Overnight Hypos with No Insulin

[slip]

I think while you've got this issue, you should keep a detailed diary of all dosages, food/drink/snacks etc and associated carb amounts and timings both for injections and food intake (even if it's only a few mins either way) - just at the moment your carb values are somewhat vague and therefore so are your bolus dosages/ratios.

 

[Rosie Longstreeth]

@Rosie Longstreeth , it's all a bit of a puzzle, will maybe get back with a few thoughts on it later on, but, meantime, if you're using libre regularly, there's a small transmitter called "blucon nightrider" which you can buy for £96 from www.ambrosiasys.com as a one-off cost, put it on top of your sensor with a plaster, link it to an android app called xDrip+ and it'll automatically read the sensor every 5 mins, so it'll give you hypo alerts.

Obviously, that doesn't address the underlying issue, but it'll at least mean that while you figure out ways of sorting it out, you'll at least have the security blanket of getting woken up by the phone ringing if you drop too low instead of getting repeated hypos night after night, which must be sooo tiring.

You can set the hypo alarm to any level you want, so, say you set it to 6 or 7, it'll catch you on the sharp drop down from the teens, and give you time to figure out how much carb you need to tail it off so it stops about 5.5 instead of going into hypo-land and not rebounding too much.

It'll maybe give you a bit of respite while you get the larger issues sorted out.

Oh brilliant thank you...I’ll have a look into this!

 

[Rosie Longstreeth]

I think while you've got this issue, you should keep a detailed diary of all dosages, food/drink/snacks etc and associated carb amounts and timings both for injections and food intake (even if it's only a few mins either way) - just at the moment your carb values are somewhat vague and therefore so are your bolus dosages/ratios.

Yes I will definitely start doing this!

 

[Lamont D]

If these circumstances were a T2, I would have thought that the patient is having Hypoglycaemic episodes because of either meds or hyperinsulinaemia. In my case too much insulin response from my pancreas to a carb laden meal.
In a T1, the fluctuations are very pronounced and seems to be too much insulin hence the hypo. Your readings are too unstable to define as to what you are doing is causing this.
I would ask about your tests being revisited, your Hba1c, c-peptide, GAD, and your insulin resistance, and probably more.
There is a lot going on and I'm not savvy about how to treat this in T1s.
Sorry, go back to your health practitioners and show them the results of your reading.
And of course what you ate and your insulin amounts.

 

[bhk]

Hi,

I would do 2 things:

1) ask your doctor to check your albumin level next time you do a blood test

2) try to have a food diary that includes the exact quantity (grams) and timing of any lipid source

I might be able to help you with that,

cheers,

 

[kitedoc]

Hi @Rosie Longstreeth,
It is strange indeed to be having a hypo at 6 amish with TID and the likelihood of very little injected insulin present.
2 thoughts: and these are just guesses and not professional opinion or advice
1) Could there be present in you some tissue other than in the pancreas gland producing insulin ?
2) Could there be some trouble with your adrenal gland so that less cortisol is being produced ?
1) and 2) may be connected, not sure.
I would think, given the uncertainty of things, you might wish to get back to your doctor and be referred to an endocrinologist.

 

[LooperCat]

@Rosie Longstreeth Wow, you’ve given us all a conundrum to sink our teeth into here...

I’d second @Scott-C and get a transmitter to sit on your Libre and give you alarms so you can deal with the crash before it happens. He uses the Bluecon, I’ve got a MiaoMiao. They’ll turn your Libre into a proper CGM, which I think would be invaluable here.

Have you considered splitting your dose of basal? Most of them have a peak at around four hours before tailing off, I used to get horrendous night hypos with a single bedtime injection of Lantus, less so when I split it morning and night.

My initial thought is that your basal is set too high, even with low carb meals, you should need a little bolus, even if it’s just for protein. As the others have already suggested, keep meticulous records of not just your insulin doses all your food, down to the last g of not just carbs but protein and fat as well. Protein can cause a slow, sustained rise if you’re not eating many carbs; fat slows them both down. I find the MySugr and MyFitnessPal apps incredibly useful for this, as you can print out paper reports to go over with your team.