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Insulin and digestion time

R

Royjk

Well-Known Member
So, I have a question about type 2 diabetes. The other day I felt a hypo coming on, so I tested and found 3.8mmol/l, so I had a small sweet drink, and tested an hour later, when the test had gone to 3.9mmol/l. So happy with that I went to bed, but still did not feel very well. After an hour or so I awoke and spent the next 4 hours being very ill. It appears that I had not digested my food for several hours, and so the insulin doses I had taken, took me down to a hypo situation.
So I wonder if anyone knows how long digestion generally takes, so that I do not repeat the incident. Is it possible for digestion to take several hours.

Royjk
 
Can't answer your digestion query, but a bit worried about your hypo treatment..

What is a hypo (hypoglycaemia)?

A hypo is when your blood sugar level, also called blood glucose level, drops too low. This is usually below 4mmol/l. A hypo, also called hypoglycaemia, can happen quickly. So it’s important to always have hypo treatments with you. It's also important to know what the signs are and how to treat...
www.diabetes.org.uk






^ advice from diabetes.org.uk
Mods, please feel free to delete this post if it's incorrect
 
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Hello @saucequery
So I was unable to take anything by mouth as for some unknown reason nothing would stay down, and I found myself in a position where it was difficault to move from the sink. So I still do not know the cause of the hypo and could not treat it. When I felt well enough to move it was over 24 hours after. By then the BG had risen to 5.4mmol/l without any food for at least 36 hours. So I spent the next day without insulin.
 
I think the answer to your question depends on what kind of food we're talking about. For example, if you just put a spoonful of sugar under your tongue or swallow a spoonful of sugar with water, the effect will be within 5 minutes. In general, any fast carbohydrates have an effect in the next half hour, but if you take a greasy pizza, for example, you can see a spike after 3 hours (usually the first spike within an hour, and the second after 2-3 hours, at least for me). In general, look at the glycemic index of the product, the higher it is, the faster the effect. Fats slow down the absorption of carbohydrates quite a lot, so it's usually more difficult with fatty foods. Alcohol blocks the synthesis of glycogen by the liver and basal begins to work as a bolus.
 
Hello @Zhnyaka
So after the 250 ml fruit gel drink failed to make a difference, after an hour I tried some liquorice comforts, but they triggered a violent vomiting event that continued over 4 hours, in all I lost about 3.5kg of weight in just a few hours. (good for dieting). However I had not eaten for more than 6 hours, so I was surprised to have my evening meal and more still undigested, Thats why I am wondering how long it takes for a very low carb diet to digest, as obviously my BG had not risen with the evening meal, but my insulin had brought on the hypo. Also I had not seen sickness as a symtom of a Hypo.
I skipped my evening basal insulin as my numbers were low.
Royjk
 
Royjk said:
Thats why I am wondering how long it takes for a very low carb diet to digest, as obviously my BG had not risen with the evening meal, but my insulin had brought on the hypo.
Click to expand...
As @Zhnyaka has said, the GI of food plays a part in how quickly it can reach your digestive system. But there are other factors that can affect the rate of digestion, such as a person's metabolism or if they have a chronic illness that affects their digestion, like IBS for instance. Depending on the person and their body, the rate of food digestion can vary, so it's not always going to be the same for everyone. But again, as Zhynyaka said, the GI of the food is a good guide when it comes to estimating how fast it is digested.
 
Hello @Introverted_And_Proud

So we are talking about tomatoes, radishes, gerkins, 2 boiled eggs and ham, non of which have high GI, so I cannot understand why they should not go through within a short time frame. I dont think that I have anything like IBS or a restricted bowl, it would be too soon to press the panic button, it seemed to come along with the feel and BG of a hypo. So I suppose I look for ways to reduce the chance of it coming back again, if someone has seen this problem before.
Royjk
 

it's not necessarily because of food. For example, if you have too much basal insulin, then bg will decrease the entire time the insulin is active and you will have to compensate for this with food for the entire time that basal insulin is working and the duration of action of basal varies from 12 to 48 hours, depending on the type of insulin.
 
Is there any chance you could be dehydrated?
It would have to be quite severe lack of water, but some of the symptoms you describe do match up.
 
Hello @Zhnyaka
Ok so I am on Tresiba, with a 48 hour active time. I think of it as reducing my night BG level so that I get a good start for each morning, So I did not take it as I did not want to lower BG any further. That was before all my trouble started.
Royjk
 
Hello @Resurgam

So I keep well hydrated about 3 ltrs a day, very carefull on that, and over the past 3 days have ensured that liquid levels are being made up, but I was severely dehydrated for all day on Friday, after the event.
Royjk
 
A stomach bug or such can very well delay digestion time, or cause food to go undigested until throwing up, nothing to do with regular digesting times.
I'd consider the possibility that the sickness had nothing to do with diabetes but caused the food in your stomach to just sit there.
 
So I did not know this but there is a nasal inhaler, glucagon nasal spray that can be used when a person has a HYPO and cannot take something sweet due to sickness. There is also an injection of the same stuff, I spoke with my doctor and I will get the nasal inhaler from the chemist. Also it was suggested that I reduce the fiasp insulin dose by 1/3rd to reduce the chances of letting BG drop too low. It appears that my low carb diet, suggested here on this forum, may have , within 6 months, brought my BG into better control.
Royjk
 
So this diabetes thing is not so easy to understand. I can see that I will have to rethink it through. Two mornings with hypo's after breakfast, and having to skip insulin at lunch time due to a hypo feel. Just ot be sure I bought a couple of mars bars, and some marzipan, and sweets just in case. But this morning the Mars bar only raised BG pre lunch by about 1mmol/l.
So tomorow I will reduce beakfast Fiasp again, or even skip it, as even with my normal breakfast it is now too much. I have checked BG every hour, and have seen 4.3 - 7 over the day, I am glad that the below 4's did not appear again. I do not understand how insulin requirements can change so quickly. I do the very low carb diet, and all has been well for the past 4 months.
Royjk
 
Royjk said:
Also it was suggested that I reduce the fiasp insulin dose by 1/3rd to reduce the chances of letting BG drop too low.
Click to expand...
Are you on fixed doses before meals?
Mealtime insulin is meant to deal with carbs, so a high carb meal will need much more insulin than a low carb meal.
 
Hello @Antje77 ,

Yes I have been on fixed doses of Fiasp and Tresiba, for the past 6 months, and have brought down my BG from numbers in the high 20's down to regular, 5's and 6's. My bad A1c was 103, but my last A1c was 32. Thanks to Kenny and Jo, I knocked carbs off the menu, and now eat a very low carb diet. In fact until last week I thought I had a grip on type 2 diabetes. But I got that 'food bug' thing where I had low BG and could not eat anything and that upset my diabetes control. I now have the nasal inhaler for hypos, it is a one shot device.

I never actually found a correlation with Fiasp and carbs or BG, so I had been taking fixed doses every day. 10,15,15 and I had trimmed these numbers to ensure that my BG was between 4.5 and 6.5 at every test, this give me a 7 day 5.5, 14 day 5.6 and 21 day 5.7. This has been good for several months, no high BG and no hypo's. Doctor said well done.
So now after this week I am on 4,4,6, and no Tresiba. I do not expect to keep tight control, But every day this week I have had 1 low BG between 3.8 and 4.2, and sweet drinks or Mars bars, do not now make a significant difference to BG.
I am in consultation with the doctor on my next steps.
Royjk
 
Royjk said:
I never actually found a correlation with Fiasp and carbs or BG, so I had been taking fixed doses every day. 10,15,15 and I had trimmed these numbers to ensure that my BG was between 4.5 and 6.5 at every test
Click to expand...
What is your testing regime? How often do you test and do you test in relation to your meals?
With your hba1c at 32 you have very tight control, much tighter than is generally advised on hypo inducing medication like insulin.

I'm happy with my hba1c comparable to yours, but only because I use a CGM and because it shows me stable graphs usually. On fingerpricks this would be lower than I'd be happy with.
 
Hello @Antje77 ,

So the HbA1c just happens, I have no way of predicting or controlling it, I can only see what it is after a doctors visit. I test my BG about 10 times a week in total, following a random pattern of the 6 times per day testing that is recommended in my diabetic diary. So one day it is morning, the next after evening meal, then next day 2 hours after breakfast, etc. I expect the numbers to be within 5mmol/l and 6.5mmol/l, and if they stray too high I note what I ate then modify my diet. But this week they strayed too low.
When I started this insulin therapy, I cut out as much high carb food as I found in my normal diet, the sugar, bread, chips, rice and flour. I also read Jason Fung's book about not putting sugar in the body, and doing short fasts.
That, with insulin has been working for me very well up until last week.
So this week I tested often for 6 days while I reduced my insulin dosing by about 60%. All while eating my normal meals.
I dont actually feel that I have tight control, I am just following my diary. On the front page it says 4.0 - 6.0 in the morning is good, and 5.0 - 7.5 two hours after eating is good. I just randomly look at these times during the day.
I only graphed up my numbers when I was in the high 20's mmol/l, when the control limits seemed to be out of reach, but that was six months ago.
Royjk
 
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