Serious treatment issue

[denisguy]

Hi! I have a serious treatment issue and I have no way of contacting my doctor. Here's the problem:
I use Humalog every time I eat and Levemir twice a day, at noon and midnight. My issues were minor until recently.
I started a year-long sabbatical during which I'm traveling the world.
Since I left home, I have had extreme highs after breakfast (20 to 26, or 360 to 460 in US reading) whatever I do (I am now injecting close to double what I'm used to with similar results.)
But that's not all:
Between 4 and 6 pm, I have extreme lows. I go down to 2.7 (50 in US reading) and stay there whatever I eat: it probably takes up to 75g of carbs to get me back up to 5.
What should I do? I tried completely cutting the noon injection of Levemir, and I ended up with highs all day!
THE ONE QUESTION I HAVE: What is causing by blood sugar to go to such extreme lows at the end of the afternoon? I don't inject insulin and I don't eat anything, and I can go from 10 to 2 (180 to 36 in US reading) in 4 hours!
Please help.

 

[LaughingHyena]

Sorry to hear you are having such swinging readings, I've been there and it's awful.

The one thing which occurs to me if you are traveling is how you have been keeping yoru insulin. I've had some pretty random results if it's going off, either from being to hot or too cold. Is there anywhere you could get a fresh batch and see if it helps.

 

[noblehead]

Rather than stopping your midday levemir why don't you reduce the dose and see if this helps, you will need to test more frequently but it's worth it to find the right dose which will keep your bg stable throughout the afternoon.

What are your fasting readings before breakfast as you don't say, it could be as Laughing Hyena says an issue with temperature effecting your insulin or it might be that your night-time basal needs increasing.

 

[Sunflower12]

Hi there, Im having exactly the same problem while travelling to Asia on a career break. Am also using the same type of insulin as you do. The funny thing is when Im back to the uk between trips, everything goes back to normal. My main problem is Im having a really high fasting reading. I disovered that I did not estimate the correct carb/insulin ratio at dinners most of the time, having eaten foreign food in a new environment. Also a few drinks here and there. So I woke up during the night to adjust insulin if required. I think you should call your diabetes nurse to discuss if your blood sugar stay high over a few weeks if possible. More often than not, the change in envionment has an impact on the diabetes management. Dont panic, keep trying different things to find out the cause of your problem as everyone is reacting differently to a new environment. All the best!