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I DONT UNDERSTAND THESE HYPOS!!!

Discussion in 'Type 1 Diabetes' started by Nicklenocky, Oct 8, 2011.

  1. Nicklenocky

    Nicklenocky · Well-Known Member

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    Hi All

    Over the last 2 days I have been having some problems hypo-ing after meals. Its not unknown for me to hypo after a meal, but I have recently made a real effort to get my blood sugars in range after years of just going with the flow...now I am checking my blood constantly, teaching myself to count carbs (I have not done DAFNE and will not be able to in the near future since I no longer live in UK) and want to get my Hba1c down from 8.3.

    I recently had ketones after recovering from the flu and left the hospital on 1st of October. So I have spent this week recovering, researching online, recording, and testing constantly. In the last month or so, I would say I have made some significant progress....I have managed to eliminate early AM hypos by taking a snack before I sleep, I have found out that rice is a great food for me and keeps me going, and apart from a few blips my blood sugars have been more than acceptable. I realize at this stage its all trial and error. But I have really struggled in the last 2 days and had 5 hypos, I feel really upset as I dont understand why, if I understood why I could work on it, but I really dont....these are the reading for the last 2 days (yes, there is an obsessive amount of testing at the moment!)

    7th Oct:
    7.20am- 6.8
    12.32- 6.9 LUNCH 47gms took 5 units of novorapid
    13.45- 7.3
    14.49- 4.3 I START FEELING HYPO IN THE 4s so took X 2 DEXTRO TABLETS
    15.46- 7.9 SNACK OF 50gms took 5 units of insulin (banana and x 4 nairns biscuits)
    17.44- 5.7
    18.15- 3.6 TOOK X 3 DEXTROS
    18.26- 2.9
    18.33- 3.8
    19.48- 6.1 DINNER 48gms took 5 units of insulin (rice, fish and vegetables)
    22.07- 5.8
    22.31- 3.6 TOOK X 3 DEXTROS AND SUPPER OF PORRIDGE

    8th Oct:
    7.50am- 6.4
    10.11- 3.4 TOOK 3 UNITS OF INSULIN 20 MINS LATER FOR APPROX 40gms SINCE I WAS LOW (banana, x 2 nairns)
    11.09- 5.5
    11.30- 4.1
    12.01- 3.7 TOOK 3 DEXTROS AND 2 BISCUITS
    12.11- 4.4
    13.52- 5.8 LUNCH 50GMS, 5 UNITS OF NOVORAPID (rice, broccoli, shrimps and 1 slice of bread)
    15.49- 7.1
    16.22- 3.3 TOOK SOME PURE ORANGE JUICE
    16.34- 3.9
    17.05-4.9
    17.43- 7

    Thats it for now, will continue to test for today.

    I am quite alarmed at how fast my blood sugar drops at times, I am completely clueless to what is going on as I haven't changed my diet at all. One other thing to point out is that my lantus was increased by 3 units one weeks ago...but it is only in the last 2 days I have been having problems.

    I am trying to remain upbeat and optimistic about it all, but to be honest I feel very disheartened and just want to eat a big piece of chocolate cake!

    Comments would be appreciated if anyone could shed some light on the situation!

    Thanks in advance
     
  2. tom79

    tom79 · Well-Known Member

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    sorry cant help as im quite new to this, but thought id say hi to a fello obsessive testing person :)
     
  3. Nicklenocky

    Nicklenocky · Well-Known Member

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    Hi Tom! Hope you are having better luck than me...I am not new to this and have always just managed to get by...I am determined to crack this!
     
  4. DunePlodder

    DunePlodder Type 1 · Well-Known Member

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    Hi Nicklenocky,

    My feeling is that your Novorapid carb ratio is too high. You appear to be using 1 unit per 10gms of carb. Perhaps try 0.8 units for a few days?

    It could be that the Lantus dose is too much - I find that it takes a few days for the effects of changes to settle down. However, your two morning readings look OK. I'd expect them to be low if you were taking too much.

    Perhaps you should make it a small piece of cake!
     
  5. Nicklenocky

    Nicklenocky · Well-Known Member

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    Hi Duneplodder

    Thanks for your reply. I may try reducing my carb ratio but I am slightly reluctant as I really believe 1 unit per 10gms has been working for me in the past.

    I think I am going to reduce my lantus slightly as I do believe its too much. I was suffering hypos every single morning 3 weeks ago before embarking on this strict regime, but I have tackled that problem now by having a small amount of porridge before I sleep, and now I sleep confidently as I usually wake up within 5 and 6s, so I think that's why I have good results in the morning.

    No chance of the cake now...I panicked with my last hypo and drank more juice than I should and now struggling to bring my blood down....sigh
     
  6. Herbie72

    Herbie72 · Well-Known Member

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    Have you tried a day (or at least a lunch and a dinner) of no-carb meals (ie. salads or really slow-release carbs that aren't worth counting), to see what your Lantus does? It could be that your background is too high. Good luck :)
     
  7. Writeangle

    Writeangle · Newbie

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    I think you should visit your doctor or diabetic nurse if you are getting hypos that you cannot control except by using dextrose frequently. A better diet for diabetics is one that uses more low glycaemic index foods and avoids foods that create a rush of sugar in the bloodstream. Orange juice is much more likely to create high sugar than eating an orange. White bread is worse than wholemeal and brown rice is better than white.
    Diabetics should eat high-fibre foods, such as fresh fruits, vegetables and whole grains as their carbohydrate choices, instead of simple carbohydrates such as biscuits, white bread, snack cakes and processed foods.
     
  8. Herbie72

    Herbie72 · Well-Known Member

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    Writeangle, the 'diabetic' diet is the healthiest diet out there, because it is a balance of different types of foods, without a large quantity of any one specific food. We don't have to be fascist about what we eat any more. We don't have to count individual peas, like in the old days. Low-glycaemic food is definitely the best, true, but we are allowed to have the odd high GI food, too, as long as we cover it with insulin.

    There's nothing in Nicklenocky's CHO / blood sugar diary to say that they're doing anything wrong, IMO. Orange juice can be a very good way getting out of a hypo, though I personally find it less effective than a glass of Lucozade. But I genuinely believe that Nicklenocky's problem is not their diet, but the background insulin dosage. I think (could be completely wrong, of course!!) that if that is sorted out then things might start slotting into place.
     
  9. Nicklenocky

    Nicklenocky · Well-Known Member

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    Hi writeangle, thanks for your reply and all points noted. However I would like to add that I have been following (or at least trying to follow) a low GI diet. Granted this is only something I have been doing for a month but I can already see the benefits. I have completely cut out potatoes and pasta as I found these dont work for me at all, but to be honest rice has worked very well and i eat it at every meal except breakfast (also it seems rice is rated in-between a high GI and low GI so not strictly high GI) The only biscuits I eat now are the Nairns oat biscuits and again I have found these have worked well.

    Herbie72, thanks for your reply too. I personally would go with your theory of my background insulin being too high, in hindsight I believe an increase of 3 units has perhaps been extreme....i have felt awful the whole of this week with my head literally feeling like its going to explode from these constant headaches I am suffering so I have already dropped the lantus by 2 units to see what happens. I can honesty see no other reason to why I am hypo-ing since I have not changed my diet at all this week.

    Regarding the orange juice, well this was a weakness on my part....I had a hypo in starbucks and just saw a juice so grabbed it...I guess I just wanted an excuse to drink it! It actually did the job very well...too well in fact since I am still suffering from it!

    Oh well, I will try again tomorrow!

    Thanks again
     
  10. Nicklenocky

    Nicklenocky · Well-Known Member

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    Just as a follow on from yesterdays results, here are today's results with one hypo this evening (I live in Middle East so I am 2 hours ahead):

    After having porridge before I slept and reducing my lantus by 2 units:

    6.01am- 4.7 (safe, went back to sleep)
    7.41am- 3.9 TOOK 5 units of insulin about 30 mins later since I was a little low for approx 50gms of carbs (porridge and banana)
    8.07- 6.4
    11.15- 5.6
    11.32- 5 (this is where i start panicking when i see my blood dropping so quickly) ate 1 apple, no insulin
    11.56- 5.6
    13.16- 8.8 took 6 units of insulin for 60gms (rice, chicken, salad)
    15.33- 12 took 1 unit of corrective
    16.11- 10.9
    17.52- 6
    18.22- 6
    19.05- 5.5
    19.35- 4.8
    20.07- 4.3 took 7 units of insulin for 70gms of carbs (rice, lamb, black eyed beans in sauce, salad)
    21.26- 7
    21.54- 4.9
    22.08- 3.6 HYPO- GUTTED and feel awful, had gatorade and porridge early as i am fed up and want to sleep

    Not quite sure why I have hypo-ed, I may have overestimated the carbs for black eyed beans as they were not in my GI book and so estimated after researching on google....but maybe it not this, super gutted!

    I do feel like its very hard work at the moment keeping my blood up, I am only just managing to stay above 5 an any lower then I know I will hypo, difficult to deal with the constant worry of hypo and even when I get a good 5 or 6 I cant relax for fear of dropping which they very obviously do.

    Hopefully better luck tomorrow.
     
  11. moonstone

    moonstone · Well-Known Member

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    When you start reducing your HbA1c you need to keep your eye out for becoming more sensitive to insulin - it's a fact of life. So you might find this is the cause - it happens to everyone. So you might now need to rethink your BI or your ratios. Good luck.
     
  12. Fallenstar

    Fallenstar · Well-Known Member

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    Hi
    I agree with Herbie in that it could be your Basal that is too high, it looks like it to me with the results you have posted. I was like this on Lantus and had a lot of sudden drops .I had to drop mine right back nearly by half(Lantus) and it helped a great deal with Hypo's.

    I have recently moved over to Levemir which I have found a much better Basal for me all round, I need to take more of this and split the dose but it gives me a much steadier even profile...no sudden drops and I don't drop at the speed I did on Lantus...That Lantus was like rocket fuel for me :roll: And I always felt lousy on it...I love the Levemir.

    Try a good drop in it for a week and see how you go,you can always increase it back if you find your sugars get high. You sometimes need to be aggressive in your experimenting to get to the bottom of what will work for you or what is going wrong..obviously seek expert advice on it all though, but your patterns look very familiar to me and it took a big drop in Lantus to get me from dropping all the time..infect from 22 units AM down to 12, obviously my Bolus slightly increased but I stopped with the nighttime Hypo's and sudden daytime drops.
    Good luck hope it works out for you
     
  13. Nicklenocky

    Nicklenocky · Well-Known Member

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    Thanks for your messages Fallenstar and moonstone.

    Fallenstar, could I ask you a question....did you ever suffer from severe headaches using lantus. I have really, really suffered for the last 10 days with the pain becoming very aggressive (and constant) when the lantus increased. I have since dropped the lantus so am hoping the headaches will subside. Funny thing is i have been on lantus for 13 years, its only recently I have suffered and generally feel like **** and a bit down....not saying its the lantus, but it did kind of spring up when I upped my dose. Probably being majorly paranoid!
     
  14. Fallenstar

    Fallenstar · Well-Known Member

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    Hey N
    No can't say I've ever been a headachy person ,so no. But if you are spending a lot of your time low at the moment or on the cusp of a Hypo then I'm sure this would be enough to be causing some bad heads.
    I have had BAD heads if I have gone very low overnight and they are brain crackers that last the whole of the following day.
    I was on Lantus for 10 years and never felt great on it ,just rough really but I put it down to other Endo problems I have. Well going on to Levemir has been a revelation to and for me :D I instantly felt so much better on ,more energy and just generally feeling much more healthy. I don't get the big drops in energy I used to get and my training is just a joy at the moment .
    I am able to do my Long runs on much more insulin while obtaining stable BG through them, so more energy. I have also changed from Apidra to Novorapid...again a much more gentle profile to it for me ,more like the Humalog I was on before which was better for me, I wish I'd never changed from the Humalog.That was my GP sticking his neb in not my Diabetic team,who are great. So yes the changes have been a resounding success for me.
    I hope you get it sorted it is not nice living with Hypo's shadowing you all day and night long..I have heard of others talk about this effect on Lantus, then it's great for others.
     
  15. Nicklenocky

    Nicklenocky · Well-Known Member

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    Thanks fallenstar for your message, nice to hear you are happy with your insulin. I am going to see my consultant on Saturday and will voice my concerns. i have read a lot of positive things about Levemir but just wonder if its wise to change what has been working with my lantus for 13 years....or has it been working!? Not so sure now!

    Thanks again
     
  16. Fallenstar

    Fallenstar · Well-Known Member

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    Hope it's a productive visit for you :) let us know what they say and how you go on.
    I wish you all the best
     
  17. Herbie72

    Herbie72 · Well-Known Member

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    I was the same as Fallenstar – switched to Levemir and things got much better. It meant an extra injection (morning Levemir and bedtime Levemir) but it seemed to work much better with my metabolism. I'm now pumping just Humalog, but the Levemir was really good while I was on it.

    Sounds like you're gonna get there, Nicklenocky, stick at it :)
     
  18. Snodger

    Snodger · Well-Known Member

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    I wouldn't count black eyed beans at all in my carb counting so I think you are spot on, this is why you hypo'd...
     
  19. Riri

    Riri Type 1 · Well-Known Member

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    Hia - just to let you know I had trouble during the earlier part of this year with sudden and rapid drops in my blood sugars - very scary. Like you I had been on lantus for a good few years and this just started out of the blue. Luckily I have a very understanding and helpful health team and we switched to levermir. I find it much more stable and although my numbers are still on the high side that is all down to me as I'm petrified of going hypo after the difficult few months I had. Also on the lantus I was having continual night time hypos. Hope you get sorted soon.
     
  20. Fallenstar

    Fallenstar · Well-Known Member

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    Hi Riri
    It is interesting that you had the sudden drops on Lantus too Riri, I can't believe how much more stable my blood sugars are on the Levemir and novorapid. The Apidra was too much for me too.
    Did you feel rough on the Lantus too?
    I was like you, fine on it for a lot of years then all of a sudden a couple of years back the trouble started on it ,interesting we both were fine then all of a sudden big drops :?

    Glad you are better now and on a pump, do you get on with it? How are Hypo's now?
     
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