous). Rarely I inject into muscle if my BSL is climbing rapidly with ketones present to bring my BSL down. It peaks some 45 minutes after injection instead of 2 hours. And <em>maybe part of your injection of insulin ends up in muscle and part in subcutaneous tissue and you experience hypos early and then later as a result.</em></p><p>Some people have<em> accidentally injected into a blood vessel </em>and with the insulin pens used these days you cannot 'draw back' on the syringe plunger to see if there is blood coming back. So injection into a blood vessel can go unnoticed although it is pretty rare in my experience. Before pens became available I used syringes and only recall finding blood on draw back on two occasions over the first fifteen years on insulin. Of course that is just my experience. People have reported feeling hypo within minutes of injection into a blood vessel.</p><p>Apart from injection into a muscle <em>I wonder whether you are underweight </em>(and so have less subcutaneous tissue, and muscle is closer to your skin) and <em>you may not store as much glucose in your liver </em>as others do. However I note that you do experience high blood sugars later. <em>Many of us have hypers following hypos </em>due to the food we take to combat the hypo plus the effect of glucagon and adrenaline, both hormones which influence the liver to release stored glucose. Our brains get tetchy when BSL is low, as the brain depends mainly on glucose for fuel. The hormones help to defend the brain against such fuel shortage. <em>We can end up giving correction doses to deal with the hypers.</em></p><p><em>I would suggest you discuss some of these above possibilities with your DSN. As you say, frequent hypos is a real drag so the sooner sorted the better.</em></p><p>Please let us know how you get on. Others may have had similar experiences to you and are seeking answers etc.</p><p>But most importantly we wish to help in whatever way we can. We cannot advise as DSNs and other professionals do but wish to see you get through this set of rapids and turbulence on the river of life !! Best wishes. <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: 1926033, member: 468714"] Hi [USER=421720]@samowen268[/USER], Sorry to hear you are having such a terrible time! My take on things from my experience as a diabetic, not professional advice or opinion is: [I]As [USER=479658]@Knikki[/USER], says you may be not having enough carbs to balance the amount of short-acting insulin you are taking. [/I] But that might take some time ? ? 30 minutes plus to cause hypos. Perhaps you have become [I]more sensitive to insulin[/I] [I]in the evening[/I] and things like weight loss, increased level of exercise or reduction in kidney function (as the kidneys breakdown and eliminate insulin from our bodies) can increase that sensitivity. Many of us find the ratio of grams of carbs to units of insulin is different between morning and evening. So we cannot use the morning ratio as a comparison for the evening. Also brands of short-acting insulin vary in how quickly they start to act. What short-acting insulin are you taking? I wonder whether you are [I]accidentally injecting insulin into your muscle.[/I] Insulin seems to be absorbed far more quickly from muscle than from under the skin (subcutaneous). Rarely I inject into muscle if my BSL is climbing rapidly with ketones present to bring my BSL down. It peaks some 45 minutes after injection instead of 2 hours. And [I]maybe part of your injection of insulin ends up in muscle and part in subcutaneous tissue and you experience hypos early and then later as a result.[/I] Some people have[I] accidentally injected into a blood vessel [/I]and with the insulin pens used these days you cannot 'draw back' on the syringe plunger to see if there is blood coming back. So injection into a blood vessel can go unnoticed although it is pretty rare in my experience. Before pens became available I used syringes and only recall finding blood on draw back on two occasions over the first fifteen years on insulin. Of course that is just my experience. People have reported feeling hypo within minutes of injection into a blood vessel. Apart from injection into a muscle [I]I wonder whether you are underweight [/I](and so have less subcutaneous tissue, and muscle is closer to your skin) and [I]you may not store as much glucose in your liver [/I]as others do. However I note that you do experience high blood sugars later. [I]Many of us have hypers following hypos [/I]due to the food we take to combat the hypo plus the effect of glucagon and adrenaline, both hormones which influence the liver to release stored glucose. Our brains get tetchy when BSL is low, as the brain depends mainly on glucose for fuel. The hormones help to defend the brain against such fuel shortage. [I]We can end up giving correction doses to deal with the hypers. I would suggest you discuss some of these above possibilities with your DSN. As you say, frequent hypos is a real drag so the sooner sorted the better.[/I] Please let us know how you get on. Others may have had similar experiences to you and are seeking answers etc. But most importantly we wish to help in whatever way we can. We cannot advise as DSNs and other professionals do but wish to see you get through this set of rapids and turbulence on the river of life !! Best wishes. :):):) [/QUOTE]
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