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Struggling with loooow

Discussion in 'Type 1 Diabetes' started by KesLouise, Nov 23, 2019.

  1. KesLouise

    KesLouise LADA · Well-Known Member

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    Hey all,

    Haven’t posted for a little while been trying to get to grips with things.

    Have been finding I’m having lows a bit now, todays is pretty horrible at 1.9, feeling terrible.

    Have had a few lows recently but this is the lowest.

    Any advice on getting through it?

    Much love!
     
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  2. miahara

    miahara Type 2 · Well-Known Member

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    Take some glucose. 3 or 4 jelly babies or 15gm of liquid glucose if you have it.
     
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  3. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Follow up the jelly babies with a couple of biscuits or a piece of toast.
     
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  4. therower

    therower Type 1 · BANNED

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    @KesLouise . Best thing for hypos is glucose whether it be glucotabs, jelly babies, orange juice etc. Follow this up with some complex carbs to stop you dropping low again in an hour or so.
    BUT all this is fire fighting if it’s happening on a regular basis. You need to find the cause of the fire or in your case the reason why you’re going low regularly.
    Re assess your insulin dosage ( I assume you’re on insulin )
    Have you changed your eating habits? Small changes can have huge impacts on BS levels.
    Have you had a lifestyle change ? More exercise, a change at work, socialising more ?
    Avoiding the amount of hypos you have isn’t easy at times but is better than continually treating them.
    Good luck and I hope the 1.9 hasn’t made you feel too bad.
     
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  5. KesLouise

    KesLouise LADA · Well-Known Member

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    Yes I am on insulin.

    I’ve found when I’m at work I’m experiencing lower levels.

    I’m currently trying to work out the doses if I’m honest as I only started on insulin in July and it’s been a bit of a roller coaster.

    I’m fairly consistent with the things that I’m eating to be honest especially when I’m at work around lunches and that sort of thing :)
     
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  6. ert

    ert Type 1 · Well-Known Member

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    To treat a hypo (below 3.5 mmol/l) you should take 15 to 20 grams of rapid-acting carbohydrate, equivalent to 100-120 ml Lucozade, 150-200ml cola or fruit juice, 5 glucose tablets. Retest 15 minutes later and repeat if still below 3.5 mmol/l. To treat low blood sugar above 3.5 mmol/l, eat 10 grams of carbohydrates like a small apple.

    I'd recommend you do some research to get to the bottom of your hypos. Keep a diary of your finger pricks for blood sugars and insulin units (at least 5 times a day): waking, four hours after breakfast, before lunch, four hours after lunch, before dinner, four hours after dinner, bedtime. This is something you could take to your diabetes nurse to ask for help.

    Myself, I'd start by checking your basal insulin is correct by having a carb-free lunch at work and seeing if your blood sugars hold a straight line from 4 hours after breakfast until dinner time. Are you on a split dose basal insulin? If so, I'd then also have a carb-free dinner and expect to hold a straight line from bedtime until waking.
    Once happy with your basal insulin, you should then consider changing your quick-acting carb ratio at lunchtime, or breakfast (due to this being something that happens at work) or where ever your blood sugars don't return to the same pre-meal levels four hours after eating.
     
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  7. KesLouise

    KesLouise LADA · Well-Known Member

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    I check my levels when I wake up, 2 hrs after breakfast, at lunch, 2 hours after lunch, dinner and then at bed time currently. Record everything in a diary.

    I don’t split my background insulin I did speak to the nurse about this but it’s not advised with abasaglar
     
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  8. therower

    therower Type 1 · BANNED

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    I’ve been diagnosed 28+ yrs and I still find myself on the rollercoaster every now and then. Being newly diagnosed like you are adds a few extra problems, mainly the honeymoon period, which doesn’t help at all. Fortunately the honeymoon doesn’t last and although you may find your insulin requirements going up things do tend to become more stable.
    I think in your situation it’s best to try and keep things simple. If the lows are mainly occurring at work then this offers up some consistency to work with. Let’s imagine a see saw, one side insulin, one side food. Currently at work the insulin side is to heavy, so two options. Option 1 and probably not the best is , eat more before and during work. Personally I would steer away from this. Option 2. Reduce the amount of insulin prior to work. If I’m right you’re injecting long acting insulin once a day. If your levels are good out of work and through the night then maybe your long acting ( basal ) insulin is about right. So I would start with looking at your bolus ( short acting ) insulin. Reduce your ratio on this insulin when you eat prior to, or being at work.
    It’s all trial and error but keeping a record of what happens is a great idea and will be extremely beneficial.
    This condition can be very difficult to figure out at times but as I said earlier try to keep it simple whenever you can, especially with you being recently diagnosed.
    And remember. Now you’re a T1 diabetic you automatically qualify for being an absolute winner.;)
     
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  9. KesLouise

    KesLouise LADA · Well-Known Member

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    Thanks thats so sweet!

    I’ll keep all the advice in mind thank you so much
     
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  10. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    Oh no i hope you're feeling better after 1.9?? I had a 2.2 last week which was horrible for me as i had next to no warning for it. Really shook me up as i normally get good warning signs. 1.9 must have been scary!

    Ask your consultant, do you have a number to text, like a diabetes nurse? Let them know first and ask them for advice, they may suggest that you lower your basal by 1 or 2 units, or alter your bolus ratios slightly.

    Really hope you're feeling better, i'd have a high carb feast to boost your energy up to normal :) personal, not professional opinion - always makes me feel better!
     
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  11. KesLouise

    KesLouise LADA · Well-Known Member

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    Things just seem to be all over the place at the moment.

    Today has been 14.1, 2.4, 4.4, 13.1, 13.3, 9.6 so far
     
  12. Hertfordshiremum

    Hertfordshiremum · Well-Known Member

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    Hi You are not alone I was diagnosed with Type 1 LADA June 2018, the last couple of months I have had to increase Levemir and Novorapid due to going high and never going back down after meals, and I eat low carb. however I have a range of 4 to 15 multiple times in the day. It drops very quickly as well which makes me feel very light headed. I am seeing my diabetic nurse again next week, It's very frustrating. I have recently bought a CBG monitor which is very good at preventing too high or low as you can scan every few minutes if necessary and try and correct. I find a resistance band good for lowering the highs. Some days I seem to spend most of my day trying to correct my blood sugar! Keep posting, I would be very interested to read how you improve this.
     
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  13. Hertfordshiremum

    Hertfordshiremum · Well-Known Member

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    Hi Ert

    You seem to know a lot about the workings of insulin so I thought I would ask you if you know what to do when you get different results despite doing the same thing. For example I eat 30g carb porridge with coconut water in the morning, walk my dog. Some days I am dropping quickly to 4 by 11.30am and others it's shot up to 15 and hardly gone down by 1pm. Also anything in between. Any ideas? I am on split dose Levemir and Novorapid, 1 unit in the morning to try and stop to highs which give me bad headaches. I have no idea what's going to happen each day. Any suggestions would be appreciated. I was diagnosed June 2018 with type 1 LADA. Thanks
     
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  14. ert

    ert Type 1 · Well-Known Member

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    This daily variability is something that even my consultants appear unable to explain, and what people not on insulin will never fathom how difficult it is to manage blood sugar. Unrepeatable results. The story of my life. Every day I have learned to expect the unexpected - some days I'm more resistant to insulin, my immune system kills off the insulin or my insulin leaks out of the injection site, no two injection sites are the same, my injection site may have lipohypertrophy, at the end of the vial my insulin isn't as effective as the beginning, my insulin appears to stop working after two weeks, tiredness, feeling under the weather, extra exercise, emotionally stressed, the accuracy fo the reported carb content, portion size changes, time of day etc, etc.

    DAFNE's preferred method is to do an adjustment (take a few more quick-acting units) with your next meal and don't sweat the highs.
    Even though variability can be the elephant in the room, I still think recording your blood sugars and insulin doses and talking to your diabetes nurse and consultant a very helpful way forward.
    My consultant, looking at my numbers, suggested that I mainly wasn't waiting long enough for my insulin to work before eating and that I needed to be prepared to change my background insulin by 10% depending on what's ahead of me in the day and how I feel. So I try to cut back or increase the split-dose basal a little based on how my numbers are trending, how much exercise I'm doing and how I feel.
    The last thing I change is my quick-acting ratios, and usually after a few days of recording data, except when exercising, when I tend to halve the amount used.
    I, like you, take a unit or two of quick-acting in the morning to combat 'feet on the floor' or 'dawn phenomena or just' the fact that I'm running out of background insulin by morning.
    You are certainly not alone. Hopefully, they will release 'smart' insulin that works as needed in not the too distant future.
     
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    #14 ert, Nov 24, 2019 at 11:43 PM
    Last edited: Nov 24, 2019
  15. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    Ahhh does not sound fun! Try not to let it get you down, easier said than done i know!
    Carry on with your normal ratios until it settles, even if it settles as a high. I'd recommend testing every hour if it's still like that, just so you can see what direction its heading in and plan ahead :) hope you're feeling better today!
     
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  16. mentat

    mentat Type 1 · Well-Known Member

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    Choosing the right insulin dose is *H*A*R*D*. It will take a lot of learning, both in theory and in practice. I suggest you read Think Like a Pancreas.

    Remember it is better to prevent lows than treat them. If your 2-hour levels are a bit low, then you may want to have a small snack to smooth things out. Make sure you record the snacks as well because they indicate that you may have taken too much insulin.
     
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  17. Hertfordshiremum

    Hertfordshiremum · Well-Known Member

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    Hi

    Thank you very much for your reply, it's good to know other people have the same issues. I seem to have all sorts of odd things happening at the moment. For example this evening 7.20pm had 2.5u Novorapid 30mins pre dinner, BG stable at 6.5, I ate my dinner containing 30g carbs, BG starts to drop. One hour after dinner BG now 4.1, starting to shake so I have 15g carb yogurt drink. Ups to 5. However at 9.30pm goes from 5 to 11 in 30 minutes, now at 14!!! Drinking lots of water, have blurry vision. I saw my diabetes nurse today who has issued perscription for longer needles as I have lots of instances where I take the Novorapid and and hour after my BG just rises to 15/16 and takes about 3 hours to go down. Also she is giving me a perscription for Fiasp, if the longer needles make no difference I am to try this quicker acting insulin. I find it very difficult to ignore the highs when they effect me quite a bit. I see you and many others are following Dr Bernstein diabetes solution, my copy arrived today.,looks a very interesting read. Thank you again for your reply and useful information.
     
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  18. Angey

    Angey Type 1 · Member

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  19. Angey

    Angey Type 1 · Member

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    Best of luck to you.... I’ve had it for nearly 50 years and it’s still a rollercoaster at times!!!
    You have lots of good advice already but no one has mentioned a hot drink. It might just be me, but a hot drink seems to help me process the sugar more quickly. Have both fast acting carbs and slow acting. Jelly babies (already mentioned ) and fruit pastilles are good fast acting carbs and chewing them in your mouth lets you absorb the glucose a lot faster than waiting til it gets to your stomach. You might have sweated a lot so drink lots to help prevent possible post-hypo headaches. Also, after being so low, be kind to yourself and just have a quiet sit to let yourself Recover. This is complicated. Be kind to yourself.
     
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  20. Hertfordshiremum

    Hertfordshiremum · Well-Known Member

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    Great fruit pastilles tip Thanks
     
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