Overnight Hypo

[MarkHaZ123]

I don't tend to get overnight hypos, I maybe dip into the 3s slightly but not for long but last night was awful. Il start with my day as I believe this has caused it.

I woke yesterday morning at 7.30 to go out on the bike at 8.30. I had my morning levemir minus a couple of shots with going out.
I was out for around 4 hours doing 60 miles with a friend. Bloods fine whilst out continuing to eat every hour and have jelly babies every half hour like I normally do.
Home around 1 and had chicken and chorizo pasta for dinner. I didn't take insulin for this
Afternoon was fine as I didn't eat or didn't have any issues when relaxing.
I get to tea time and have a fry up, I took 6 shots as I believe it was just over but I also had some chocolate for afters so I believed that would take me well past the number of shots I'd had.
Anyway I went to bed on 6.9 around 10pm but woke up at 12.30 at 2.2, my body shaking and dripping with sweat. I got to the kitchen and had a couple of jelly babies followed by a jam sandwich and a bag of crisps. A little too much for a hypo but I was plummeting so jusy over ate

My bloods during the night then went up to around 15 but I have woke this morning at 4.7 and dropping still.


I generally go out on the bike 3 times a week but do around 30-40 miles each time, I never have any issues and I have similar days to what I had yesterday in terms of eating and my bloods are always fine. I just can't believe how rapid my bloods dropped over a 2 and half hour period. I'd had tea at 7.30 so would of expected to have been lower at 10 if I had issues.

Il take this as a learning curve for next time I'm out, I can't believe how that extra 20 miles has affected me. Iv had to take the day off work today as I have a thumping headache and just feel so grotty

Does anyone else have times like this? Especially anyone who does alot of exercise

 

[MarkMunday]

It

,,, Does anyone else have times like this? Especially anyone who does alot of exercise

The extra exercise may have aggravated the situation, but looks to me like your pancreas decided to make some insulin too. Not unusual for people diagnosed as adults. Happened a lot to me, but not anymore. Been T1 for 43 years now, so no residual insulin production.

 

[MarkHaZ123]

It

The extra exercise may have aggravated the situation, but looks to me like your pancreas decided to make some insulin too. Not unusual for people diagnosed as adults. Happened a lot to me, but not anymore. Been T1 for 43 years now, so no residual insulin production.

Never thought of it that way. Possible the extra work has done that and just made my bloods low over night

Could have been during the day when I can control it easier

 

[kev-w]

I find this if I do unplanned or 'extra' exercise, I don't think it's because I suddenly make insulin but to do with the way the T1 body works with exercise, as @In Response explains it (much better than I could) above, swimming can be a trigger if I do an extra half k.

So forewarned is forearmed or so they say I tend to reduce my meal 'bolus' after a heavy session in anticipation of the drop and adjust if I need to at suppertime and go from there.

The hazards of being a manual pancreas I guess...

 

[Juicyj]

Hi @MarkHaZ123 I find after a heavy work out that I have to make sure my BG levels are above 8/9 before bed and reduce my basal, during the night is when your levels will fall to their lowest around 2-3am. After exercise depending on the intensity, muscles will need to repair which requires glycogen, in a resting state your body goes into maintenance mode hence the need for glucose during the night.

If you feel unsure about whether you're ok for sleep during the night then set an alarm around 2am so you can catch it in time, also make sure you keep glucose next to your bed within easy reach, I keep a tub of glucotabs under the bed so I only have to reach down to get it, hypos can cause confusion and waking in a sweating confused state and staggering downstairs is no fun

 

[Marie 2]

I ride my exercise bike 10 miles everyday, with almost no issues, I'm completely used to doing it. But I also snorkel once a week. That once a week is more physical work and work I'm not as regularly used too. I have to reduce my basal the first night ( I have a pump) and I usually keep dropping more easily the next day too. How bad I am depends on how much work snorkeling was. It has to do with the art of trying to figure out what you have to do to be able to exercise lol. It's annoying isn't it to have to eat extra sometimes to be able too?

 

[Jaylee]

I don't tend to get overnight hypos, I maybe dip into the 3s slightly but not for long but last night was awful. Il start with my day as I believe this has caused it.

I woke yesterday morning at 7.30 to go out on the bike at 8.30. I had my morning levemir minus a couple of shots with going out.
I was out for around 4 hours doing 60 miles with a friend. Bloods fine whilst out continuing to eat every hour and have jelly babies every half hour like I normally do.
Home around 1 and had chicken and chorizo pasta for dinner. I didn't take insulin for this
Afternoon was fine as I didn't eat or didn't have any issues when relaxing.
I get to tea time and have a fry up, I took 6 shots as I believe it was just over but I also had some chocolate for afters so I believed that would take me well past the number of shots I'd had.
Anyway I went to bed on 6.9 around 10pm but woke up at 12.30 at 2.2, my body shaking and dripping with sweat. I got to the kitchen and had a couple of jelly babies followed by a jam sandwich and a bag of crisps. A little too much for a hypo but I was plummeting so jusy over ate

My bloods during the night then went up to around 15 but I have woke this morning at 4.7 and dropping still.


I generally go out on the bike 3 times a week but do around 30-40 miles each time, I never have any issues and I have similar days to what I had yesterday in terms of eating and my bloods are always fine. I just can't believe how rapid my bloods dropped over a 2 and half hour period. I'd had tea at 7.30 so would of expected to have been lower at 10 if I had issues.

Il take this as a learning curve for next time I'm out, I can't believe how that extra 20 miles has affected me. Iv had to take the day off work today as I have a thumping headache and just feel so grotty

Does anyone else have times like this? Especially anyone who does alot of exercise

Hi,

Looking at the timing of your hypo & the timing of your bolus shot for tea. There is a possibility you still had IOB?
I find Novorapid can have a little lick in it's tail in the 5th hour?

It could also have been your basal too? If mine (Lantus) is out? During a days graft short acting carbs (you mentioned stopping for JBs.)
I can be sipping Lucozade on the go in a simalar fashion, never quite keeping things happy. Which sometimes correlates for some reason with the start of a brand new cartridge of the aforementioned.

There are quite a few variables which the above have addressed. After 44 years, at least I can discount a spluttering pancreas.

 

[KK123]

Hi there, I suspect it is down to the fact that you changed the exercise without giving your body at least two weeks notice!! Your body gets used to your normal exercise routine and then wham, suddenly it's panicking and is forced to try and adjust. I find that extra bouts of exercise ALWAYS lowers my glucose for at least 36 hours or more so I have to compensate for that by taking less insulin (as you did). It still catches me out sometimes though and I get a hypo. Sometimes no matter what you do it's simply impossible to mimic a normal pancreas. Also, keep a hypo treatment next to your bed, rather than a stagger to the kitchen.

 

[JMK1954]

I agree totally. I have kept glucotabs in the top drawer of the bedside cabinet for years.

 

[MarkHaZ123]

Your experience completely reflects mine and has nothing to do with my pancreas jumping back to life ... at least not after more than 10 years.
It was explained to me that when we exercise, especially for longer periods, we use our glucagon supplies from our liver. As a result, we have less to drip out over the next 24 to 48 hours until those supplies have been replenished. This can result in hypos. For me, just eating lots of carbs after exercise doesn't seem to do it ... it's as if my liver can only take on so much at a time.

The way I manage this is to reduce my basal for the next 48 hours as well as reducing it before exercise.

Unfortunately, the grottiness and thumping headache the morning after is what I call my "hypo hang over". For me, it tends to ease at about 4pm.

My advice to you for the next 24 hours would be
- keep a close eye on your BG ... you may have more hypos
- temporarily reduce your basal (about 20% worked for me but we are all different)
- stay hydrated
- rest

Take care.

That might be why I found even this morning after having muffins for breakfast and a slice of toast I had a hypo coming on. I'd only had 3 shots this morning for that

Iv just had dinner so took a couple less for dinner so will see what it's like in an hour to 3 hours

Like you say just keep checking BG which I generally do


I'm used to going on the bike and doing 30-40 miles 2-3 times a week but since starting these insulins in October time Iv not really done many rides longer. If I have it's been by myself and Iv taken it easier

Just about learning from it and changing things for next time

 

[MarkHaZ123]

Thanks for the advice everyone. Some good stuff to take a look at and use future reference

I don't tend to hammer it round a route like I did yesterday but as I was out with a friend we pushed it. If I do 50+ miles alone I generally take it a little easier so never had the issues before

It's just a right pain that it knocks you for six and takes time to get over it. The joys of been a diabetic I suppose

 

[KK123]

Thanks for the advice everyone. Some good stuff to take a look at and use future reference

I don't tend to hammer it round a route like I did yesterday but as I was out with a friend we pushed it. If I do 50+ miles alone I generally take it a little easier so never had the issues before

It's just a right pain that it knocks you for six and takes time to get over it. The joys of been a diabetic I suppose

Hi Mark, there is certainly NOTHING wrong with hammering it around a route as fast as or for as long as you want. No need to take anything easier or apologise for not doing so. Yep, it's harder in that the pesky diabetes needs addressing but as far as I am concerned you deserve a WOW for that cycle ride!!

 

[MarkHaZ123]

Hi Mark, there is certainly NOTHING wrong with hammering it around a route as fast as or for as long as you want. No need to take anything easier or apologise for not doing so. Yep, it's harder in that the pesky diabetes needs addressing but as far as I am concerned you deserve a WOW for that cycle ride!!

Thanks.
I love cycling and I am in prep for doing the way of the roses coast to coast in September after it got cancelled in March. Its part of my fundraising for the Bradley Lowery foundation

I generally don't go at it so hard like I did yesterday, if I'm alone I normally just relax and take it a little easier but when you are with others you tend to find you push more which we did yesterday, obviously it has its downsides which I'm suffering from now
The last couple of long distances over 50 miles Iv never had issues as like I say Iv done it alone

I just know now for next time to massively reduce both my insulins after my ride for the next 24 hours or so.

 

[UK T1]

Hi, agree with many here - no need to reduce your exercise but just something to be aware of an plan for. Diabetes means you might have to be more organised, but I'm happy being organised if it means I'm not stopped/prevented from living my life how I'd like to live it.

I'd personally prefer to risk being a bit higher and lowering my basal the day before and day of the increased exercise than having a night hypo. I have a little carton of orange/apple juice and dextrose tablets in the bedside cabinet just incase too. The carton is good as it makes it less likely I over eat to treat the hypo!

Something else to factor in might have been the weather. It was lovely and warm, blue skies and sunny yesterday where I live, and many find their glucose levels drop in hotter weather. So it might have been multiple factors all coming together, not so clear cut I'm afraid. Hope you feel better soon!